Inspection on 14/10/08 for Whitehatch

This inspection was carried out on 14th October 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

CARE HOME ADULTS 18-65 Whitehatch Oldfield Road Horley Surrey RH6 7EP Lead Inspector Mary Williamson Unannounced Inspection 14th October 2008 10:00 Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitehatch Address Oldfield Road Horley Surrey RH6 7EP 01293 782123 01293 823231 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.achuk.com Aitch Care Homes (London) Ltd Ms Anne Bicknell Care Home 10 Category(ies) of Learning disability (0) registration, with number of places Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only – (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD) The maximum number of service users to be accommodated is 10. Date of last inspection Brief Description of the Service: Whitehatch has recently been registered by The CSCI to provide residential care for ten service users with a learning disability. The home has been adapted to provide single en-suite bedrooms for service users arranged over two floors. The first floor is accessible by a shaft lift. There is ample communal accommodation including a large lounge, conservatory and dining room. There is also a log cabin in the back garden which is used as a sensory room or as a quiet area. The home is located on the outskirts of Horley Town in a residential road, and accessible to local shops, train station, and local buses. There is a well maintained garden to the rear with decking and a ramp. The front of the home has been adapted to provide ample car parking space. The fees charged in this home range from £1,175 to £1,700 per week. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is a two star rating. This means that people living in the home experience good quality outcomes. As this was the first inspection since the home was registered a good rating is the maximum the home can be judged at this stage. This was the first site visit of a key inspection and was unannounced. The inspection was undertaken by Regulation Inspector Mary Williamson over five hours. The Registered Manager Anne Bicknell represented the home throughout the inspection. People who use the service prefer to be referred to as service users and this term is used throughout this report. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. It was possible to meet most of the service users living in the home and gain their views on what it is like living in Whitehatch. It was also possible to talk with staff on duty and explore the training they had undertaken in relation to meeting the needs of the service users in their care. Both deputy managers and the regional manager were also present for some of the inspection. There were no relatives or visitors in the home during the inspection. The manager completed an Annual Quality Assurance Assessment (AQAA), which provided us with information we asked for, some of which was sampled during the inspection. The CSCI would like to thank the service users, and staff team for their cooperation and hospitality during this inspection. What the service does well: Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 6 The home provides good quality care and support for the service users living there. They operate a robust admission procedure including a detailed needs assessment, and several pre admission visits to establish the suitability of the placement. The home encourages service users to make choices in all aspects of their daily living. A detailed activity programme meets individual assessed needs. Diverse needs are addressed and one resident attends a Jehovah meeting regularly while another has expressed a wish to attend church. Service users are given opportunity for educational development and two attend a local college. Staff recruitment procedures are robust and protect service users. Staff training and development is ongoing and provides staff with the skills and competence necessary to meet the assessed needs of the people living in the home. What has improved since the last inspection? What they could do better: Currently the home is operating to a good standard and there are no requirements as an outcome of this inspection. Although the Registered Manager has been trained in the safeguarding procedures of another local authority, it is recommended that she attends Surrey’s Multi Agencies training on Safeguarding Vulnerable Adults. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, and 5. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective service users have access to appropriate information, and are encouraged to visit, to help them make a choice about living in the home. Needs assessments and contracts of occupancy are in place. EVIDENCE: The home has a statement of purpose and service users guide in place and this is available to all prospective service users and their relatives prior to admission. This provides them with ample information about the home to help them in their decision. The deputy manager is currently developing this document in picture format for service users who require this information. All prospective service users have a full needs assessment in place prior to admission to the home. This is usually undertaken by the organisation’s referral officer and the home manager. The assessments sampled are detailed and informative and provide a good indication if the home will be able to meet specific needs. The management team explained the admission procedure. Prospective service uses are encouraged to visit the home over a period of time for meals, and overnight stays prior to moving in. The home staff will also visit prospective service users in their own environment to gain more understanding of overall needs and personalities. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 10 Contracts of occupancy are in pace. A selection of these were sampled, and outlined the accommodation offered, the care provided, and the fees charged. Contracts are signed and dated. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Assessed needs and goals are reflected in well maintained care plans, which include risk assessments. Service users can make decisions about all aspects of their life in the home. EVIDENCE: A selection of care plans were seen. These are person centred and involve the service users as much as possible. They are also based on the pre admission needs assessment, information received from family, specialist reports from other agencies, and direct observation. Changing needs are reflected, and daily records are completed on all aspects of care provided. Staff support service users to make choices regarding all aspects of their life in the home. Service users stated that they can get up and go to bed when they wish. They can wear what they want, and eat what they want, and have personal care when they wish according to preference. They are also control of how they spend their leisure time. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 12 Risk assessments are in place for all identified risks and include moving and handling, using a wheelchair, use of wheelchair lap belts, and the use of a company vehicle. The risk assessments in place for accessing community and home facilities do not restrict independence. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17. People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff enable service users to participate in appropriate leisure and educational activities for personal development and recreation. Community facilities are used and family links are maintained. The nutritional needs of service users are met. EVIDENCE: The home was bustling with activity and service users were preparing for a wide range of activity. Two service users were attending Crawley College, one decided to go out for morning coffee, another was taken for a walk, someone was doing puzzles in the conservatory, another was having a quite moment in his room, and a service user arrived for respite care. Individual activity plans are included in care plans and include bowling, shopping, adult education, wheelchair dancing, horse riding, gardening, trips to coast and places of interest, art and craft, and cooking. The home has a log cabin in the back garden which is designed and equipped as a sensory room. Some service users enjoy this as a relaxing area, or the manager stated it can also be used as a private visiting area. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 14 Service users stated that they liked to use the facilities in their local town of Horley. Family links are maintained and relatives and visitors are encouraged to visit at any reasonable time. They are also encouraged to take an active part in care planning. The manager stated that the service users and staff are looking forward to their first Christmas and inviting family and friends to home functions. Menus are planned daily and residents take it in turns to shop in the local Tesco Superstore as part of their development and training. There is a choice of at least two main evening meals which are prepared by the staff with input from service users. Some service users take a packed lunch to college, and others are supported to prepare their own. Most of the service users like to share a Sunday roast together. Special diets are catered for and these are mainly soft food, or a healthy eating plan to help someone with a weight problem. All the staff hold a current food hygiene certificate. The kitchen is very modern, well equipped, clean and hygienic. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Personal support is carried out as outlined in individual care plans. Appropriate arrangements are in place to meet the health care needs of service users, and they are protected by the medication policies and procedures in place. EVIDENCE: The home benefits from a selection of communal shower/bath rooms and ensuite facilities to enable service users receive personal care of their choice. This is outlined in individual person centred plans. Staff delivering care are aware of individual needs. All the service users are registered with a local GP. The manager and deputy manager confirmed that service users are well supported by the surgery and service users feel comfortable visiting there. There is also good support from the district nurse who is due to visit the home next week to administer flu vaccines. Service uses have access to a dentist, chiropodist and optician. There is also psychiatric support available at a nearby resource centre. Physiotherapy, speech therapy and other specialist therapy can be arranged by referral. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 16 The home has a medication policy in place and all staff who administer medication are familiar with this policy. Boots the chemist supply all the medication to the home mainly in blister pack format. They also undertake audits of medication and provide advice regarding medication issues. At a recent visit, recommendations were made about the layout of the medication storage area which were altered immediately. The medication recording charts (MAR) were seen and are well maintained. There is a fridge provided for medication storage. Staff undertake “safe handling of medication training” and only administer medication on completion of this training. Currently there are no service users who self medicate. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints procedure and the safeguarding procedures in place protect service users living in the home. EVIDENCE: The home has a complaints procedure in place and all service users and their relatives have access to a copy of this, which in part of the service users guide. There is also a copy of this displayed at the reception area. The home maintains a complaints log and there has been one complaint recorded since the home opened, which was resolved using the home’s procedure. There is a safeguarding vulnerable adults policy, and a whistle blowing policy in place. All staff undertake training in these policies and were aware of them during discussion. The home has a copy of Surreys Multi Agency Policies and Procedures on Safeguarding Vulnerable Adults in place. The manager has agreed to attend training on these procedures as soon as possible. She has however experience of other local authorities safeguarding procedures. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28, and 30. People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable, well furnished, clean and safe home that is suitable for its stated purpose. EVIDENCE: This home is newly registered and is decorated to an excellent standard. All parts of the home are well maintained providing service users with a comfortable, homely and safe place to live. There is ample communal space provided and includes a large lounge, conservatory, and dining room. There is also a log cabin provided in the garden for sensory use or can also be users as a quiet room. Service user’s bedrooms are all single en-suite rooms. These have been decorated and personalised to reflect individual choice and personality. Several service users stated that they liked their rooms. Staff support service users to maintain individual space. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 19 The standard of cleanliness is good and the home is clean and hygienic. The laundry is well equipped and accessible to service users to promote independence. There is a control of infection policy in place and staff undertake training in this policy. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, and 36. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are supported by a competent and qualified staff team in sufficient numbers to meet their assessed needs. The procedure for recruiting staff is safe. EVIDENCE: The staff duty rota was seen and outlined that there were ample staff on duty to meet the assessed needs of the service users. The manager explained that there is a basic number of staff allocated per shift and that extra staff will be allocated accordingly, depending on individual activities and commitment. For example two staff were on duty to support a service user to an out patients appointment. Individual staff training and development profiles are in place. All staff undertake induction training following the common induction standards for social care. This takes place over a six week period and is recorded. The manager stated that she buys in the services of “in care services”, and “training the carer” for mandatory training in manual handling, first aid, fire safety, food hygiene, infection control, medication administration and understanding epilepsy. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 21 Some care staff have an NVQ qualification and others have been identified as commencing NVQ training in November 2008, with Skills for Care. The manager is an NVQ assessor. The home follows the corporate recruitment procedures. Three staff employment files were sampled. These are well maintained and include an employment history, written references and a CRB (Criminal Records Bureau) disclosure. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interest of the service users. The health, safety and welfare of the service users and staff is observed and promoted. EVIDENCE: The home is well managed by the registered manager who has several years experience in a managerial role. She was recruited to the post to commission the home. She has an NVQ level 4, and a Registered Managers Award (RMA). There are also two deputy managers in post who undertake various managerial responsibilities. The home benefits from good organisational and support. There are systems in place to monitor quality assurance. Monthly regulation 26 visits are undertaken by the regional manager and retained on file in the home. Regular audits of care plans, medication audits, health and safety Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 23 visits, service user meetings, and staff meetings are all part of the quality assurance process. The manager explained now that the home has been operational for almost six months the organisation will be distributing service user satisfaction questionnaires to monitor progress and act on feedback. There are a wide range of health and safety policies and procedures in lace, a sample of which were sighted during the inspection. All staff are aware of and undertake training in these policies and procedures. Fire safety is observed and contracts are in place for the maintenance of firefighting equipment and emergency lighting. Risk assessments are in place for all identified risks and safe working practice. A routine programme of maintenance is in place. Accidents and incidents are reported appropriately. Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 4 27 X 28 4 29 X 30 4 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Whitehatch DS0000072268.V372671.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA23 Good Practice Recommendations It is recommended that the Registered Manager attends the Surrey Multi Agency Safeguarding Vulnerable Adults training when a place becomes available. 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