Inspection on 25/09/06 for Whitehaven Care Home

This inspection was carried out on 25th September 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Whitehaven Care Home 09/05/07

Whitehaven Care Home 20/12/05

Whitehaven Care Home 05/07/05

Whitehaven Care Home 17/11/04

Whitehaven Care Home 10/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Whitehaven Care Home 22 Whitehaven Horndean Portsmouth Hampshire PO8 0DN Lead Inspector Clare Hall Unannounced Inspection 25th September 2006 08:30 X10015.doc Version 1.40 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 Whitehaven Care Home DS0000011581.V306168.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 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 Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitehaven Care Home Address 22 Whitehaven Horndean Portsmouth Hampshire PO8 0DN 023 9259 2300 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) Mr Roland Fiford Ms Beverley Walton Ms Beverley Walton Care Home 15 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (15), Old age, not falling within any other of places category (15) Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the DE category must be at least 60 years of age. Date of last inspection 20th December 2005 Brief Description of the Service: Whitehaven is situated in a quiet residential area of Horndean. The home is registered with the Commission for Social Care Inspection (CSCI) and provides accommodation for 15 older people many of who have dementia. The home does not offer any nursing. All service users have their own room and there is a pleasant rear garden where service users can sit out in the warmer weather. The current fees are a standard charge of £550 which includes toiletries, chiropody, refexology and activities. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook a visit to the premises and during the time spent there spoke with service users and the care staff, cook and deputy manager. A full tour of the premises was also undertaken. Comment cards were provided to service users, relatives, visiting health and social care professionals and all of the homes staff were provided with comment cards during the inspection. Feedback has been considered and reflected in this report. Staff were also observed throughout the day assisting and supporting clients and their practices were observed for good practice. Service users were observed making use of shared facilities and taking breakfast and lunch. Case tracking was undertaken as part of the evidence gathering process, with the involvement of service users. Information was requested from the manager eight weeks prior to inspection to evidence whether the service was operating in line with the National Minimum Standards. This information was provided. Additional information considered was all recorded contact with the home, including events and Regulation 37 notifications. Ten requirements have been raised as a result of this audit process. What the service does well: Observing care delivery and talking with service users and care staff it is very clear that the principles on which the home’s philosophy of care is based ensure that residents are treated with respect, that their dignity is preserved at all times, and that their right to privacy is always observed. Comments received in respect of the service were very complimentary and one relative thanked the staff by saying, “The home is a lovely place for residents and a credit to all of you for all your kindness and dedication to your profession, your kindness patience and professionalism have been second to none .You have been extremely supportive. “Thank you for your wonderful care.” Observing the staff through out the day communicating with service users identified that there is a very high commitment by the staff to treat all service users as individuals with desires, hopes and expectations. Service users with Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 6 short-term memory loss were dealt with sympathetically, respectfully and with dignity. Observation and discussion identified that the home is very welcoming and any service user with an interest to see how the home is run is welcome to visit regularly, stay for lunch and meet and develop a rapport with staff before under taking a commitment to stay. Just some of the comments received from care staff in respect of the service were, • Generally I feel the home is well run and all residents seem happy here. • I felt very welcome here when beginning the job, all staff were very informative and friendly. I feel I can ask anyone questions if I feel unsure. • The residents have a really high level of care. • The manager is doing a great job in running the home. • There is great team of care staff. The care records and documents in the home are of a good standard and are regularly reviewed. What has improved since the last inspection? What they could do better: The atmosphere during the visit and the observations made have identified this is a good home providing good care by caring staff. Unfortunately there have been a number of requirements raised for a second time with respect to the environment and this will have an effect on the rating. The manager has been informed of concerns with regards to the district nurse’s current policy for the preparation of insulin and the handling of the keys and for the storage of medication. The homes external space will need a review by the health and safety executive as there are steep steps and uneven paving slabs. The manager must also ensure that every service user is only admitted on a basis of full pre –assessment as the home is not demonstrating it’s capacity to meet the assessed needs of all individuals admitted to the home. The homes recruitment practices are very poor. Staff have not had robust checks undertaken prior to employment and the files lack evidence to indicate the process of how suitability is established. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 7 Further areas of concern are the homes laundry facilities, which need significant improvement along with the updating of the home infection control policies and procedures. Consultation must be undertaken with the health protection nurse and the health and safety representatives to address concerns identified regarding the laundry and access between the laundry front door and kitchen. Water temperature monitoring is needed and maintenance of the broken heating system. The uncovered radiators, which could pose a significant risk to this client group, must be addressed. 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 Care Home DS0000011581.V306168.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 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 the following standard(s): 1,2,3,4,5 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The records indicate that the manager usually undertakes the necessary assessments prior to admission but has failed on the last occasion to do this leading to an inappropriate admission to the care home which is against the homes stated purpose and service guide. EVIDENCE: The manager has developed a very informative guide to the home which in a combined pictorial and worded format. It was stated in the pre- inspection questionnaire that she hopes to develop this further by providing this information in a format suitable for those residents who have sight impairments. In the main hallway there is a copy of the most recent inspection report and further information regarding, services for care workers and advocate services. The home has a complaints procedure and information on view including details of the Commission and local social services and health care authorities. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 10 It was confirmed by a relative that service users receive contracts of terms and conditions and it had been made clear what the fees in respect of any extras, i.e. chiropody and hairdressing, covered. The homes statement of purpose and guide given to service users and their relatives states they will be provided with a comprehensive guide to the home, which will also include details of the complaints procedure, medical and dental facilities available the latest homes inspection report, statement of terms and conditions and a quality audit sheet and this was confirmed. The homes statements of purpose states that every prospective resident will have their needs expertly assessed before a decision is taken regarding admission and that the manager will demonstrate to every person about to be admitted to the home that they are confident that they can meet their needs and offer trial visits to prospective residents to avoid unplanned admissions. One relative informed the inspector that the manager visited her mother twice before she came to live at the home. The homes completed pre assessment documentation held for one resident was very detailed and informative regarding the needs of the resident prior to their admission. A further questionnaire was seen being implemented so as to monitor the quality of the admissions process. Residents opinions are sought on whether they were given enough information about the home to all areas of the admission and whether they were supported which is considered good practice. The manager had accepted a resident who was flown in from abroad and she did not have the necessary information in respect of this gentleman prior to the admission. It was clearly evident on the day of the visit that this gentleman was not happy with his environment. He has a degree of mobility problems and he considers his room too small. He cannot access and use the toilet and feels as if he is in a prison. The manager understood that the lack of pre assessment had led to this gentleman being inappropriately placed and was doing everything possible to move this gentlemen to a place more suited to his needs and wishes. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The service users care records are complete up to date and reflect their care needs with exception to one. The care provided promotes core values individuality and is person centred. EVIDENCE: The care planning records audited were of a good standard. While case tracking the needs of residents the inspector was able to follow the resident’s current and changing needs. During the visit all care staff were given questionnaires and the responses confirmed that before staff begin working with the service users they are given the relevant information to identify what their needs are and time to read the care plan. They also confirmed that the manager /person leading the shift give them clear instructions about the job they are expected to do, told them about any particular needs which the service users have and tell them how to understand, work to and record in the care plan. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 12 A comment received from one senior care staff member was the care the residents receive is 100 . Staff are able to spend one to one time generally in the afternoons to look at for example, photos, letters and newspapers, which residents value. There is also a good activities program. When another care worker was asked, “Is there anything that the home does really well that you want to tell us about?” the response was “the excellent care of each service user where individual needs are met. It is their home” Through out the visit whilst observing the interactions between staff and residents, it was very apparent that the principles on which the home’s philosophy of care is based are ones which ensure that residents are treated with respect, that their dignity is preserved at all times, and that their right to privacy is observed. Residents confirmed these principles are put into practice. Outcomes in respect of the standards of support and attention to detail in respect of the individuals preferences i.e. jewelry, footwear, clothing were being respected by staff. On the day, two healthcare workers were on the premises and reported to the inspector that they felt the home communicates clearly and in partnership with them and that there is always a senior member of staff on duty to confer with. It was further stated that all service users are seen in private, and that they thought the staff demonstrated a clear understanding of the care needs of the residents. They also stated that any specialist advice given by them is incorporated into the care plan and that they felt the management /staff take appropriate decisions when they can no longer manage the care needs of an individual. Both staff were satisfied with the overall care provided. Further comment received by health and social care staff were, “ I am always greeted by a member of staff who shows me to a room where I can see my patient in private. Staff in Whitehaven are always in communication with district nurses and General Practitioners regarding their residents and we advise on care.” and, “The staff are always friendly when greeting me on arrival. The patients always seem comfortable and well looked after when I visit”. Service users met through out the day confirmed they had their national health service entitlements for eye checks and dentistry are maintained and informed the inspector that if they want to see a doctor all they would have to do is ask a member of staff to phone on their behalf. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 13 The service users assessments in respect of nutrition, mental health status, skin and mobility are well maintained except for one recently admitted service user where the staff had not completed the necessary information. On the whole the remaining service users had up to date and well-reviewed care records. The home medication storage policy and procedures were viewed. Medication administration records were completed and the service users records have a good pain scale tool to measure effectiveness of analgesia given. Three issues were raised with the manager in respect to improving practice and that was to hold the drug keys separately to the main house keys, to audit the fridge temperatures and review the current practice for district nurses drawing up pre- filled syringes of insulin in advance when this is not considered to be safe and good practice. The manager has put together a good drug reference for staff. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Staff are caring and respect each residents dignity and help and support him or her to fulfil their needs and meet their expectations. The home provision of food and drink is of a very good standard. EVIDENCE: Care records and residents care plans identified concerns regarding resident’s failure to eat, noting whether through physical inability, depression, or poor health. Staff were observed consulting the residents in respect of choices for meals, activities, seating and respecting the wishes and requests made for food, drink, papers, doors to be shut or opened etc. Service users confirmed that staff are respectful, supportive and caring. The inspector read numerous cards complimenting the staff on their care and the inspector was able to speak with healthcare professionals, visitors and all the staff of the home during the visit and elicit their views some of which were as follows: “Sincere thanks for all the support you have given mum. You kindly helped her maintain her dignity, her independence by caring for her in a sensitive way. You were available whenever and whatever reason and mum was always determined to maintain her spirit.” “Thank you to all for being there for her when she needed the help and thank you for the love care and attention.” Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 15 Care records described care workers intervention to include monitoring the individual resident’s food intake in a discreet and unregimented a way as possible. Care and tact was observed during mealtimes and the outcomes in this standard were very high. Food was well presented on china plates and drinks laid up on trays with cups, saucers and jugs of milk and pots of tea (in a risk assessment framework). Residents were given individual gravy jugs and staff were observed sensitively prompting and offering assistance. There was plenty of fresh fruit available and good quantities of high quality food products in the storage areas, all appropriately labeled. Service users were observed being provided drinks as requested in suitable receptacles and there were plenty of equipments to encourage independence such as plate guards, straws, double handed cups. Service users spoken to in their rooms always seemed to have a hot cup of tea or drink nearby and snacks whether biscuits, chocolates or sweets. Despite the seating area in the dining room not being able to accommodate all service users at one time it was accommodating those service users who wished to eat in a group as some chose to eat in their rooms or in the lounge. The inspector noticed the positive mood of the group as service users chatted, laughed and sang and smiled. The staff were also very aware of the individual preferences of residents and the records documented the choices offered and specialist diets in respect of soft foods and diabetics diets. One lady was seen with the necessary supplements provided as prescribed by her GP for weight loss as part of her risk assessment. The homes guide states that visitors may come at any reasonable time. One service user had it recorded on his calendar that he was going out that evening for a drink down the pub with his son and the home does