Inspection on 20/02/07 for Whitehouse

This inspection was carried out on 20th February 2007.

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

Whitehouse 09/02/09

Whitehouse 15/02/06

Whitehouse 07/06/05

Whitehouse 18/01/05

Whitehouse 16/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Whitehouse Leesons Hill Orpington Kent BR5 2NH Lead Inspector David Lacey Unannounced Inspection 20th February 2007 14.00 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 Whitehouse DS0000006894.V326120.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. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitehouse Address Leesons Hill Orpington Kent BR5 2NH 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) 01689 876 267 01689 878 031 Mrs Susan Margaret Lingham Mr Kenneth Lingham Mrs Susan Margaret Lingham Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 Elderly persons of either sex within the category old age Date of last inspection 15th February 2006 Brief Description of the Service: White House is a care home registered to provide a service for up to three older people. The home is a detached eight-bedroom house in an elevated position set back from a busy main road. There is a steep driveway to the front of the house. All service users accommodation is on the ground floor. Each service user has a bedroom and access to two toilets and one bathroom with walk-in shower. There is a sun lounge at the back of the house overlooking the secluded garden, which is the communal seating area for service users. The home admits service users who wish to smoke. Mr & Mrs Lingham were registered by Bromley Local Authority in 1992 as approved care providers with the borough’s former Adult Home Finding Scheme and they continue to provide care within their own home. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included an unannounced visit to Whitehouse. During the visit, I spoke privately with each of the service users in residence, and the home’s owner/manager. I toured the premises and examined various pieces of documentation. I also sought service users’ views by means of a postal questionnaire and have incorporated their responses into this report. The weekly fees for this home range from £350 - £450. What the service does well: What has improved since the last inspection? What they could do better: The handrails at the front entrance of the home need repair or replacement. The light fitting in the shower room used by the service users must be kept covered, using an appropriate cover for a bathroom light. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 6 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. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 7 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 Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assessed to ensure the home can meet their needs. Service users’ residency is protected by an appropriate contract. This home does not offer intermediate care thus standard 6 does not apply. EVIDENCE: The home’s owner has provided a contract for a service user who is privately funded, which sets out the terms and conditions of residency and the rights and responsibilities of each party. For the other service users living in the home, there are contracts in place between the placing authority and the home’s owner. All three service users confirmed they had received a contract and enough information about the home before they moved in so they could decide if it was the right place for them. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 9 The manager carries out pre-admission assessments of service users referred for placement, and this had taken place for the most recently admitted service user. The service user was offered a trial visit to the home before moving in. The service user commented , “I visited for afternoon tea and met the family and one of the other residents”. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have a plan for their care, based on their assessed needs. Service users have good access to health care services. Their privacy is respected. The administration of medicines is satisfactory. EVIDENCE: The service users’ files contained care plans and supporting documentation. The care plans were based on assessment of the service users’ needs and had been reviewed regularly. The plans included a description of the service user, physical health and conditions, assessment of various daily living skills, care plan assessment, social needs, and contacts with relevant professionals. There had been liaison with social workers about care management reviews. All the service users confirmed in their CSCI questionnaire responses that they receive the medical support they need. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 11 Service users looked well groomed, and were dressed appropriately for the time of year. A service user’s hair and beard were clean and neatly trimmed. There were signs of wellbeing amongst the service users, who were alert and speaking freely with the manager and members of her family. Two service users said they felt they were being looked after well and confirmed their privacy is respected. All of the service users confirmed they receive the care and support they needed, one commented, “I feel safe and content”. Each of the service users can manage their own personal care with minimal supervision and occasional prompting. The males receive assistance with showering from the owner’s husband, while the owner helps the female service user as required. I spoke with each of the service users privately and none raised any concerns about the nature or frequency of personal care they receive, which is mainly assistance with bathing. The manager ensures that service users have access to relevant health care services, including a GP, and they are supported to keep health or social care appointments. Management of medications was satisfactory. They are stored in a locked cabinet in the kitchen, away from any direct heat source. The owner keeps records of medication administered to the service users, and these records were available for inspection. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to choose how and with whom they spend their time. They are encouraged to keep contact with their families and friends, as they choose. A balanced diet is provided and service users like the food served. EVIDENCE: From their separate conversations with me, service users were content with their levels of activity. One service user goes out from the home most days, another normally goes out only with his family and likes to spend time watching TV or listening to the radio. Service users said they had choice in relation to aspects of life in the home, such as when they go to bed or get up and where they take their meals. In their questionnaire responses, service users stated there were always activities arranged by the home that they could take part in. One commented that the owner/manager often takes them out to the shops or to eat. Another service user stated, “I like it when we go to feed the ducks”. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 13 Service users are welcome to have visitors in the home at any reasonable time. There is enough room for service users to receive visitors in private other than in their own bedrooms. All the service users said that they enjoyed the food provided, and that their likes and dislikes were taken into account. Service users said they always had enough to eat and drink, with variety, and that mealtimes were not rushed and they had sufficient time to eat their food. None of the service users required assistance with eating or drinking. The owner keeps a record of food provided to service users. She only records details of the food if the meal provided is different to that on the menu, which is an acceptable practice. