Inspection on 07/06/05 for Whitehouse

This inspection was carried out on 7th June 2005.

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 20/02/07

Whitehouse 15/02/06

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 White House Leesons Hill Orpington Kent BR5 2NH Lead Inspector Lorraine Pumford Unannounced 7 June 2005 14:00 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. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service White House Address Leesons Hill, Orpington, Kent, BR5 2NH 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) 01689 876 267 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 White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 3 Elderly persons of either sex within the category of old age Date of last inspection 18/01/05 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 paved driveway to the front of the house and easier access to the side of the property. 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 back 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 Adult Home Finding Scheme and they continue to provide care within their own home. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector spent approximately 3.5 hours in the White House. This inspection was unannounced. The registered manager provided information in relation to the care provided and records maintained in relation to service users’ health, activities and service users’ general demeanour. All three service users were spoken with in the privacy of their own bedrooms and their comments have been incorporated into this report. What the service does well: What has improved since the last inspection? The medication cabinet has been relocated to ensure that medication is not unduly affected by heat from the cooker. The manager has changed the response time for addressing complaints to the CSCI recommended period of 28 days. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 6 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. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4,5, Prospective service users are not admitted unless the homeowners have ascertained through the assessment process they can meet their needs. At present all service users do not have a contract of residency. A contract of residency is necessary to ensure all parties rights and responsibilities are protected. EVIDENCE: Three service users have been living at the White House for a number of years. The manager stated that in the event of a vacancy becoming available, a full assessment of need would be undertaken in relation to any prospective service user. The manager stated that any prospective service user would be given the opportunity along with their relatives or representative to visit the home to view the accommodation, to meet with other service users and discuss their care needs. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 9 Contracts of tenancy were examined, two service users receive funding from local authorities and the contract is between the local authority and the homeowners. The third service user’s financial situation has changed recently and the manager stated she is preparing a contract between the home and service user directly. A requirement was made at the time of the last inspection that service user care should be formally reviewed on a regular basis. The manager provided written evidence indicating that care managers based in local Social Services departments had been contacted requesting they attend formal reviews of care. The manager stated that to date no action has been taken by Social Services to arrange a review of service users care. She has therefore continued to arrange informal reviews with service users and their relatives. The manager stated that fortunately two service users have frequent contact with relatives and informal discussion takes place when they visit regarding care being provided. One service user does not have any relatives who can provide support and to date the manager has been unable to find any advocacy support for this person. Service users spoken with stated their needs are well met and they were happy living in the White House. The manager was able to verbally demonstrate a good understanding of service users’ needs. The White House does not provide intermediate care. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8,9,10,11 The home maintains comprehensive care plans. Service users’ privacy is respected. For reasons of safety medication must be stored in a locked cabinet at all times. EVIDENCE: The manager has compiled detailed care plans for each service user; key headings include service users’ needs in relation to personal care, rest and sleep, emotional needs, money, communication, mobility and comprehension. There was written evidence that the manager reviews these care plans on a regular basis. There was evidence that service users are supported to attend regular health checks such as doctors appointments as and when required. During the previous inspection a recommendation was made to relocate the medicine cabinet away from the cooker as the heat could possible adversely affect medication. The medication cabinet has been relocated and has a lockable facility. However on the day of the inspection the cabinet was unlocked. Records indicated the manager keeps a record of medication administered to service users. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 11 Service users stated they felt their privacy was respected; at present all three service uses are male and receive intimate personal care from a male member of staff. The manager stated that she had ascertained service users’ views in relation to action to be taken following death. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Social activities are well managed and provide daily variation and interest for people living in the home. Daily records of meals provided must be kept by the manager to ensure a varied and nutritional diet for service users. EVIDENCE: The manager stated that all three service users choose to spend their time involved in different activities. One service user in particular enjoys going out for days and uses public transport to travel to local shopping centres, meet friends and visit other recreational facilities. Another service user has frequent visits from relatives who take him out for meals etc and enjoys watching sport on TV and makes use of the large video selection that the homeowners provide. The manager stated that it had proved difficult to motivate the third service user to do any activities in the home, however, he enjoys listening to the radio the manager has put in his bedroom. In discussion, all service users said they enjoyed the way they spend their time each day. There are also a number of games and puzzles available if service users wish to use them. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 13 Service users said their relatives are free to visit as they wish. Due to its small size the home does not have a room solely available for service users to meet with guests in private. However all three service users are accommodated in single bedrooms which affords them privacy if it is required. The manager stated that there is a written menu plan. However this was seldom followed due to changes in service users’ plans, the weather etc. Records seen by the inspector indicated that service users have been consulted about their likes and dislikes in relation to food and service users spoken with stated they enjoyed the food provided. Discussion took place around the need to keep records of meals provided to service users to enable people inspecting to be sure that service users are provided with a varied nutritional diet. The manager agreed to keep this documentation on a daily basis. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Although there have been no complaints received, the home has an adequate complaints procedure in place. EVIDENCE: The manager stated that in the event of a receiving a complaint from a service user or relative, a record would be kept of any action taken by her to address the concern. The manager stated that following the last inspection she has amended the response time from 14 days to 28 days as recommended by the previous inspector. The manager stated that service users and relatives had been provided with a copy of the complaints procedure and written a copy of this was seen at time of this inspection. A service user spoken with stated he felt he could raise any concerns he had with the manager. The CSCI have received no complaints in relation to this home since the last inspection in January 2005. The manager stated that she was aware of issues relating to adult protection and had a copy of the Social Services guidelines in relation to this matter. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 15 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) 19,21,22,23,24,25,26 The accommodation is appropriate for the service users living in the home. Tthey are provided with a clean, safe, comfortable environment suitable for their needs. EVIDENCE: The house lays back from the main road and is positioned on top of a steep slope Whilst it is possible to drive a car directly to the top, it would be difficult for service users with reduced mobility to access the building independently. Service users’ bedroom doorways are a standard width; two of the bedrooms in particular could not be accessed by wheelchair dependent service users. There is a large shower room with a walk-in shower and seat. The home provides no other aids and adaptations for disabled people. However, at present, none is required for the existing service user group. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 16 All rooms used by service users are situated on the ground floor; this includes bedrooms, WC, shower room and a large conservatory, which is the communal lounge and dining area for the three service users. There are patio doors from the conservatory leading directly out into a pleasant garden. On the day of the inspection all areas used by service users were clean and free from unpleasant odours. Areas were appropriately decorated and furnished. Service users stated they liked their bedrooms and felt they had been provided with everything they needed. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.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) 27,29 There are an adequate number of staff employed to meet service users’ needs. Appropriate safeguards are in place to offer protection to people living in the home. EVIDENCE: The registered manager and her husband are registered with the CSCI. In addition other members of their family provide assistance on a part-time basis or when the registered providers spend time away from the home. The manager stated that CRB checks have been completed in relation to all members of her family who work or have contact with the service users. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.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) These standards were not assessed on this occasion. EVIDENCE: White House G51-G01 s6894 White House UI v229944 070605 Stage 4.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 2 3 3 3 N/A 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 x 15 2 COMPLAINTS AND PROTECTION 3 x 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x White House G51-G01 s6894 White House UI v229944 070605 Stage 4.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. 2. Standard 9 15 Regulation 13(2) 17(2)sch4 Requirement Ensure that medication is kept secure at all times. Ensure a record is kept of all food provided to service users in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory in relation to nutrition. Timescale for action 30.06.05 30.06.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 2 Good Practice Recommendations All service users are provided with a written contract detailing the terms of conditions, the room to be occupied, the care and services provided, fees payable and by whom, any additional services to be paid for over and above those included in the fees, the rights and obligations of the service user unregistered provider, the terms and conditions of occupancy including any period of notice. White House G51-G01 s6894 White House UI v229944 070605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection River House 1 Maidstone Road Sidcup DA14 5RH 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. 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