have links with a number of outside agencies including the Patey centre. It was further established that the home supports relatives during periods of their relative’s ill health and can provided them with accommodation food and drinks and support. Comments and compliments received by the home in respect of this were: Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 16 “Thanks for making the last months comfortable and happy. Through out the last months of her life you treated her with such respect and dignity all in a truly caring environment. Thank you to you all who make mums life a happy one. You are special people.” The homes residents guide states: “The home places the rights of residents at the forefront of it’s own philosophy of care. We seek to advance these rights in all aspects of the environment and service we provide and encourage our residents to exercise their rights to the full.” The home also supports residents’ special birthdays and anniversaries. Comment received by the home stated: “Thanks for the hard work that you did to make mum’s birthday a special day. The tea party was excellent and much appreciated.” The inspector saw an abundance of compliment and thank you of which one stated: “I always enjoyed visiting because of the friendly welcome I received from you. There is a lovely and caring atmosphere. I am so pleased mum had such a lovely place to stay”. The staff newsletter read during the visit described some of the duties of the 2-8pm shifts. It stated, any spare time should be spent with residents doing activities and not doing kitchen tasks and stating despite there hot weather residents should be given the choice whether they would like to play bingo, go through family photos as many of the residents value this quality time with staff. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 16,17,18 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Staff are aware of the need to report any concerns for poor practice and the importance of disclosing dissatisfactions and improving the outcomes for service users. EVIDENCE: All staff questionnaires indicated an awareness of reporting abuse and taking all complaints seriously. Comments received from the manager identified that it was the managers aim to ensure that all her staff and service users would be able to make a complaint, freely and be supported at all times. The manager has not ensured all necessary checks have been undertaken prior to employment of staff. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 18 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 the following standard(s): 19,20,21,22,24,25,26 Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to this service. The environment has been adapted to suit the needs and preferences of the service users but the manager needs to make sure it complies with health and safety and infection control practices so as to protect the service users from harm. EVIDENCE: Since the last visit the manager has re-arranged the communal lounge and dining area following the comments made by the previous inspector. The dining room can only accommodate 10 people but all service users wishing to sit at the table for lunch could do so at this time. The inspector was also able to sit at the table, as there were spaces available. During a tour of the premises it was identified that the home is comfortable, homely and decorated to a good standard. Several residents’ bedrooms were seen and these were comfortable, containing numerous items of personal possessions and furnishings. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 19 Residents confirmed how much they like their bedroom. The inspector did raise the condition of the communal dining and lounge carpets with the manager as these were heavily stained and well worn despite only being two years old. All service users had acceptable access to call bells and alerting staff to their needs. As it was a warm day it was difficult to measure whether there is adequate heating provided. This was raised at the previous inspection and the manager informed the inspector that the corridor radiators do not work both upstairs and down stairs. This may be an issue in the colder months. All of the radiators seen in the communal areas were uncovered and so were radiators in some service users rooms, bathroom and laundry. This was raised as a concern at the last inspection and the provider and manager reminded that this has been a national minimum standard since 1st April 2002. Also raised at the last visit was that a hot water tank, contained in a cupboard, and was also accessible to residents, posing a risk of possible burning and this cupboard remained unlocked during the visit. The inspector did not think the home was appropriately signed from the street. The homes number 22 is placed at the back door, which is also at the front of the property. The inspector naturally went to the door where the house number was as there is no other signage stating where the front door is. She was surprised to be led through the door straight into the laundry. Conversations with staff confirmed this is common practice for visitors; especially those who are not familiar with the premises to walk to this door and come through the laundry. The inspector was also concerned that the laundry door led through into the kitchen. The staff were seen using this door rather than the alternative access leading from the front of the house. This could pose an infection risk. The laundry itself had a torn linoleum floor covering and poor standards of shelving, which would not facilitate adequate cleaning in respect for the prevention of infection. The procedures identified for sluicing were also outdated. The general processes for handling soiled linens, colour coding cleaning equipment and infection control procedures are not currently in line with the department of health guidance for care home release 2006 and the manager was informed she will need to consult the health protection nurse and the environmental health department to review the concerns. This must include the positioning of the laundry, its access to the kitchen, its use as a passage way and its access by relatives and visitors. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 20 There are deep steps in the back garden down to the lawn and the irregularity of the patio area. The inspector has asked the manager to consult the health and safety departments in respect of giving their professional opinion of this. There is attention to small details to the environment, such as nicely decorated personal spaces, personalized and individual furnishings, bedding and fresh flowers through out the home. When staff stated they tested bath temperature by means of their feeling it the inspector asked the manager to ensure the appropriate bath thermometers were used and water temperatures recorded. The need to cover the homes radiators has been raised previously. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 21 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The manager has failed to ensure all necessary checks are undertaken prior to employing staff and has been given an immediate requirement in respect of this shortfall. Despite this the staff employed have been supervised and given the necessary training and kept well informed to fulfill their role and the outcome for service users is good care practices. EVIDENCE: Comments received from staff were complimentary towards the support given to them by the managers. Staff even sent the manager thank you cards for helping them with their NVQ 3. All staff comments cards reported that supervision is undertaken regularly and that it is planned recorded. Records confirmed this. Staff further confirmed that they are observed working as a part of this process. Through –out the inspection the inspector was shown articles and information and resources available to staff in respect of best practice. The manager had the latest updates in respect of medication, advocacy and the capacity act, changes in the fire regulations and good practice initiatives in respect of infection control and MRSA. The manager explained her policies have not yet been updated to reflect these changes but there was evidence to demonstrate this was being undertaken. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 22 The staff also receive health information regarding the client group in their newsletters.One read covered topics such as, ‘coping with repetition and recognizing a stroke’. Comments received from staff in respect of the home were, “Generally I feel the home is well run and all residents seem happy here” and “I felt very welcome here when beginning the job, all staff were very informative and friendly. I feel I can ask anyone questions if I feel unsure.” Staff questionnaires also confirmed that staff receive job descriptions and training in respect of fire, mental health issues, moving and handling and basic first aid which was also recorded in the pre inspection questionnaire. There is a tendency in the home not to have formal team meetings but print regular staff newsletters and bulletins. To allow for a more two-way information process the staff could be given the opportunity to have meetings to address an agenda of their choice. The staff newsletter was read and covered topics such as, welcome statements to new staff, information regarding staff rotas, activities, supervision and staff leave and recruitment topics. Staff reported that one thing the home does really well is that they, keep a close-knit relationship with all service users and the management are always extremely supportive to service users and staff Further comments were, “With the home having a maximum capacity of 15 service users there is a really nice atmosphere. You get to know the service users and their families quickly and can build up a good rapport with them” and “ There is time to read care plans and up date yourself on service users well being and management”. Records identify that staff are employed prior to all checks being undertaken. Staff records lacked full criminal record bureau checks prior to employment. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 23 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. There is strong leadership and staff feel supported. Outcomes for the care and support of service users is good and the staff have been given good opportunities to develop and become trained in this field of social care but the manager must address previously raised concerns as she is currently non complaint with previously raised issues of concern. These concerns do have a direct impact on the health safety and welfare of service users and have been at the fore- front of the care standards for many years. EVIDENCE: The manager showed the inspector the quality assurance records, which indicated that service users view had been sought in respect of the service. The questionnaires sought the views of the residents on the catering and food and elicited opinions in respect of how their choices and preferences were met. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 24 The questionnaire also asks how satisfied they are with the personal care and support they receive, the arrangements for daily living, the premises and management and seeks suggestions and comments. The responses identified that the manager monitored the outcomes and responded to any issues raised. The outcomes had not been summarized but had been monitored. It was explained that this could now be developed still further to summarize overall outcomes for service users in relation to all the standards. When reviewing the recruitment records with the manager it was identified that the process needs to be improved .The manager agreed and was aware that there were shortfalls. Staff have been recruited and worked prior to all the necessary checks being undertaken. The manager received an immediate requirement in respect of this on the day. The homes training records would indicate staff are undertaken a good induction and foundation and are supported to undertake national vocational qualifications. The manager is currently updating the homes procedures for induction to bring it in line with the skills for care council and knowledge sets. Records also identify that staff are receiving a minimum of three paid days training per year including health and safety, manual handling and first aid. It was obvious by the discussions held with the manager that she leads and directs the staff and is committed to providing a quality service which is led and dictated by the opinions and preferences of the residents. The manager is keeping abreast of current changes with legislation and discussed the new fire regulations (May 2006) and requirements in respect of updating fire risk assessments (October 2006), which will need to be undertaken. The issues and concerns raised as an outcome to this visit were mainly in relation to the environment and recruitment as it was noted that the overall care and support outcomes for residents are good. Service users definitely benefit from the ethos, leadership and management approach of the home and have a good standard of care provided in a homely environment. The manager also ensures that the management approach of the home creates an open, positive and inclusive atmosphere and definitely communicates a clear sense of direction and leadership. The manager also audits the outcomes of practice and service. Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 25 Staff records clearly record supervision sessions in detail and overall the record keeping within the home is of a good standard. The only concerns are that the manager has not addressed the shortfalls in respect of the environment and this will have a direct influence on the outcomes for the health safety and well being of the residents and the quality rating of the service. The manager is updating the fire safety records ands keeps good records in respect of accidents and incidents. The homes infection control procedures and management needs a complete overhaul and the manager needs to tighten up the monitoring of water temperatures as previously discussed. Both the manager and deputy hold their manager’s qualifications and the standard of the induction for staff and information provided ensures that all staff is well informed. One service users relatives comments to the manager was, “The home is a lovely place for residents and a credit to all of you for all your kindness and dedication to your profession, your kindness patience and professionalism have been second to none. You have been extremely supportive. Thank you for your wonderful care.” Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 26 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 2 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 2 2 2 X X 2 1 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 1 Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 12,13 Requirement No one is to be accommodated without it being established pre admission that his or her needs can be met. Steps must be taken to ensure that all service users needs are being met. The manager must ensure that insulin is drawn up and given within the guidelines of safe and best practice initiatives only. The medication keys are held in line with recommended practice and that the drug fridge temperatures are monitored to ensure medications are stored at the appropriate temperature. The home must maintain the heating system and ensure there is an adequate air temperature. This is a requirement, which has not been met by the given date of 20/01/05 and has been raised again. 5 OP29 OP18 7,9,19 All staff recruited must have the DS0000011581.V306168.R01.S.doc Timescale for action 25/10/06 2 OP4 12(1) 25/10/06 3 OP9 13,12 25/11/06 4. OP25 OP38 23(2)(p) 25/12/06 26/09/06 Page 28 Whitehaven Care Home Version 5.2 6 OP38 OP22 OP19 Schedule 2 23,13 necessary checks undertaken prior to employment. The manager must ensure the health and safety issues are addressed regarding the outside space, paving and steps down to the lawn and in respect of the laundry facilities. 25/12/06 7 OP21 OP38 23 8 OP26 OP24 13,16,12 9 OP38 16 Staff must ensure water 25/10/06 temperatures are checked prior to bathing residents and that this is done through a risk assessment framework. The registered person must 25/12/06 ensure all floor coverings are clean and fit for purpose. (Dining room, lounge and laundry) The manager must review the 25/11/06 homes infection prevention and control procedures and policies with respect to the use of towels, the situation and access to the laundry as a through fare and route to the kitchen and access by the front/back door. The homes policy and procedures must reflect current best practice initiatives issued by the Department of Health. The following health and safety measures must be taken: Protecting residents from hot radiators and hot surfaces by the provision of radiator covers and by locking the door to the cupboard containing the hot water tank Where radiator covers are not installed this must be supported by written risk assessments Weekly testing of the fire alarm This is a requirement, which has not been met by the given date of 20/01/05 and has been raised again. DS0000011581.V306168.R01.S.doc 10 OP38 13(4) 25/12/06 Whitehaven Care Home Version 5.2 Page 29 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Whitehaven Care Home DS0000011581.V306168.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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