Inspection on 03/05/06 for Whitestones

This inspection was carried out on 3rd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Whitestones 21/11/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Whitestones 129 Manchester Road Chapel-en-le-Frith Derbyshire SE23 9TW Lead Inspector Denise Bate Key Unannounced Inspection 3rd May 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 Whitestones DS0000062727.V290788.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. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whitestones Address 129 Manchester Road Chapel-en-le-Frith Derbyshire SE23 9TW 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) 01298 308166 01298 308130 whitestones@derbyshire.gov.uk Derbyshire County Council Christine Mulryan Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection First inspection Brief Description of the Service: Whitestones Care Home is a new purpose built home which has been built on the site of the old care home. It is registered to provide accommodation for 41 residents, comprising of 1 double room (for couples), 4 short term care beds and 37 long term care beds. All rooms have en suite bathrooms. Each room has its own private patio area or verandah. It is situated on the outskirts of Chapel en le Frith. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This new purpose built home has amalgamated residents and staff from two previously existing Derbyshire County Council Care homes, as well as being in the process of attracting new residents and recruiting new staff. At the time of inspection there were 30 residents and some new staff had just taken up their posts. The inspection was unannounced and took place over eight hours. During the inspection 7 service users, 3 relatives, and 3 staff members, including one of the deputy managers, were spoken with. The Manager was present throughout the inspection and provided assistance and information. The Statement of Purpose and Service User Guide were looked at prior to inspection. Written information was provided prior to the inspection and several conversations took place with the manager after the inspection to provide additional details and discuss medication administration arrangements. Several CSCI service user questionnaires were left at the home. A tour of the part of the building took place. A number of records were examined, including risk assessments and care plans, health and safety documentation, staff files, medication records and Regulation 26 visit records. Four residents were case tracked. What the service does well: What has improved since the last inspection? The home was registered in November 2005 and this was the first inspection. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Whitestones DS0000062727.V290788.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 Whitestones DS0000062727.V290788.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): 1, 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home have a system for assessing residents’ needs that generally ensures that the care provided can meet residents’ needs appropriately. EVIDENCE: The home have a Statement of Purpose and Service Users Guide that is clear and well written. Information about the home’s commitment to equal opportunities, choice, complaints, and sharing information with service users is clearly laid out. The Inspector was informed that copies of these documents are available in the office, and are given to prospective residents, but have not yet been made available to all current service users, although this is planned in the near future. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 9 Information in the Statement of Purpose and Service Users Guide makes it clear that prospective residents are invited to the home to spend time there as part of the assessment process, this can include an overnight stay. The home are not providing intermediate care at the moment, although it is understood that this is under consideration as a future development. Working closely in partnership with health colleagues to promote service user independence on a short term care basis is one of the business plan objectives drawn up by the manager. Whitestones DS0000062727.V290788.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): 7, 8, 9, 10, 11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Not all documentation could demonstrate that residents’ health, safety and welfare of residents and staff are generally promoted and protected. EVIDENCE: There is a good basic system in place for recording of care planning information. However, care plans seen on four case tracked residents were made up of a variety of old documents, new assessments and care plans (some of which had not been completed or signed and dated), none had recent evidence of discussion with residents, some assessments (e.g. moving and handling, nutrition) needed updating, some had very helpful monthly summaries while others did not. Most had detailed plans of daily living to ensure service user choice was respected, all had daily logs, a last wishes record, and a record of medical visits. Some care planning documentation included untoward incident/accident records where appropriate. Accurate, consistent and up to date care planning is of particular importance as there are large numbers of residents, including short term care residents, combined with new staff who need a clear guidance. The assessment process was discussed Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 11 with the manager, and it was noted that a couple of emergency admissions had been made over recent months. The inspector was informed that there is a regular programme of reviews in place, and that records are kept of contact with relatives and other carers. The home has a medication room and operated a Nomad system of medicine administration. The containers did not contain details of the individual medication as required by current guidelines as per Royal Pharmaceutical Society of Great Britain Guidance 2003. There were some gaps in recording and there was not a record of administering staffs signatures. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities are being planned that will generally suit the expressed preferences of residents. Most service users have regular visitors who are made welcome. Other community contacts are being developed. This will assist in contributing to the service users well being. EVIDENCE: The home are in the process of developing an activities programme. Some service users felt that there were not enough activities in the home, other service users preferred to use the their bedrooms as ‘bed sits’. There is a designated activities room. Residents are in the process of being consulted about outings, entertainment etc. The manager is in the process of rebuilding links with community groups. Three relatives were spoken to, most visit regularly and feel they are made welcome. Both service users and relatives felt the staff worked very hard, but some reticence was expressed in making individual preferences clear in some areas. The key worker system, commitment expressed in the Service User Guide, and service user ‘coffee morning’ meetings being held by the manager, Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 13 and planned quality assurance programme to be held in a few months time, should all enable service users to express their views clearly so they can be incorporated into the day to day running of the home. Most residents spoken to felt satisfied with the quality of food at the home, although some views were expressed that indicated more consultation was needed, e.g. choice when the menu does not meet a service users’ preference, some variation in the quality of meals. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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. There are systems in place which promote the protection of service users from abuse and neglect. A complaints procedure is in place. EVIDENCE: Derbyshire County Council has clear procedures for dealing with the safety of service users and protecting them from harm. Staff had training in adult protection. Staff spoken to showed an awareness of adult protection issues and would pass any concerns on to their line manager. Most residents and relatives spoken to were aware that there was a formal complaints procedure. The complaints procedure was displayed, and information about complaints is clear in the Statement of Purpose and Service User Guide. One issue was discussed in detail with the manager. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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. The standard of the environment within the home is good and provides service users with an attractive, spacious and well equipped place to live. EVIDENCE: A tour of the building took place. The home is newly built and offers spacious attractive accommodation with a choice of lounges, an attractive courtyard, an activities room, hairdressing room and kitchens that can be used by service users and their families. There is ample storage and office space, and a variety of aids and adaptations. Service users and their relatives are all very pleased with the standards of individual bedrooms, which all have en suite facilities including showers. All Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 16 rooms are spacious and have a private patio or balcony. Service users in the balcony rooms are risk assessed. There are two bathrooms with hoists, and other toilet facilities conveniently located. In one bathroom the hoist was out of order on the day of inspection but was to be repaired. All rooms are on the ground floor. The main outstanding issue relating to the environment is that none of the sinks have overflow pipes and therefore plugs cannot be used. All the sinks are placed at a low level. It is understood that the sinks will be replaced and residents consulted about the choice of a new style of sink. It was noted that some work remains to be done to tidy the garden area below the balconies. Some residents have only just received keys to their rooms, and keys are being provided for residents for access to their patio areas/balconies. Areas of the home seen on the day of inspection were clean and tidy. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. A trained and competent workforce are in place which meet the dependency needs of service users currently accommodated within the home. EVIDENCE: The staff rotas were discussed and found to provide adequate staffing to meet service users’ needs at the current time, although staff were often very busy. New staff have been recruited as occupancy levels have risen. Continued vigilance will be needed to ensure that staffing levels continue to meet service users’ needs as current service users become more dependent. Increased hours are going to be provided in the mornings which will benefit both service users and staff and enable the activities programme to be developed. It is anticipated that staffing rotas will be looked at again at future inspections,the building is very large and staff rotas need to take this into account when establishing care hours needed. The manager said that generally staff worked constructively together and that staff from the two previous care homes and new staff had integrated well. Staff spoken to were responsible and enthusiastic, and were observed being responsive to service users’ needs. There is a team approach to work, and staff said they feel well supported by both their colleagues and their managers. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 18 Staff files seen had evidence of CRB checks, copies of contracts and references. Derbyshire County Council has a thorough and detailed recruitment and selection procedure. Discussion with staff indicated that they felt they were offered good training opportunities and all staff spoken to were keen to make use of these. Most staff have been trained to level NVQ2. New members of staff felt well supported and had had detailed induction training. The manager is in the process of creating detailed training records for all staff to establish a rolling programme of mandatory training. A variety of training is planned for the near future including mandatory fire safety training, dementia training, basic food hygiene, and managing personal safety. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides clear leadership throughout the home with staff demonstrating an awareness of their roles and responsibilities ensuring that the home is run in the best interests of the residents. EVIDENCE: Service users and staff spoke positively about the manager and the management team. Each member of the management team takes responsibility for a particular area of the running of the home. The manager is sensitive to the effects of change on staff and residents, particularly as most of them have been working or living in much smaller care homes. She is working hard to create and consolidate the day to day running of the home on a firm and safe basis but this will inevitably take time. It was noted that the recruitment and induction of new staff, and the interest shown by prospective Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 20 and actual new service users has taken a great deal of management time. The inspector was informed by the manager and staff that supervision has taken place but not at the specified intervals. The manager has a plan in place to address this issue. The home is visited regularly by a representative of the registered person and two Regulation 26 visit reports were made available to the inspector. These indicated that matters of day to day management are dealt with, but copies of all the monthly visits were not in the home on the day of inspection. The manager has a business plan that clearly identifies plans for the coming year, e.g. introduction of key worker system, re-establishing community links. Progress is being made in achieving the goals identified. The inspector was informed that the home is moving towards a computerised system for managing residents’ finances. At present residents finances are kept in the safe and manual records kept, which appears to work satisfactorily. Residents have not yet been formally consulted during a quality assurance exercise, but this is planned in a few months time. In the meantime the manager is meeting over coffee with small groups of service users to discuss various aspects of the day to day running of the home. Minutes of these meetings are kept and were made available. These indicated that this ‘small group’ format was conducive to enabling service users to express their views. A variety of health and safety records were looked at and found to be satisfactory. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 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 X 2 X x X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 2 3 3 3 3 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 3 3 3 X 3 X 3 x Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 Requirement Care Planning documentation must be made consistent, up to date, and complete and include evidence that personal development plans have been discussed with the service user. Medication storage and administration must be carried out in accordance with current guidelines as per Royal Pharmaceutical Society of Great Britain Guidance 2003 A full and suitable programme of activities, outings and entertainment must be developed. Staff training records must be updated. Timescale for action 30/08/06 2 OP9 13 (2) 30/06/06 3 OP12 16 (2) (m) 18 © (i) 30/07/06 4 OP30 30/07/06 Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 23 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 2 3 4 5 Refer to Standard OP1 OP21 OP36 OP33 OP33 Good Practice Recommendations The Statement of Purpose and Service User Guide should be made available to all service users. Sinks should be replaced to ensure they are appropriate for service users comfort and safety. The programme of regular staff supervision to recommended timescales should to implemented. Copies of all monthly Regulation 26 visits should be available at the home. The planned quality assurance programme should be carried out. Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Whitestones DS0000062727.V290788.R01.S.doc Version 5.1 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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