Inspection on 09/02/09 for Whitehouse

This inspection was carried out on 9th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitehouse 20/02/07

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Whitehouse Leesons Hill Orpington Kent BR5 2NH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: David Lacey     Date: 0 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Whitehouse Leesons Hill Orpington Kent BR5 2NH 01689876267 01689878031 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Kenneth Lingham,Mrs Susan Margaret Lingham care home 3 Number of places (if applicable): Under 65 Over 65 3 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home 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 residents accommodation is on the ground floor. Each resident 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 residents. The home admits residents who wish to smoke. Mr and Mrs Lingham were registered by Bromley Local Authority in 1992 as approved care providers with the boroughs former Adult Home Finding Scheme and they continue to Care Homes for Older People Page 4 of 27 Brief description of the care home provide care within their own home. At the time of our inspection in February 2009, the fees for this home ranged from £420 - £480 per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included an unannounced visit to Whitehouse. During the visit, the inspector spoke privately with each of the three people living in the home, and with the homes owners and manager. The premises used by the residents were inspected, including two of the bedrooms. Various pieces of documentation were examined, including care information and policies and procedures. The views of residents and relatives were sought by means of a postal questionnaire and the responses we received helped to inform the inspection visit. We have also taken into account the homes quality assurance assessment that it submitted to the commission in December 2008, and the findings of our annual service Care Homes for Older People Page 6 of 27 review of Whitehouse in February 2008 that indicated it was continuing to provide a good service. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed to make sure the home can provide the care they require. There is appropriate information available to help people choose whether Whitehouse is the right care home for them. There are contracts for residents with the terms and conditions of their stay. Whitehouse does not offer intermediate care thus standard 6 does not apply. Evidence: For two of the residents there are contracts in place between the placing authority and the homes owner. For a resident who is privately funded, the homes owner has provided a contract that sets out the terms and conditions of residency and the rights and responsibilities of each party. All three residents 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. Care Homes for Older People Page 10 of 27 Evidence: There had not been any new admissions to the home over the past year. From discussions and documentation inspected, it was evident the manager had carried out pre-admission assessments of people living in the home when they were referred for placement. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have a plan for their care, which is based on their assessed needs. People are supported to have access to any health care services they need. Their privacy is respected. People living in the home receive support with their medication as they need. Evidence: Each of the three residents care files were inspected. They contained care plans and supporting documentation. Each care plan was based on assessment of the persons needs and had been reviewed regularly. There had been liaison with health and social care professionals for specific aspects of residents care. All the residents confirmed in their questionnaire responses to us that they receive the medical support they need. Each of the residents looked well groomed, and were dressed in clothing that was appropriate for the time of year. The residents were alert and speaking freely with the homes owners. The inspector spoke with each of the residents privately. A relative responding to our survey commented, I notice no person enters an individuals room Care Homes for Older People Page 12 of 27 Evidence: without knocking and also stated that, everyones choice and their dignity seems to be respected. Two residents said they felt they were being looked after well and confirmed their privacy is respected. One resident whose verbal communication is restricted indicated he is happy and being looked after well. All of the residents stated in survey responses that they receive the care and support they need. Each of the residents is independently mobile and can manage their personal care with minimal supervision or occasional prompting. Each of the residents receive some supervision during bathing to ensure their safety. This includes checking the hot water temperature to make sure there is no risk of scalding. The male residents receive assistance with showering from the owners husband, while the owner helps the female resident. The manager makes sure that the residents have access to relevant health care services, including a GP, and that they are supported to keep health or social care appointments. A relative responding to our survey commented, The home has an excellent relationship with GP and outside healthcare services. Management of medications was generally satisfactory. The manager keeps records of medication administered to the residents. The manager stated that none of the three residents was able to manage their medication without assistance, and residents confirmed they preferred to receive this help. Medicines are stored in a locked cabinet in the kitchen, fixed to a solid wall, away from any direct heat source. There were no controlled drugs (CD) being stored in the home at the time of this inspection. The owner/manager was advised that the cabinet being used does not meet requirements for storing CDs, and would need to be replaced before any CDs are stored in the home in the future. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to keep contact with their families and friends as they choose, and are able to exercise their preferences about how and with whom they spend their time. A balanced diet is provided and residents like the food served. Evidence: Residents were generally content with their levels of activity. All stated in their responses to our questionnaire that the home arranges activities they can always take part in. One resident commented they go bowling and to the bingo club every week. A resident had photographs on his bedroom wall of the recent presentation of his bowling award and proudly showed his trophy to the inspector. Another resident likes to spend time watching TV or listening to the radio, while another likes to read books and play her mandolin. Residents 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, residents stated there were always activities arranged by the home that they could take part in. A relative responding to our survey commented, I know they have choices of venues if they wish to go out, options are varied to suit all. Care Homes for Older People Page 14 of 27 Evidence: People are welcome to have visitors in the home at any reasonable time. There is enough room for people to receive visitors in private other than in their own bedrooms. All the residents said that they enjoyed the food provided, and it was evident their likes and dislikes are taken into account. People said they always had enough to eat and drink. None of the residents need assistance with eating or drinking. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are appropriate policies and procedures in the home for managing complaints and for protecting residents from abuse. Evidence: The home has a complaints procedure, which is made available to residents and their families. People confirmed they knew how to make a complaint and who to speak to if they were not happy. All stated they would tell the owner/manager if something was wrong. The annual quality assurance assessment (AQAA) submitted to the commission confirmed there had been no complaints made directly to the home over the past year. A relative responding to our survey commented, I have never known or experienced any cause for concern within this care home. The local social services multi-agency safeguarding guidelines were available, and it was evident the owner/manager had undertaken relevant training. The home has a policy in place to preclude staff involvement in helping to make or benefit from residents wills. Interactions during the inspection visit between the owner, members of her family and the residents were appropriate and friendly. Two residents said the owner is approachable and caring towards them. Care Homes for Older People Page 16 of 27 Evidence: The commission has neither received nor been made aware of any complaints, concerns or allegations about this home over the past year. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Areas of the home used by residents were clean, comfortable and reasonably well maintained. Our previous requirements for two specific environmental improvements have been met. Evidence: The home is domestic in character, providing homely accommodation for its residents. The residents bedrooms are comfortably furnished and have personal items to make them feel homely. Residents have access to the ground floor of the home, which was comfortably furnished. The home admits people who wish to smoke, and two of the residents were seen smoking in the conservatory. On the day of this unannounced inspection, the home was clean, tidy and free from unpleasant odour. Each of the residents confirmed the home is always kept fresh and clean. The inspection visit was carried out during a period of very cold weather. The home was comfortably warm, and extra heaters had been provided in the conservatory and bedrooms for use as required. People said their bedrooms were warm during the cold weather. The homes layout and facilities were unchanged from the previous inspection, though some improvements had taken place. Two bedrooms had been redecorated and our Care Homes for Older People Page 18 of 27 Evidence: previous requirements to improve the handrails at the front entrance of the home and the light fitting in the shower room had been met. Fire safety measures had been improved, following a visit by the fire authority. These measures included the installation of a mains powered, linked fire alarm system and the fitting of a fireresistant door to the kitchen. There are domestic machines for washing and drying laundry. People were satisfied with the laundry arrangements and said they always had supplies of clean clothing. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes owners have experience of providing care to older people at Whitehouse. The owner/manager has undertaken training relevant to her work. Evidence: The owner/manager and two members of her family provide care to the residents. She and her husband (the other owner) were both present throughout the inspection. Maintenance issues at the home are dealt with by the managers husband or by external contractors. The care home does not provide waking night staff. It is the owners own residence and they are available if needed. Their son provides care to residents on a part-time basis. All persons giving personal care to residents are at least 18 and no persons under the age of 21 are left in charge of the home. In their responses to our questionnaire, each of the residents 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. A relative responding to our survey commented that the people providing care are very capable and caring. The owners have employed one of their relatives to work part-time in the home, to provide cleaning services. No other staff have been recruited to work in the home. The owner stated this relative has applied for an enhanced CRB disclosure, as it is intended Care Homes for Older People Page 20 of 27 Evidence: she extends her role in future to undertake some care work with the residents. The owner has attended training arranged by Bromley Council for carers in its Scheme for Adult Placement. The training included philosophy of care, moving and handling, food hygiene, and medication update. Evidence of other completed training included first aid and adult protection. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their representatives can be assured that a person with the necessary skills and experience is running the home. Evidence: The owner/manager has provided care in her own home for some years, including 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 home and received good reports. The owner was approved as a carer by the Bromley Scheme for Adult Placement but decided that Whitehouse will remain as a registered care home. The residents live with the owner/manager and her family, in a domestic environment. Residents views are sought informally, rather than operating a formal quality Care Homes for Older People Page 22 of 27 Evidence: assurance and monitoring system. Bromley social services has arranged the placement of each of the present residents, and evidence was seen of how the social services department monitors the quality of care provided to their clients. Finances for one person are managed by social services (the placing authority), with his pocket money and allowances accounted for by the homes owner/manager. A solicitor has power of attorney for one resident. The family of the third resident helps him with managing finances. As noted above under the environmental standards, fire safety measures had been improved, following a visit by the fire authority. These measures included the installation of a mains powered, linked fire alarm system and the fitting of a fireresistant door to the kitchen. The owners confirmed they hold regular fire drills. The owners were not able to produce up to date certificates for gas and electrical safety. Evidence was needed for both portable appliance testing and for a check of the electrical installation (see requirements). These issues were discussed with the owners, who undertook to obtain the necessary updates. Since our previous inspection, two of the residents had needed hospital treatment for specific conditions. We had not been notified of these admissions and the necessity to do this was brought to the owners attention (see requirements). Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 37 37 The registered person must notify the commission without delay when a resident is admitted to hospital. The home needs to let the commission know about any event that adversely affects a residents well-being or safety. 06/03/2009 2 38 13 The registered person must ensure the home has an up to date gas safety certificate. This is important to ensure residents safety. 06/03/2009 3 38 13 The registered person must ensure the home has evidence of up to date checks of the electrical installation and of the portable electrical appliances. This is important to ensure residents safety. 06/03/2009 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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