Inspection on 31/12/05 for Whitelodge

This inspection was carried out on 31st December 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

Whitelodge 19/11/08

Whitelodge 12/12/05

Whitelodge 25/07/05

Whitelodge 25/01/05

Whitelodge 25/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Whitelodge 101 Downend Road Fishponds Bristol BS16 5BD Lead Inspector Jon Clarke Key Unannounced Inspection 22nd November 2006 09:30 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 Whitelodge DS0000045884.V320765.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. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitelodge Address 101 Downend Road Fishponds Bristol BS16 5BD 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) 0117 9567109 Quality Care Homes Ltd Ms Karen Jayne Notton Care Home 21 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (19) of places Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 21 persons aged 65 years and over including 2 persons with dementia 12th December 2005 Date of last inspection Brief Description of the Service: Whitelodge is a care home for older people in the Fishponds area of Bristol it is one of three homes owned by Quality Homes Ltd. Accommodation is provided for 17 residents over two floors with stair lift access. All of the residents rooms are for single occupancy 14 have en-suite facilities. There are two lounges with their own dining areas. There is direct access to the garden from one of the lounges. Whitelodge is registered to provide care for 15 individuals over 65 and 2 over 65 with dementia. One of the aims of Whitelodge is to ensure that living in a residential setting is a positive experience (from Statement of Purpose) Fees: £348-500 per week dependant on need. Fully Inclusive other than Community Health Services such as chiropody, dental etc. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. The manager was present throughout the inspection. As part of this inspection a number of records were looked at including care plans, pre-admission assessments, daily care records, recruitment and training. The arrangements for managing medication were also examined. There was also an opportunity to discuss with residents and staff their experience of living and working at Whitelodge. Pre-Inspection questionnaires “Have Your Say” were sent to the home. 13 of 15 sent were returned having been completed by residents, 8 Relative Comment Cards were also received. These have been used to inform the inspection and reach conclusions about the quality of service. What the service does well: Whitelodge provides an environment where individuals with a range of needs at times of a high dependency can receive care in a supportive and caring way. A resident commented “staff are all so kind to me, there’s such a nice atmosphere”; other comments included “it’s the friendliness and caring I like”, “staff are very friendly and will try to help you in anyway they can”. Staff have a good level of experience and extensive training is made available so that staff have the necessary skills and knowledge to meet identified health and social care needs. A resident commented, “problems dealt with in a manner which only trained staff could apply”. There is good retention of staff which helps in providing continuity of care and a strong team who work well together. A member of staff who had worked at other care homes commented that they “all worked well as a team much better than other homes I have been in”. Relative’s comments (from homes questionnaire and CSCI comment cards) illustrate the high regard in which the home and staff are held: “Whitelodge is beyond expectation, staff are exceptional. What a wonderful place! 10/10”. “My -------- is happy and secure and very well cared for”. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 6 “we have found the staff understanding at all times and ----- has received the best possible care” “he is happy and secure and very well cared for………I feel at ease knowing he is well cared for”. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Whitelodge DS0000045884.V320765.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 Whitelodge DS0000045884.V320765.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: A number of pre-admission assessments were looked at and showed that the home undertake assessments providing them with information about the health and social care needs of the individual. Included are care needs about daily routines such as dressing and undressing, mobility. Where an individual has mental health difficulties a mental health assessment is obtained. If an individual is known to the local authority a copy of the social services care assessment is also obtained. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 9 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. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents can be met. Residents’ health needs are well met. Arrangements for administering medication make sure that residents are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 10 A number of care plans were looked at and showed that there is good practice in this area. Full and detailed information is recorded about care tasks and support that individuals need particularly personal care and mobility. Included are Life Profiles providing information about the social history, interests and routines of the individual this is good practice in that they help staff understand and see each resident as an individual to provide more personcentred care. However staff need to be thorough in completing these profiles in that some were only partially completed. This was discussed with the manager at the time of this inspection. Risk assessments are completed and regularly reviewed, as are moving & handling assessments. Care plans had been signed by the individual evidencing their involvement. In talking with a resident they were aware of their care plan and confirmed they had discussed “the help I need” with a member of staff. Residents have full access to local health service and there is visiting district nurse service available where individuals need such support. Other services such as chiropody, dental and optician are all arranged by the home and will visit the home or where able residents may use local services. The home has good links with GP surgeries and residents can choose to remain