CARE HOMES FOR OLDER PEOPLE
Whitehaven Fosseway Midsomer Norton Bath & N E Somerset BA3 4AU Lead Inspector
Jon Clarke Unannounced 3rd June 2005 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 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 Older People. 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. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Whitehaven Address Fosseway Midsomer Norton Bath & N E Somerset BA3 4AU 01761 413143 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Quality Care Homes Limited Mrs Lorraine Denise Musson Care Home only 23 Category(ies) of OP Old age,23 registration, with number of places Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: May accommodate up to 23 persons aged 65 years and over requiring personal care only. May accommodate a named person with a Mental Disorder (MD). Will revert when named person leaves. Sufficient communal space for 23 people be provided in the home by the 30th September 2004 to ensure compliance with Standard 20.4 of the current National Minimum Standards for care homes for older people. Date of last inspection 19-Jan-2005 Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 5 Brief Description of the Service: Whitehaven is one of three care homes owned and managed by Quality Care Homes Ltd. It is registered for up to 23 older people and situated in the town of Midsomer Norton within walking distance of local shops and amenties. Accomodation is provided over two floors with lift access between floor. Ten of the rooms offer en-suite facilities and the rear of the building has 4 rooms with access to the attractive and accessible gardens. There is a seperate dining room as well as dining area attached to a lounge area. The aim of Whitehaven is to ensure an excellent quality of life for residents by providing first class care in a friendly, relaxed yet stimulating environment and to ensure that living in a residential setting is a positive experience ( taken from the homes Statement of Purpose ) Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and in the main was spent talking with residents individually or as a group. The majority of residents were spoken to during the inspection some of this was a ‘formal’ interview, which took up to an hour. In particular residents who had come to the home since the last inspection were interviewed. A residents meeting was held on the day of this inspection at which 12 residents attended and with permission of the residents the inspector was able to attend this meeting. A number of documents were examined including care plans, assessments and documents relating to recruitment and training of staff who have joined the home since the last inspection. What the service does well: What has improved since the last inspection?
The home has maintained the high standard of care as reflected in previous inspection reports. The dining room structural repairs and re-decoration has been completed as well as general refurbishment of the home. A member of staff has recently taken the responsibility of organising activities with residents and is now being given allocated shifts twice a week to undertake activities and it is hoped she will be provided with specific training to help with this
Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 7 responsibility. This is a very positive development in that it will ensure activities take place on a regular basis. What they could do better: 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. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 The quality of assessments obtained by the home and undertaken by the home on admission were of a good standard providing a full and comprehensive picture of individual’s health and social care needs. This helps the home to meet identified needs and provide good quality care. The home provide an opportunity whenever possible for prospective residents to visit the home so that they can make an informed decision about the suitability of the home. EVIDENCE: Assessments seen illustrated the level of information required about the prospective residents social and health care needs. The home also completes their own Initial Assessments on admission, which adds to the information supplied by the local authority assessment. Where individuals may have mental health needs assessments have been provided by Avon Mental Health team. Following assessment by the home which may include a day visit to the home a letter is sent to the prospective resident or their representative which
Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 10 confirms that subject to a trial period (normally of 4 weeks) the home is able to meet the needs of the individual. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,10 There is a clear and detailed care planning system in place to make sure that staff have the information they need to satisfactorily meet resident’s needs. The working practices in the home ensure that residents are treated with respect and there are positive and appropriate relationships between residents and staff. EVIDENCE: Care Plans contained information about the health and social care needs of the individual and set out in details the tasks required of staff to meet those needs. Included were details about: personal hygiene, bathing, dressing, continence, mobility and dietary needs. There were also risk assessments covering areas such as smoking and risk of fire identifying the actions to alleviate the risk and where a resident had poor eyesight. Reviews of individual needs take place on a regular basis. Residents if able had signed the care plans. In talking with residents it was clear that they felt they were treated with respect and importantly their choices were respected. One resident stated that
Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 12 she “ felt safe and they always listen to what I want ’’, another “ they respect you as a person here ’’. Other residents spoke of “ feeling safe ’’. In a daily record report it stated that a resident did not wish to “ bath today she will have one tomorrow ’’ confirming that individual choice is respected. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14,15 The home is improving its arrangements and opportunity for meeting the social and recreational needs of residents giving choice to residents about how they spend their day and activities they may take part in. The food provided at the home is well-balanced and nutritious offering choice and variety whilst also meeting the dietary needs of all the residents. EVIDENCE: There are a range of activities and recreational opportunities made available to residents and this has also improved since a specific member of staff has been allocated particular time to organise activities. Residents have asked what they would like to do and this also discussed in the residents meeting. One resident spoken to stated that she “ was not bored and had enjoyed the outside entertainment provided by the home ’’, another “ enjoy the bingo and crafts “. Speaking to the staff member who has responsibility to organise activities there was a real committement to offering as much choice as possible and importantly involving residents in choosing what they do. A number of residents commented that they felt able to chose how they spent their day and daily routines such as getting up, going to bed were “ when I like “, and “ don’t feel I have to do anything if I don’t want to ’’.
Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 14 Sitting with resident during lunchtime gave an opportunity to discuss the meals provided at the home. There were a number of positive comments about all the meals provided, how there was a “good choice ’’, “ always look good ’’. Throughout the inspection when talking to residents as a group or individually there were very favourable comments about the meals provided at the home. Popular with residents is the residents choice this is where one resident each week chooses the main meal of the day. The food provided at the home and menu was also discussed at the residents meeting and again there were compliments made as well as suggestions about changing the menu. A resident also made a suggestion about having sugar bowls on the tables and this was agreed. In talking with the chef it was very clear he had a very good understanding of the dietary needs of residents. He was particularly keen to make sure that diabetics who needed particular diet received wherever possible the same visually so were not seen as being different. He also makes a point of talking with residents on a daily basis about the food provided so providing an opportunity for residents to comment on the quality of meals provided. Menus over the past month were seen and showed a variety of meals being provided with a good choice. The chef was again very aware of the likes and dislikes of individuals and always made sure there was a choice available every day. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents are confident about making a complaint or suggestion about the quality of care provided and are aware of the complaints procedure in the home. EVIDENCE: In talking with a number of residents they all felt able to voice their views and if something happened they were unhappy about tell “ a member of staff ’’, “ tell Raine ’’ ( the manager ). Also that they would be “ listened to ’’ and something would be done. During the residents meeting a number of residents made comments and these were received very positively by the manager who was chairing the meeting. A number of residents when asked if they felt safe in the home replied “ definitely’’, “ trust people here ’’. The home had not received any complaints and it was noted that a number of relatives had written to the home praising the care provided and how good the staff were at their job. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The environment of the home is good providing residents with a safe and wellmaintained place to live. EVIDENCE: Since the previous inspection the dining room work has been completed and has been re-decorated and is now a pleasant and inviting room. The home is well maintained with re-decoration of rooms as required and planned fitting of new carpet in the lounge area. There is good access to the rear gardens, which have been landscaped, and raised beds have been installed. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29,30 The home has established good practice in the recruitment of staff with appropriate checks being carried out to make sure that as far as possible resident’s welfare is protected. Staff are well trained and competent in providing care to the residents of the home. EVIDENCE: Recruitment records were seen and all required documents such as two references, medical declaration had been obtained as part of the recruitment process. All new staff have had POVA and enhanced criminal record checks. New staff had completed the necessary training in order to meet the needs of residents such as moving and handling. Staff had also completed a through induction to include fire safety. During this inspection staff were observed responding to a fire alarm. They all acted promptly and efficiently and reassured residents in a supportive way. There are a number of training opportunities available to staff including: Promoting Continence and Promoting Choice and Self-Esteem. A number of residents made comments about the staff at the home: “ all very good ’’, “ do a really good job ’’. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 The manager recognises the importance of an open environment where residents are able to voice their views and are valued as individuals. EVIDENCE: In observing staff and in discussion with both the manager and staff it is clear that there is a real sense of a home which encourages residents to be very central to the life of the home in every way. Residents spoke positively of their ability to “ say what we think ’’, “ a friendly atmosphere ’’, “ relaxed ’’. This was also observed during the resident’s meeting when all were encouraged and given every opportunity to say what they wanted to say and make decisions. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x x x x Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 20 No 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. 1. 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. 2. Refer to Standard 22 30 Good Practice Recommendations Fitting of loop system in dining area to assist those residents who have hearing loss. Provide training relating to recreational activities to staff member who has direct to provide activities. Whitehaven D56_D05_S45883_Whitehaven_V231621_030605_ Stage4.doc Version 1.30 Page 21 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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