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures for complaints and for protecting service users from abuse. EVIDENCE: The home has a complaints procedure, which is made available to service users and their families. Service users confirmed they knew how to make a complaint and who to speak to if they were not happy, and all stated they would tell the owner if something was wrong. The pre-inspection information submitted by the owner confirmed there had been no complaints made directly to the home since the previous inspection. The commission was informed of recent concerns from the family of a service user, which were being addressed by the placing authority (Bromley). It was planned that the family meet at the home with the providers and social workers to discuss matters relating to their relative’s care. Also, issues raised were considered in a general way during this inspection with regard to all of the service users living in the home. Following its review, the authority confirmed the outcome was that the service user is considered well placed at Whitehouse. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 15 The local social services multi-agency guidelines for adult protection were available. The home had a policy to preclude staff involvement in helping to make or benefit from service users’ wills. Interactions during my visit between the owner and members of her family and the service users were appropriate and friendly. None of the service users raised any concerns with me about the attitudes or behaviour of individual family members who help them with their care. Two said they could approach the owner to talk with her at any reasonable time, and that she was caring towards them. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Areas of the home used by service users are clean, comfortable and reasonably well maintained. The handrails at the entrance to the house must be repaired or replaced and the shower room light must always be covered appropriately. EVIDENCE: The home is domestic in character, providing homely accommodation to the service users. The service users’ bedrooms are comfortably furnished and have personal items to make them feel homely. The service users have access to the ground floor of the home, which was comfortably furnished. The home admits service users who wish to smoke, and service users were seen smoking either in their bedrooms or in the communal sitting area. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 17 The home’s layout and facilities were unchanged from the previous inspection, though some improvements have taken place. The kitchen has been refurbished, the conservatory repainted and the flat roof to the annexe (where there are two service users’ bedrooms) has been renewed. There are domestic machines for washing and drying laundry. Service users said they were happy with the laundry arrangements and they always had supplies of clean clothing. On the day of this unannounced inspection, the home was clean, tidy and free from unpleasant odour. Each of the service users confirmed the home was always fresh and clean. The temperature of the home was comfortable throughout. Service users said their rooms were warm during the cold weather. Some environmental adaptations are provided, for example, a grab rail for the toilet and a ramp to provide level access from the sun lounge to the patio. The home has a battery powered call alarm system in each bedroom. The handrails at the front entrance of the home needed repair or replacement, as they were loose. I raised this with the owner who said she would ensure these are fixed promptly. A requirement has been made in this respect. The light fitting in the shower room used by the service users was uncovered. The owner had the original cover, which had been removed. The light must be kept covered, either using the original cover or another one appropriate for a light in a bathroom. The owner has made enquiries to the local authority (Bromley) about the improvement grants currently being made available to care homes for older people. As her plans for improvement would benefit the service users, I have asked a Bromley social services colleague who has service users placed at the home to support any application. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s owners have a number of years experience providing care to older people at Whitehouse. The owner has undertaken training relevant to her work. EVIDENCE: The registered person and members of her family provide care to the service users. She and her husband were both present throughout the inspection, and one of their sons for part of the visit. Maintenance issues at the home are dealt with by the registered person’s husband or by external contractors. The care home does not provide waking night staff. It is the registered person’s own residence and either she or her husband are available if needed. All persons giving personal care to service users are at least 18 and no persons under the age of 21 are left in charge of the home. In their CSCI questionnaire responses, each of the service users stated their carers in the home always listened and acted on what they said. They also confirmed there was always someone available when they needed them. One commented, “There is always someone here I can talk to and ask for anything I need”, another stated there was “always someone here if I need them”. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 19 The owner has employed a relative to work part-time in the home for a number of years and this person is understood to hold an NVQ2 in care. No other staff have been recruited to work in the home. The owner stated that since the last inspection she has attended training arranged by the Bromley Scheme for Adult Placement in philosophy of care, moving and handling, food hygiene, and first aid. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that a person with the necessary skills and experience is running the home. EVIDENCE: The owner has provided care to service users for some years. This has included respite care. She does not hold formal care qualifications but was originally an approved carer with the Bromley Adult Home-finding Scheme. When that Scheme closed, she registered the home under the Registered Homes (Amendment) Act 1991. Until 2002, the home was being inspected by Bromley social services, and the registered person showed her ability to manage the Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 21 home and received good reports. The owner has recently been approved as a carer by the new Bromley Scheme for Adult Placement but has decided that Whitehouse will remain as a registered care home. The service users live with the registered person and her family, in a domestic environment. Service users’ views are sought informally, rather than operating a formal quality assurance and monitoring system. Staff from Bromley social services, which has two service users placed in the home, monitor the quality of care provided. The service users had ready access to me and met with me individually and privately to give their views. I did not see any evidence to suggest that the home had any shortage of provision for service users. Finances for one service user are managed by social services (the placing authority), with his pocket money and allowances accounted for by the registered person. A solicitor has power of attorney for one service user, and the solicitor’s clerk visited this service user during the inspection to discuss a financial matter. The family of the other service user assists him with managing finances. Service users are supervised during bathing to ensure their safety. The owners have installed smoke detectors (battery operated), a fire blanket and fire extinguishers. The most recent fire drill was recorded as having taken place on 03/01/07. Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 22 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 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 23(2) Requirement The registered person must ensure that the handrails by the front entrance to the house are repaired or replaced. Timescale for action 16/03/07 2 OP19 23(2) The registered person must 16/03/07 ensure that the light fitting in the shower room is always kept appropriately covered. 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 Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Whitehouse DS0000006894.V326120.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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