with their GP if they are still in the catchment area. Responding to Do you receive the medical support you need?’ in the pre-inspection questionnaire 13 out of 15 residents said yes and 2 usually. The storage and administering of medication was looked at and there was the required secure storage including separate secure storage for controlled drugs. Returns of medication are recorded as required with signature of pharmacist or their representative. Administering records were seen and had been completed accurately with no gaps in records as to medication being given. It is the practice of the home that residents who are able can self-administer medication. At the current time no residents are self-administering. In talking with residents about staff eg did they feel staff treated them with respect comments from residents included “as I would want” “can’t fault them” “it makes all the difference the little things they do” “staff very good”. Staff were also observed talking and assisting residents in an appropriate and sensitive way particularly in relation to one resident who was restless and repetitive in her questioning of staff. Staff were also observed knocking on residents doors before entering and when asked a number of residents confirmed “they always do that”. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 11 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. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals which are balanced and which meet the dietary needs of individuals in the home. EVIDENCE: The home arranges a range of activities including: quizzes, board games, bingo, sing-a-long. There is a monthly religious service. A clothes party was arranged in November and outside entertainers regularly come into the home. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 12 Since the last inspection a member of staff has been employed to undertake activities sessions at present this is twice a week though the manager was hoping this could be increased. In response to the Have Your Say question ‘Are there activities arranged by the home that you can take part in?’ 11 out of 15 said always 1 usually 1 sometimes. 2 residents said they choose not to take part in activities. In talking with residents they stated that they felt there “was enough going on” “enough for me”. The home has an open visiting policy and in a Relatives survey undertaken by the home 60 said the home was “warm and welcoming” with 90 saying staff were approachable. A comment from a relative was that they were “very satisfied and find staff approachable”. When asked residents said when they had visitors they felt staff were always welcoming “its never a problem having my family coming to see me”. In talking with a number of residents they spoke of their ability to choose how they spend their day and the flexibility in the home particularly in getting up and going to bed. One resident who spent most of her time in her room said how she felt staff accepting “that it was up to me they never try to get me to do different” though she was made aware of activities by staff again she chose not to take part “its my choice”. Another resident said how they were always “able to do as I like ” and another “ I don’t feel I have to do anything if I don’t want to”. Looking at daily records there was evidence that staff are flexible in for example giving baths one comment said how an individual didn’t want to have bath at that time and staff had said to have another day”. Residents confirmed the quality of food and daily menu offers a “good choice” one resident described the food as “good and wholesome” another as “quite good” and “I always enjoy my food”. A resident who has particular likes and dislike said she that staff knew what she liked and she always got what she wanted. In response to questionnaire 9 residents said they always liked the food and 4 said they usually do. Menus were looked at and showed there was good variety of food available. At a recent residents meeting suggestions had been made about changes to the menu and these had been acted upon. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 13 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 a complaint procedure in place so that individuals are able if they to make a complaint and voice their views about the service they receive and know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: Residents when asked were aware of their ability to make a complaint or say if they were unhappy about anything. Copies of the complaints procedure are displayed in the home and this makes it clear how individuals can make a complaint. Residents said that they would “always say” “tell staff” if they were unhappy about anything. Importantly they felt “something will be done” “staff always listen to what I have to say”. In response to question (Have Your Say questionaire): ‘Do staff listen and act on what you say?’ all respondents said yes and again all said they knew how to make a complaint though for some this was about would they make a complaint. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 14 8 relatives comment cards were returned; all stated they were aware of the home’s complaints procedure and none had needed to make a complaint. Since the last inspection a complaint was made to the CSCI about the care received by a resident. The complaint was not upheld however requirements were made about training of staff specifically relating to the care of individuals at risk or having pressure sores and about record keeping. These requirements have now been met. All staff have completed Adult Protection training and the home has policies and procedures about protecting individuals from abuse and actions to take in the event any allegations of abuse are made. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 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. 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. There are good arrangements in place to ensure that residents live in an environment that is safe, well maintained, clean and hygienic. EVIDENCE: In looking around the home during this inspection there was evidence through the good state of repair and well-decorated areas of the home that there is regular maintenance of areas of the home and re-decoration. In the past year the home has extended through conversion of the loft area which was previously a flat. This now provides well-furnished and fitted rooms with ensuite toilet facilities and shower room. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 16 On the ground floor alterations have been made to increase the size of the lounge area with new fitted carpet and furnishings making an attractive seating area. Access to the first and second floor has been provided with the installation of a lift, thereby improving the facilities to residents of the home. The inspector noted however that the top lounge would benefit from updating and improved lighting; this was mentioned by a resident as being poor. This lounge and dining area in the inspector’s view did appear rather tired and uninviting in comparison with the lower lounge. The home has procedures in place about safe working practice particularly in maintaining hygiene and dealing with infections with staff having undertaken training in Infection Control. Residents spoke of the home as “always” being clean and in the questionnaire all respondents said the home was “always” fresh and clean. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 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 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. Staffing arrangements in the home are good so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible - the health and welfare of residents is protected. EVIDENCE: In discussion with the manager about staffing levels in the home it was clear that current staffing is good. Staffing arrangements are 2 on duty am, 2 pm with waking night and sleep-in staff available in the event of an emergency. There is also very good retention of staff which helps to promote continuity of care. It was discussed with the manager how the introduction of dependency levels monitoring would assist in ensuring that staffing continue to meet the needs of residents and would identify where needs have changed. It would also help in making sure the needs of prospective residents can be met within the existing staffing. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 18 All staff have or are undertaking NVQ training to level 2 or 3 and the home has exceeded the 50 of staff who have completed this qualification. Recruitment records were looked at and showed that the required checks had been undertaken: CRB (criminal record) and two references. Application forms provide complete and detailed information about the applicant with full employment history, applicants also complete a medical declaration stating that they are able to undertake the needs of the post for which they are applying. Training records for 4 members of staff showed they had all undertaken the necessary mandatory areas of training: moving and handling, first aid, adult protection and health and safety including fire safety. In addition staff have attended training around dementia and medication. The manager was in the process of arranging training about care of individuals who are at risk or have pressure sores. This was a requirement made as a result of a complaint investigated by the CSCI. It should be noted that this training was required to improve the level of knowledge and skills of staff in this area. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 19 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): 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for residents and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff is protected. However improvement must take place to ensure - as far as possible - the safety of residents and staff with regard to public access to the home. EVIDENCE: Regular residents meetings are held and minutes showed that these have been used to inform residents about changes in the home such as new staff and Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 20 importantly residents have been able to voice their views about the service they receive. In particular residents have commented on the food and activities and made suggestions about what could be improved. In the current year no residents questionnaire have been issued so that residents can formally voice their views though a relatives questionnaire has been undertaken. It was discussed with the manager as to the frequency of such resident’s questionnaires so that there is evidence of the quality of the service they receive and identifying areas for improvement. Such Quality Assurance questionnaires would also inform the CSCI of the overall quality of care provided at Whitelodge. Relatives Comments cards received by the CSCI all stated they were satisfied with the overall care provided by the home. Health and Safety records were looked at specifically those relating to equipment and fire safety systems in the home. Records showed there is yearly maintenance of equipment such as hoists and lift. A Gas Safety certificate was issued on 23/02/06. Fire alarms tests are held weekly with emergency lighting monthly as required. The Fire System was serviced on 21/07/06. Staff complete drills at the required intervals. Environmental as well as Fire Risk assessments have been completed and reviewed. As stated elsewhere in this report the safety of residents and staff in relation to visitors to the home was discussed as result of comments received from a relative. Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 21 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 X 3 X X X 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 3 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 X X 3 X X X X 2 Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 22 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 OP38 Regulation 13(4)(c) 17(2) Schedule 4.17 Requirement Ensure that unnecessary risks to the health or safety of residents are identified and so far as possible eliminated. Keep a record of all visitors to the home. (This relates to making sure as far as possible that staff are aware of visitors to the home and instructions to visitors are prominently displayed about signing visitors book and staff make sure this happens). Timescale for action 22/11/06 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 Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Whitelodge DS0000045884.V320765.R01.S.doc Version 5.2 Page 24 - 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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