Inspection on 09/01/07 for Whiteoak Court Nursing Home

This inspection was carried out on 9th January 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

Whiteoak Court Nursing Home 11/07/08

Whiteoak Court Nursing Home 18/02/08

Whiteoak Court Nursing Home 10/01/06

Whiteoak Court Nursing Home 21/06/05

Whiteoak Court Nursing Home 02/11/04

Whiteoak Court Nursing Home 26/04/04

Whiteoak Court Nursing Home 13/11/03

Whiteoak Court Nursing Home 08/05/03

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

CARE HOMES FOR OLDER PEOPLE Whiteoak Court Nursing Home 15 Selby Close Chislehurst Kent BR7 5RU Lead Inspector Unannounced Inspection 9th January 2007 10:00 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 Whiteoak Court Nursing Home DS0000010146.V318531.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. Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whiteoak Court Nursing Home Address 15 Selby Close Chislehurst Kent BR7 5RU 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) 020 8467 0954 020 8467 0954 Messrs I R & RP Tappin and Mrs S M Schluep Mrs Mary Lyons Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing Notice issued 4 March 1999 Date of last inspection 10th January 2006 Brief Description of the Service: Whiteoak Court is a two-storey nursing home in Chislehurst registered to provide nursing care for up to 27 elderly persons. This is a well-maintained building and a larger than average property for this size home. Accommodation in the home includes bedrooms on the ground floor and the first floor. There is a lift to the upper floor. All bedrooms are fitted with a hand basin. On the ground floor there is a large dining-room and separate lounge area. There is car parking to the front of the building and a garden to the rear. The Home is staffed throughout the 24-hour period with both Nursing and Care staff. There is always qualified nursing staff on duty. The Home has the regular support services of a GP, chiropody, optician and dentist. Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection carried out over 7 hours. The manager of the home Mary Lyons assisted the inspector throughout the inspection. The inspector observed the staff, spoke with one relative, three members of staff, two service users and the Registered Provider. The inspector case tracked four service users’ files and examined three staff files. A tour of the environment was also undertaken. At the end of the inspection feedback was given to the manager, outlining the overall findings of the inspection, and the recommendations/requirements made. Residents spoken with were positive about the care they were receiving. The residents that were unable to communicate appeared to be well cared for and were happy in their surroundings. Comment cards received were mostly complimentary of the service; however one relative did comment that when he visited his father prior to him moving into the home he was assured that the home could manage his hearing aid. However when he visits he finds that he either does not have his hearing aid in or that the batteries are dead or they are fitted incorrectly. A comment card returned by the GP stated that any issues are dealt with promptly and there are no problems. What the service does well: Discussions with staff were positive and they talked about working in a friendly supportive environment where they are trusted to get on with their work. There is a comprehensive training programme. The home is well maintained, clean and free from odours. Service Users were complimentary about the care they were receiving. The inspector noted that Residents who were unable to communicate were very well cared for and appeared happy in their surroundings. There was one visiting relative at the time of the inspection and she confirmed that she was happy with the care her mother was receiving; comment cards returned by relatives were also positive Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 6 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. Whiteoak Court Nursing Home DS0000010146.V318531.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 Whiteoak Court Nursing Home DS0000010146.V318531.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): 1, 2, 3, 4, 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service User Guide were seen and needs to be updated. The registered person must keep under review and, where appropriate revise the statement of purpose and the service user’s guide and notify the Commission and the service users of any such revision within 28 days. (Req. 1) Prospective service users / relatives are invited to look around the home prior to making a decision. Relatives are invited to be involved in the pre-admission assessments if they wish to ensure the needs are identified, and to discuss care plans. The assessment record of the files examined by the inspector included the daily living activities and personal care needs that would be required before the service user is admitted. There was no letter to the service Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 9 user confirming that the home can meet their needs. The registered manager must confirm in writing to all prospective service users its ability to meet the service users’ needs prior to moving in to the home. (Req. 2) Service Users and/or their relatives are given a copy of the terms and conditions of residency, including fees to be paid and the room they will occupy. The home does not offer intermediate care. Whiteoak Court Nursing Home DS0000010146.V318531.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, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records seen evidence that residents’ health and personal care needs were constantly being identified and subsequently being met. Records contained comprehensive medical histories and also social histories on each service user. Residents’ preferences had been determined and record areas such as the agreed arrangements in the event of death. A sample of four care plans was undertaken. Risk assessments for each service user were seen but these are kept separate from the care plans. The Manager informed the inspector that in conjunction with the doctor a summary of each service users medical history is kept on file and this is useful for new staff to read up without going through loads of paper and this is also useful when a service user is admitted to hospital. These are updated as and Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 11 when necessary. Whilst all the necessary information is available, these are kept in separate files that make it difficult to access. The inspector recommends that the registered manager review the policy so that service users records are kept together in one file that makes it easy for staff to access. (Recommendation 1) Whiteoak Court Nursing Home DS0000010146.V318531.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. The lifestyle provided by the home is meeting the needs of the service users and links with family are actively encouraged. The menus seen provide meals that are in keeping with residents’ choices and assessed needs. EVIDENCE: Staff were observed interacting with service users in a positive and appropriate manner, reassuring residents who were unsettled. The activity organiser was present on the day of the inspection and a group of service users were being engaged in activities during the time of the inspection Visitors are welcomed to the home. The Clergy visit the home weekly or when requested. Meals are provided from a well-run kitchen. A new cooker was recently installed. Carefully prepared menus avoid meals being repeated too often. Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 13 The cook has extensive knowledge of individual residents’ requirements and this allow a good choice of meals and alternatives. Cultural and health needs are also catered for. Residents are offered snacks and drinks at regular intervals throughout the day, including fruit, tea and biscuits. The care staff were observed assisting those service users who required support whilst feeding. Whiteoak Court Nursing Home DS0000010146.V318531.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, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure was in place, and displayed in the lobby of the home so this is visible to all visitors to the home. EVIDENCE: The home has a clear complaints procedure. There were no recorded complaints since the last inspection. However the inspector noted from one comment card received that a relative had expressed concerns about how her father’s hearing aid is managed; this concern was not recorded in the complaints book. The registered manager must ensure that all complaints regardless of how trivial must be recorded in the complaints book, with the action taken and the outcome. (Req. 2) Staff spoken to were aware oF their right to express their grievances and of the Whistle Blowing procedures. Residents’ legal rights are protected by the systems in place, including a contract, the review of assessments and care planning and the complaints procedure. Whiteoak Court Nursing Home DS0000010146.V318531.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, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, a tour of the building, and discussion with staff. EVIDENCE: Externally the home is well presented with well-maintained gardens and driveway. Internally, the home is maintained to a high standard throughout. The home was clean, warm and comfortable. There is a continuous programme of refurbishment, the home has purchased a new hoist, new bedpan washer, 4 new beds and 6 new commode chairs, a new cooker, new carpets in a number of bedrooms and new lighting in each bedroom. There is also an new carpet shampooer, a new fridge, new suction machine, more fans for the home during Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 16 the hot weather (one for each room). Bedrooms are nicely personalised and safely arranged. The assisted bathrooms and toilets were in working order and in a hygienic state. Specialist equipment is provided for the residents as required and serviced as necessary to ensure safety. Water temperatures and boilers are all regularly tested. The ancillary staff was working hard to ensure the environment was of a good clean standard. Domestic staff had knowledge of COSSH requirements relating to the cleaning products they were using. The manager of the home ensures that the standard of the home’s cleanliness is acceptable. Whiteoak Court Nursing Home DS0000010146.V318531.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, discussions with the manager, examination of the staff rota, staff training and supervision. EVIDENCE: Staffing levels at the home are good. Rotas showed that staff levels have been maintained. The home has its own supply of Bank staff that is called on to maintain staffing levels when necessary. Agency staff is only used as a last resort. The home provided adequate and sufficient staffing levels to meet the needs of the residents in their care at the time of the inspection, with 4 – 5 carers and the night shift (from 8.00 pm to 8.00 am) staffing consists of one qualified nurse and two carers. Staffing on the morning shift consists of 2 – 3 qualified nurses with 5 carers, a cook, 3 domestics, a laundry person, and a handyman 3 mornings each week. The evening shift has one qualified nurse with 4 – 5 carers. Discussion with staff was very positive, all felt valued and all felt that they belong to a committed team. All the care staff except one has NVQ 2 or 3 qualifications. The manager of the home is fully supernumerary which enables her to complete her managerial duties. Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 18 The home adheres to robust recruitment policies and procedures. Staff files that were inspected had been subject to POVA /CRB comprehensive checks and these are recorded. All necessary processes had been followed and were evidenced. The home has a full and clear staff training programme that includes Dementia, Medication, Food Hygiene, Pressure Care, Nutrition, Use of syringe driver, Moving and Handling NVQ 2 and 3. Whiteoak Court Nursing Home DS0000010146.V318531.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): 31, 32, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, discussion with the Manager, Service Users and staff, examination of records and from the comment cards returned and from direct observation. EVIDENCE: The home is well run by a manager with strong leadership skills and supported by a team of nurses and experienced care staff. Care staff spoken with and records seen confirmed that care staff are receiving supervision as require under National Minimum Standard 36. This is an ongoing situation. Whiteoak Court Nursing Home DS0000010146.V318531.R01.S.doc Version 5.2 Page 20 Regular staff meetings are held and all staff involved in the running of the home. Several care staff is trained in first aid and food hygiene updates are continuous. Fire Safety training is in order; however the inspector recommends that the names of staff taking part in fire safety training is entered on the records. Health and Safety checks of equipment and systems within the home were evidenced to be in order. Accident and incident recording was completed in line with requirements. Portable appliance testing was up to date. Whiteoak Court Nursing Home DS0000010146.V318531.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 2 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 4 4 3 3 3 4 4 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 x x x 3 3 3 Whiteoak Court Nursing Home DS0000010146.V318531.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 OP1 Regulation 6 (a) (b) Requirement The registered person must kep under review and, where appropriate revise the statement of purpose and the service user’s guide and notify the Commission and the service users of any such revision within 28days. The registered person must confirmed in writing to the service user that the home can meet their needs. The registered manager must ensure that all complaints regardless of how trivial must be recorded in the complaints book, with the action taken and the outcome. Timescale for action 28/02/07 2 OP4 14 (d) 28/02/07 3 OP16 22.3 28/02/07 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 OP7 Good Practice Recommendations The inspector recommends that the registered manager DS0000010146.V318531.R01.S.doc Version 5.2 Page 23 Whiteoak Court Nursing Home review the policy so that service users records are kept together in one file that makes it easy for staff to access. Whiteoak Court Nursing Home DS0000010146.V318531.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. 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