CARE HOMES FOR OLDER PEOPLE
Whitestone Lodge Residential Care Home 56 - 58 Church Road Roby Knowsley Merseyside L36 9TP Lead Inspector
Miss Orla Murphy Unannounced Inspection 21st February 2006 11:00 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 Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 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. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Whitestone Lodge Residential Care Home Address 56 - 58 Church Road Roby Knowsley Merseyside L36 9TP 0151-480-4237 0151 489 9505 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) Mr Caulton Mrs V Caulton Mrs V Caulton Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability over 65 years of age of places (20) Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 20 OP and up to 20 PD (E) Date of last inspection 05/07/05 Brief Description of the Service: Whitestone Lodge is located in the Roby area of Liverpool, close to Huyton Village. Private individuals, Mr & Mrs Caulton, own the home. It is located in a residential area. The home can accommodate up to 20 residents who are of old age or with a physical disability. Accommodation is over 2 storeys and bedrooms and bathing areas are on both floors. There is a large garden to the rear of the house which residents use. The house is accessible to public transport and Huyton, Prescot and Liverpool are all within reach from the home. Limited parking is available to the front of the home but parking is available on side streets. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Inspection was unannounced and neither residents nor staff knew the Inspector was coming. The last inspection report was examined and some requirements needed to be followed up on this visit. The Inspection was the second in the home’s required visits, which are 2 inspection visits per year. 5 residents and three staff were spoken to at the inspection. Two residents were “case tracked”. Case tracking means that the Inspector concentrates on the care given and experiences of one or more residents to get an idea of what is like to live there and how that person’s needs are being met. Case tracking also shows the inspector where needs aren’t being met. A variety of records (care plans, medical notes, complaints records, assessments, medication sheets, meeting minutes, menus, timetables, staff rotas and significant events) were examined. What the service does well: What has improved since the last inspection?
Records and the standard of recording have improved since the last inspection. The Care Manager has had external support and new records and systems are
Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 6 being introduced. These were all examined and will benefit staff in developing administration & recording in the home. New policies and guidance are in place and these were of a good standard. Some areas have been redecorated 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. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 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 Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 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 the following standard(s): 3 All residents are assessed by both the placing authority, (social services) and by the Home Manager to ensure the home can meet their needs, before they move into the home. EVIDENCE: Two residents were case tracked. All assessments for these residents were examined. These all were clearly laid out the areas the resident needs help with and their likes/dislikes and preferences. The new assessment process seen is more detailed and looks at the individual’s social history, which will be very positive. Relatives and other staff involved with the resident (such as GP’s/Nurses) are asked to contribute to the assessment but this isn’t formalised under the current assessment. This helps the Manager make a decision as to if the service would be able to care for the potential resident. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 9 Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 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 the following standard(s): 10 Residents feel they are respected & treated in a dignified manner. EVIDENCE: Staff records were positive and respectful of the individual’s privacy. Staff were observed interacting respectfully and kindly with residents in this and previous inspections. Staff dealt with personal care discreetly, and were available to support and chat to all residents and visitors throughout the inspection. One of the residents case tracked was staying in the home for a trial stay. He stated staff were “ very kind, cant do enough for me”. Other residents spoken to were very clear that staff respected all aspects of their lives and treated them in a dignified way. One resident said, “ They (staff) are lovely, very helpful and nice”. It was evident from records and observations that staff and residents have a long-standing positive and trusting relationship. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 14. Residents feel they have a range of experiences that meet their needs in the home. Residents have as much choice as they wish to. EVIDENCE: Residents spoken to were enthusiastic about events in the home and say they have been given a lot of opportunity to be involved with local events, groups and leisure. Visiting clergy meets spiritual needs and keeps people in touch with the community. Particular activities are popular. On the day of the inspection, some residents were having a quiz & some reading, listening to music or talking to visitors. The service is not restrictive and residents do as much or less as they wish. Some residents have particular routines they like to maintain & others activity & choice depends on their health & wellbeing. Generally within the home residents choose activities, meals, décor, events and visitors. One resident spoken to stated she felt staff were helpful to her and she felt happy choosing her routine & telling staff what she would like to do. One of the residents case tracked said he felt that staff encouraged him to make choices but also supported him when he needs advice.
Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 12 Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. Residents are comfortable reporting any concerns or complaints they have and the home’s procedure is satisfactory. EVIDENCE: All residents spoken to knew that they could make complaints if they wanted to. No-one said they were reluctant to do this and 2 residents also said if they had a problem they would mention it to staff or the Managers as they felt it would get sorted quickly. The complaints procedure is on display in the home. There have been no complaints to the home or CSCI in the period since the last inspection. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 26. The home is clean, hygienic and comfortable. EVIDENCE: All areas of the home seen were clean and hygienic. Communal areas were tidy & comfortable. Some communal areas were being redecorated. Residents said the home is always clean and tidy and one resident said that rooms were kept to a good standard. Domestic staff are employed and cleaning products are stored securely in line with Health & Safety legislation. It is evident through observation that staff respect residents belongings, personal space and the building, and as such it is maintained well. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30. The recruitment processes are good and ensure that residents are protected. EVIDENCE: 4 staff files were inspected and the standards for the recruitment of staff are good. All files contained necessary details including 2 satisfactory references, identification documents, POVA [Protection of Vulnerable Adults] and Criminal Records Bureau [CRB] checks. Staff training & qualifications were on file, in addition to original applications, staff contracts, employee information and proof of qualifications. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35. The home is run in the best interests of residents but this needs to be reflected in records more. Finances, (assets/income), are managed by relatives, with minor monies managed by the home. EVIDENCE: The standards of care & accommodation are maintained daily and residents reinforce this with their positive feedback. Care Plans and daily case notes show that staff respect residents and are aware of their moods, welfare and activity but new care plans give more opportunity to develop goals for all areas of the individual’s life. Residents commented on how well staff care for them and their rooms/belongings. Staff supported residents with personal care very discreetly on the day of the visit. The focus of discussions with the Manager, staff and residents showed that the welfare of residents was paramount. Some of the residents do not have the capacity to manage their own finances, or choose not to. The policy of the home is for relatives to manage this. The manager manages personal allowances in house with input from relatives.
Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 17 Records are maintained and receipts kept for money spent. These were seen for the resident’s case tracked and they were satisfactory. Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 18 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X X Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES 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. 3. 4. 5. Standard OP3 OP7 OP7 OP37 OP30 Regulation 15 15 15 17 18 Requirement The new assessment tools must be introduced. Care Plans must be detailed and all completed in the new format. Full dates must be recorded where plans are reviewed. All new records currently being updated must be introduced. All staff statutory training must be brought up to date and a Training & development Plan introduced. The cook must undertake Food Hygiene training. Timescale for action 21/04/06 30/06/06 30/06/06 01/06/06 30/06/06 6. OP27 18 01/05/06 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 Whitestone Lodge Residential Care Home DS0000021473.V285525.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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