Inspection on 06/02/06 for Whitfield Care Home

This inspection was carried out on 6th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Whitfield Care Home 22/04/08

Whitfield Care Home 24/04/07

Whitfield Care Home 08/11/06

Whitfield Care Home 28/06/06

Whitfield Care Home 11/08/05

Whitfield Care Home 08/03/05

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

CARE HOMES FOR OLDER PEOPLE Whitfield Care Home Whitfield Care Home 107 Sandwich Road Whitfield Dover Kent CT16 3JP Lead Inspector Chris Randall Unannounced Inspection 6th February 2006 09:25 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 Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 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. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Whitfield Care Home Address Whitfield Care Home 107 Sandwich Road Whitfield Dover Kent CT16 3JP 01304 820236 01304 825861 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 Kanagaratnam Rajaseelan Mr Kanagaratnam Rajamenon Vacant Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Resident under the age of 65 yrs is restricted to one whose date of birth is 16/01/1943. 11th August 2005 Date of last inspection Brief Description of the Service: The Whitfield Care Home is a large detached house, registered to provide care for 30 older people. It is located in the village of Whitfield, and is set back from the main road that runs through the village. At the front of the home there are parking facilities for several cars, and at the rear there is a small lawned area for residents’ use. Local shops and a post office can be found nearby, and there are also several public houses and take-away food premises. There is a regular bus service to the village. The town and port of Dover is within easy driving distance, with Deal, Sandwich, Canterbury, and Ramsgate just a little further away. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection held over one day with 6.25 hours being spent in the home, plus preparation time. As there had been a thorough announced inspection in August 2005 this inspection concentrated on checking the requirements and recommendations made at that time, checking on standards not previously covered, talking to and gaining the views of 9 service users, 4 visitors, and 6 staff, talking to the manager and the area manager, examining some records, and having a tour of the building. The majority of the requirements and recommendations made on the last report have either been actioned or are scheduled for attention in the near future. There was a friendly and welcoming feel to the home that was clean and, with the exception of one small area, was odour free. The acting manager has settled well into her post and is working hard at ensuring the home complies with the required standards. A visitor commented, “if you want a vote of confidence you can get it from these 2 happy people” and a service user commented, “I’m looked after very well”. A staff member said, “they are lovely here, like a family”. What the service does well: What has improved since the last inspection? Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 6 There have been many improvements made since the last inspection. Choices have been introduced at meal times. Residents meetings and staff meetings have been introduced. Staff and service users contracts have been updated to reflect the change in ownership of the home. The level of entertainment and activities has been increased and complementary outings to the hotel for lunch have been introduced Mandatory training has improved and a new training package has been purchased. The care plans are all in the process of being totally rewritten, they are now reviewed monthly and weights are taken and recorded monthly. The system of medication has been totally changed. Staff supervisions have now started. All opened food stored in the refrigerator is now covered and dated with the date of opening. Since the last inspection the home has been fitted with 2 new boilers. New foot operated hazard bins have been supplied in toilets. 7 bedrooms have been re-carpeted, and one has had complete new flooring. Two rooms have had new furniture. The roof has had some attention. A new dishwasher, microwave, washing machine and tumble drier have all been purchased. Keypad security has been fitted on several rooms restricted to staff access. Decoration of the toilets has been started and is ongoing. There have been some changes to the staffing rotas and the acting manager is now allowed sufficient time to carry out management responsibilities without her time being eaten into by the need to cover planned absences of staff. What they could do better: Although the manager is in the process of obtaining the service users views about the locks and the provision of keys for bedroom doors this has not yet been completed and the locks have not been changed. Risk assessments and a priority list are currently being completed for the provision of radiator covers to protect service users and this remains an outstanding requirement. Although the odour in the home had improved there is still one area where there is a lingering offensive odour and this needs to be addressed. Training still needs to continue to ensure that 50 of care staff are qualified to NVQ 2 or above. Although quotes have been obtained an occupational therapist assessment of the home has not yet taken place as previously recommended. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 7 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. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 8 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 Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 9 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): 2 Each service user has an appropriate written contract/statement of terms and conditions with the home. EVIDENCE: Service users contracts have been updated to reflect the change of ownership as required on the last inspection report. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 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 Service users can be confident that their health and personal care needs will be recorded in their care plan, be met by the staff and multi-disciplinary team, and that their rights to privacy and dignity will be upheld. EVIDENCE: Each service user has an individual plan of care that is formed initially from the pre-admission assessment undertaken by the home, and supplemented by a joint assessment for service users who are care managed. The care plan system is in the process of being totally revised and updated. The new care plans include Data protection forms, photograph, citizens rights information, admission record, medical history, choices, favourite and don’t like foods, meal times (which indicates ‘there are no restrictions to anyone requesting tea/coffee or other drinks’), social history and social contact, enjoyed activities, personal care and level of care required, individual risk assessments, communication and support needed, moving and handling risk assessment and support needed, walking/mobility, falls chart, waterlow assessment, continence assessment, nutritional risk assessment, medication agreement, appointments, last wishes, and daily report. Evidence was witnessed of monthly reviews with the service user or their representative, and of monthly weights being Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 11 recorded, as required at the last inspection. All service users have a key worker and this person is responsible for the updating of the care plans monthly or more often if needed. A staff member commented, “I am going on a course for care planning”. Service users health care needs are met by the staff of the home supported by a multi-disciplinary professional team of doctors, nurses, continence nurse, optician, dentist, and chiropodist. Service users commented, “its alright, they look after me well”, “I feel fine”, “if you need a doctor they will phone for you”, “there are no doubts they look after me”, and “if I want the doctor they get him for me”. Visitors commented, “they look after xxx very well”, “I am very happy with the care my mother is receiving”, and “he is well looked after”. Opportunities are given for appropriate exercise with weekly sessions of armchair exercises with Andy who also promotes good health and healthy eating. Any suspicion of pressure areas developing is reported to the district nurse, who provides guidance, support, treatment, and any necessary equipment. As the home has lost the services of the person who gave hand massage to the service users they have produced their own hand massage and manicure set for staff to perform this service. Nutritional screening is undertaken on admission and weights are now taken and recorded monthly, with any significant variations being explored. Staff members commented, “residents are well cared for, the carers are very good with the residents”, and “the care is very good, they are getting first class care and it shows, the residents are all happy”. The homes policies, and procedures for the administration of medication are sound. Since the last inspection they have changed pharmacists, have stopped using the dosette system and have changed to the Monitored Dosage System. All drugs received, administered and disposed of are properly recorded and recording of controlled drugs is appropriate. The administration of medication is carried out sensitively. As the current controlled drugs cabinet does not comply with the regulations a recommendation has been made that a purpose built cabinet is provided. The home has a dedicated drugs refrigerator and the temperature is recorded daily. Service users rights to privacy and dignity are upheld. Two service users both commented, “they treat me with respect”. Staff members commented, “Most like to be called by their first name but whatever they choose I respect their wishes, I always knock on doors before entering and I respect their dignity when washing them”, and “we change their clothes every day”. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 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 Service users have a lifestyle that meets their expectations and preferences, they are offered choices in all aspects of daily life, are encouraged to maintain contact with families and friends, and receive a balanced and nutritious diet. EVIDENCE: Choices are offered to service users in all aspects of their daily lives. Their interests and choices are recorded in their care plans. A staff member commented, “they have choices in meals, drinks, what to wear, when to get up and go to bed, where to spend their time”, and service users commented, “the food is nice, we get a choice”, “I go to the lounge occasionally”, and “now and again I join in the activities”. Choices are also explored at the quarterly residents meetings that have recently been introduced. 16 service users attended the last meeting and agenda items included what time tea is served, activities required, and choice as to whether breakfast be served in the dining room or bedrooms. As recommended on the last report the level of activities and entertainment has been increased. The owners have introduced the opportunity and provide the transport for a group of service users to be taken to the local hotel, which is in their ownership, each week for a complementary lunch on pensioners’ day. 4 service users and a member of staff taken to the hotel by Taxi each Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 13 Thursday. This has been a popular addition to the activities offered to the service users. As well as having a 2-course lunch, the service users also have the opportunity to mix with and chat to their peers from the local community. Other organised activities include ‘Chirpy Tunes’ each Monday, a service user commented, “The man plays the piano every Monday”. On the day of the inspection 15 service users were listening to the music and many were also singing along. A weekly keep fit session takes place on Tuesdays. There is bingo at least once a week, at the residents meeting the service users expressed their choice to play for money rather than prizes and this is now the norm. Service users commented, “I like the bingo, we have it once a week”, and “its good when we have a game of bingo”. The owners have indicated that the hotel’s mini bus will be made available to the home for outings in the warmer weather. In addition to organised events the manager has produced an activities box for staff to use with the service users in the afternoons on an ad-hoc basis. This box includes pens, paper, cards, bingo, dominoes, paints, and the equipment for manicures and hand massage. A staff member said, “we try with the activities box but they often decline”. Staff try to give service users 1:1 attention whenever possible. One staff member commente4d “we give them as much time as we can when we get them up etc.”. A popular visitor to the home is the hairdresser, a service user said, “the hairdresser comes every two weeks or when you want her”. Other comments included a service user who said, “now and again I join in activities”. One comment included on a quality questionnaire return to the home was, “any activities that stimulate the residents are good. Improvements have already been noted”. Maintaining contact between service users and their friends and families is actively encouraged. Visitors are always made welcome in the home and can see the service users in their own bedrooms, the main lounge, the dining room or the quiet lounge. Visitor comments included “we come in most days”, and “nothing is too much trouble”, service users said, “my niece takes me out once a week”, “I have quite a few visitors, they always make them welcome and they get a cup of tea if the want one”, “my nephew does all my shopping”, and “my grandchildren are very good”. Either service users themselves, or their families or powers of attorney, handle their financial affairs, the home only dealing with small amounts of petty cash for a few service users. Service users commented, “My nephew is doing my banking for me”, “my son is sorting my affairs, he has power of attorney”, and “I do all my own business, my niece supervises me”. Details of advocacy services are readily available in the home for any service user who needs this facility. Access to personal records is in accordance with the Data Protection Act. Service users are encouraged to bring in items of their own furniture and belongings to personalise their rooms and make them more like home. The service users are provided with a varied, appealing, wholesome and nutritious diet, which is attractively served. A staff member commented, “they have breakfast, lunch and tea and then they have sandwiches, cake and a hot Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 14 drink for supper”. The cook explained that food choices have been introduced for each meal. A service user commented, “sometimes they come and ask you what you want”, and a staff member commented, “They have food choices everyday”. For the lunch there is one main meal listed on the menu but service users are asked if they would prefer an alternative. A copy of the menu of the day is displayed on the board in the dining room. After lunch the cook goes around and asks the service users their choice for tea. General food choices are recorded in service users care plans and a list of preferences and allergies is kept in the kitchen. Service users can eat in the dining room, the lounge, or in their own bedrooms and at the recent residents meeting it was majority resident choice to continue having breakfast in their own bedrooms. A service user commented, “we have breakfast in bed”. General comments about the food were positive, with service users commenting, “the food is very good “there is plenty to eat”, and “the food is excellent”, a visitor said, “lovely dinners by the lovely cook”, and staff commented, “the food is really very good, all fresh meat, fish and vegetables”, and “the food is lovely, all fresh veg”. The home now records percentages of food eaten/returned for the lunchtime meal. Percentages for breakfast and teas are soon to be started. Both of the cooks are booked to attend a forthcoming Intermediate Food Hygiene course. At the last inspection a requirement was made that all opened food stored in the refrigerator or freezer should be covered and dated and this is now being done. Since the last inspection the kitchen has been fitted with a new dishwasher and a new microwave. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 15 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 Service users can be confident that their complaints will be taken seriously and acted upon, and that they will be protected from abuse. EVIDENCE: The home has a clear complaints procedure and a copy is on display in the main lounge. A record is kept of all complaints, and outcomes are also recorded. There had been one minor complaint lodged since the last inspection and this had been satisfactorily resolved. Visitors commented, “if I had any complaints I would go straight to Liz”, “so far so good”, “nothing is too much trouble”, and “we are pretty satisfied”, and service users said, “no faults with any of the girls, nothing is to much trouble”, and “no complaints at all”. Service users are protected from abuse. Recruitment procedures ensure that no new member of staff is employed until an enhanced disclosure has been requested and a satisfactory POVA first check has been received. The home has appropriate abuse and whistle blowing policies and all staff are all aware of their responsibilities. Staff members commented, “if I suspected abuse I would whistle blow”, “if I suspected abuse I would report it”, and “I did abuse with my NVQ, if I suspected it I would report and record it”. Protection of vulnerable adults is included in the new training package that the home has recently purchased. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 16 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): 22, 24, 25, & 26 Despite efforts to meet requirements additional actions are needed to ensure that service users live in a safe, comfortable and hygienic home with the specialist equipment they need to maximise their independence. EVIDENCE: As this section was looked at comprehensively at the last inspection the only standards that have been revisited on this occasion are those where requirements or recommendations were made on the last report. To gain a full picture the last report should also be taken into consideration. The home are investigating the recommendation on the last report that they arrange an assessment of the premises and facilities by a suitably qualified person, and quotes are currently being obtained from suitable occupational therapists and this task will be on the list of tasks to undertake. However as this assessment has not yet happened the recommendation has been repeated on this report. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 17 The new acting manager has carried out risk assessments on all of the radiators in the home and these are now being prioritised for covers to be provided. Some have already been completed and the toilets and hallways have been identified as a priority. The rest of the radiator covers are to be fitted in order of priority. The previous requirement has been repeated to ensure that this work is completed. Various strategies have been employed to rid the home of the offensive odours, for which a requirement was made on the last report. Actions taken include the replacement of various carpets and flooring. However there is still one area of the home in which an unpleasant odour was noted on the day of the inspection and therefore the requirement has been repeated. Although there are locks on service users bedroom doors, which can be easily opened in an emergency, and this was witnessed during the inspection, these locks do not allow for service users to have their own keys to maximise their independence and privacy. The acting manager is currently reviewing the situation individually with service users, carrying out risk assessments, and consultation as to which service users would wish and be assessed suitable to have their own key. Once this process is finished a priority list will be drawn up for the fitting of new locks. As the work has not yet been carried out this requirement has been repeated. A recommendation was placed on the last report that the provision of a sluice facility and a washing machine with a sluice programme should be included in any development plans for the home. The home has recently been fitted with a new washing machine but unfortunately on investigation it was found that this is not fitted with a sluice programme, therefore this recommendation has also been repeated on this report. A new tumble drier has been fitted in the laundry, and new foot operated hazard bins have been sited in all toilets. Other general improvements to the home since the last inspection include work to the roof, the fitting of 2 new boilers, new carpet in 7 rooms and total new flooring in one room, decoration of the toilets is ongoing, 2 bedrooms have been fitted with new furniture and all bedrooms are now redecorated prior to admission of a new service user. Internal security has improved with the fitting of keypad access to staff only areas General comments on the environment included service users who said, “its nice and comfortable”, “the bedrooms are quite nice”, “its comfortable”, “its nice and its warm”, and “they keep it nice and clean”, and staff who commented, “its alright here, all kept up quite well”, “I think they need more cleaners but they do their best”, and “the new owners have made changes for the better, with repairs and training”. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 18 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 Service users needs are met by a sufficient number of caring staff. The homes recruitment processes are sound and protect the service users but NVQ training needs to be increased EVIDENCE: The staffing rotas had been revised and the new rota started on the day of the inspection. Care staff have changed from 4 shifts a day to 3, and the number of care staff has been increased to 4 on duty each morning to ensure the needs of the service users are met. In addition there is a domestic and a laundry assistant employed each day. Domestic hours have been reduced slightly and the home will need to keep a close eye to ensure that the cleanliness in the home does not suffer as a result of this. Staff commented, “we are a bit short on the domestic side at the moment but any problems we report to Liz”, and “they have a domestic at the weekends to do beds, bins, basins and commodes”. There is a good teamwork atmosphere in the home, staff commented, “the girls are good”, “we all work together”, “the staff are all good”, and “you have to work as a team and we all get on with everyone”. Currently 6 of the 15 care staff hold NVQ2 (40 ) and two of these also have NVQ3. One carer is currently undertaking this training and a further 2 are scheduled to start shortly. A staff member commented, “the NVQ is putting into practice what you are doing but it also helps you to know why you do things”. A recommendation has been added that training continues to ensure that 50 of the care staff are trained to this level. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 19 Recruitment procedures in the home are sound and designed to protect the service users. No new member of staff is employed in the home until 2 satisfactory references have been received, an enhanced disclosure has been submitted, and a satisfactory POVA first check has been received. New staff work under supervision at all times until a satisfactory full enhanced disclosure is received. All members of staff receive a copy of a statement of terms and conditions and these documents have recently been updated to reflect the revised ownership. Currently the manager is ensuring that all staff are up to date with their mandatory training and staff are booked on various courses over the next few weeks. Staff members commented, “I’m booked to do manual handling and infection control courses”, and “I have done fire training”. Once this cycle of training has been completed the home will be making use of a new training package that they have recently purchased which includes such subjects as induction, legislation, protection of vulnerable adults, medication, aggression, infection control, moving and handling, dementia, diet and nutrition, risk assessment, fire, health and safety, basic first aid and food hygiene. General comments about staff included service users who said, “the staff are very nice”, “the staff are alright”, “the staff are very friendly and caring”, and “the staff are pretty good”, and visitors who commented, “lots of lovely smiling staff”, and “on the whole the girls are very good, they all have a good sense of humour”. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 20 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, 36, & 37 Service users benefit from a well run home where an open and inclusive ethos is promoted. Record keeping at the home protects the service users interests. EVIDENCE: Since the last inspection a new acting manager, (previously the deputy manager), has been appointed; and her application for registration is now awaited. A recommendation has been made that this application should now be progressed. The acting manager holds an NVQ 2 & 3 in care and is currently waiting to be assessed for her NVQ 4 & RMA. Her appointment has met with the approval of service users, visitors, and staff. A service user said, “Liz is very good, they are just getting it nice now”, a visitor commented, “Liz is very good”, and staff members said, “Liz is brilliant”, “Liz is very good to us, she is special to me”, and “she is doing a really good job”. There are clear lines of accountability within the home and with the external management and on the day of the inspection the area manager was visiting the home. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 21 Management time has increased since the last inspection and the acting manager is no longer required to fill in for holidays and planned staff vacancies. Staff commented, “It’s all very good from the top down, and “the new owner is very good”. The ethos in the home is open and positive, and the acting manager promotes an open door policy and an inclusive atmosphere. Staff commented, “Liz does very well, she supports us well, and we can talk to her at any time”, “Liz is supportive”, and “Liz is lovely, really good, she tells me if you have any problems come and talk to me”. Since her appointment the acting manager has introduced both residents and staff meetings and these have been very successful and give an arena for service users and staff to have their say. The home has effective quality assurance and quality monitoring systems in place and is about to add quality questionnaires for visiting professionals to the existing service users and visitors questionnaires. In addition to the quality questionnaires service users views are also sought at residents meetings and on 1:1’s with the acting manager. On the last report a recommendation was made with regard to staff supervisions, the paperwork has now been put into place and supervisions have recently started to take place on a regular basis. A staff member commented, “We have 1:1’s and staff meetings” Records kept at the home are kept up to date, accurate and relevant, and are securely stored. Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 22 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X X X 2 X 1 1 1 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X X 3 3 X Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 23 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 Standard OP24 Regulation 16 2c 12 4a 13 4ac Requirement Timescale for action 30/04/06 2 OP26 16 2k, 23 1d 3 OP25 13 4a,c Doors to residents bedrooms shall be fitted with locks suited to their capabilities and accessible to staff in emergencies and all residents shall be provided with a key to their room unless their risk assessment suggests otherwise (Previous timescale of 31/12/05 not met) The home shall be kept clean, 30/04/06 hygienic and free from offensive odours throughout (Previous timescale of 30/09/05 not met) The covering of all radiators shall 31/05/06 continue in accordance with the homes risk assessment and priority list (Previous timescale of 31/12/05 extended) Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 24 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 OP9 OP22 OP26 OP28 OP31 Good Practice Recommendations The home should purchase a metal controlled drugs cupboard which complies with the misuse of Drugs (Safe Custody) Regulations 1973 The home should arrange for an assessment of the premises and facilities by a suitably qualified person with specialist knowledge of the client group The home should consider the provision of a sluice facility, and a washing machine with an appropriate sluice programme should be fitted in the laundry. Training should continue to ensure that a minimum of 50 of care staff are trained to at least NVQ level 2 in care. An application for Registered Manager should be submitted to CSCI Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Whitfield Care Home DS0000063744.V268512.R01.S.doc Version 5.0 Page 26 - 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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