Inspection on 27/11/07 for Whitgift Foundation The

This inspection was carried out on 27th November 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

Whitgift Foundation The 15/09/06

Whitgift Foundation The 10/01/06

Whitgift Foundation The 11/11/04

Whitgift Foundation The 09/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Whitgift Foundation The Whitgift House 76 Brighton Road South Croydon Surrey CR2 6AB Lead Inspector Jon Fry Key Unannounced Inspection 27th November 2007 10:10 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 Whitgift Foundation The DS0000019047.V353103.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. Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitgift Foundation The Address Whitgift House 76 Brighton Road South Croydon Surrey CR2 6AB 020 8760 0472 020 8681 1269 matron@whitgiftfoundation.co.uk 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) The Whitgift Foundation Mrs Philomena Kavanagh Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th September 2006 Brief Description of the Service: Whitgift House provides residential and nursing care for up twenty older people. The home is owned and managed by the Whitgift Foundation. The home shares its grounds with a secondary school and sheltered accommodation, which are both run by the same organisation. The home is well maintained and the extensive grounds are well kept, with trees, lawns and a cricket pitch. Shops and local public transport links are all within easy reach. Accommodation is provided in large single rooms over two floors. Each room has a doorbell and some have a letterbox, a small kitchenette and en-suite toilet facilities. Weekly fees currently range from £635 - £735. Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent six hours in the home and spoke to nine people who live there. We also spoke to one relative or friend of an individual and four staff members. We looked at records and documents, including two people’s care plans and the home’s User Guide. Completed surveys were received from two people who live at the service. What the service does well: What has improved since the last inspection? What they could do better: The challenge is to make the care and support provided even more person centred. People with dementia or with high support needs in particular could be better served by more individualised support from staff with the necessary specialist training. Care plans could be made better by containing much more individual information about all areas of their lives. Staff should see occupation, engagement and ensuring well being as very important areas of their work. Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 6 Mealtimes on the first floor could be made more positive for all involved. The service needs to think creatively about how this can be done and make sure that staff have the training to achieve this. 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. Whitgift Foundation The DS0000019047.V353103.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 Whitgift Foundation The DS0000019047.V353103.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, 3 and 4. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available about the home to help people make a choice about living there. Assessments are completed before people move in and these are kept under review. EVIDENCE: We saw that a guide is available which tells people about the home and the service it offers. This is currently available in normal type and large print on request. We have recommended that it be made available in other formats such as pictures and audiotape. Assessments had been completed for two people whose files we looked at. These record some good information about physical needs but could be improved to be more person centred and capture more detailed information Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 9 about the person’s background and their likes and dislikes. This may help staff to plan the care better and tailor the service provided much more to the individual. We did see that the activities co-ordinator obtains some good information about individuals once they have settled in. This information could also be better used in the person’s individual care plan. We found that one person had been admitted to the home whose primary need was their dementia. The service is not currently registered to admit people whose needs focus mainly around their dementia and we have asked them not to admit any further people with these needs. Whitgift Foundation The DS0000019047.V353103.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 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans look at the health, personal and social care needs of individuals but need improvement to be even more person centred. Arrangements for the handling, storage and administration of medication are good. The health needs of individuals are well addressed by the home. EVIDENCE: We looked at the care plans for two people. Each care plan sets out how their needs are to be met and this document is reviewed regularly. The plans could be improved to contain more individualised information to help staff deliver person centred care. We did see some good detail recorded about the person but this tended to be mainly about their health and physical care. Many actions recorded were however too generalised and repetitive such as ‘ensure medication is given as prescribed’ or ‘baths or showers twice weekly’. Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 11 Care staff need to make sure that good quality and specific person centred information is recorded for everyone who lives there. For example when looking at personal care needs, does the person like a bath or a shower, which bathroom do they use, what day or time do they prefer and who do they like to help them? Social care plans are in place but these could be improved. The information being developed by the activities co-ordinator around social care needs to be made widely available to all staff working there. It is recommended that the service look at how this important information can be fully included in each persons care plan. This may help the plans to capture more of the person and their social and emotional needs. Daily notes kept by staff should also be looked at to make sure that good quality useful information is always recorded. We saw that some notes tended to be repetitive and made general statements – ‘safety maintained’ and ‘has been protected from danger’. The health needs of individuals are met well. Comments from individuals included “I saw the Dr yesterday”, “the Dr comes in once a week” and “quite a good GP here”. We saw that records are kept of appointments with health professionals. Risk assessments are completed well for areas such as pressure areas and nutrition. We saw that these are kept under review. We saw that staff administer medication to people living there safely and keep accurate records of this. Whitgift Foundation The DS0000019047.V353103.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 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A good range of activities is offered. There is scope to improve this provision particularly for people who now have dementia and/or very high support needs. Improvements need to be made to make sure that mealtimes are a positive occasion for everybody living there. EVIDENCE: People we spoke to were positive about the activities on offer to them. Their comments included “there’s enough going on”, “always something to do” and “plenty going on”. The home has one activities co-ordinator who is employed for 15 hours per week. A weekly schedule is displayed throughout the home. Activities include skittles, exercises, visiting entertainers and coffee mornings. Outings are arranged outside of the home and the schedule displayed included trips to Kew Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 13 Gardens and to the School panto. Religious services are held regularly in the home’s own Chapel. We think that the service needs to look in particular at developing the activities provision for people who now have dementia or who have very high support needs. We saw that the activities co-ordinator was doing some good work around developing social profiles for each person. It is recommended that life story books be developed with the people living there and these could then be shared with others in the home. We saw a photograph album for one person that had been provided by a relative. Books like this may help staff to relate to people as individuals and encourage more interaction. Staff may wish to develop their own life story books as part of this process also. Staff spoken to said that they helped provide activities each day. Two staff said that they would however welcome more time to spend with individuals with one person commenting “we sometimes haven’t got the quality time”. The staff team could look at the routines in place to see if there are areas where they could move away from any task based care to a more person led approach. The hours available to the activities co-ordinator could also be increased to support this. Most people spoken with said that they enjoyed the food offered with comments including “very good”, “it’s quite good especially three days a week”, “good”, “not too bad” and “they give me too much”. The mealtime experience for people living on the first floor unit could be improved. This is in part due to the limited space available for dining and the home will be expanding this as part of the planned building work. We did see one example of poor practice when a member of staff was helping an individual and this was discussed at the time of inspection. All staff helping people with eating must have the training to do this. Ideas such as protected mealtimes and staff eating their meals with the people who live there should also be considered. The menus for the home could also be reviewed to be in picture format. Whitgift Foundation The DS0000019047.V353103.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 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are protected from abuse. Concerns about the care provided are listened to and acted upon. EVIDENCE: Comments from people who live at the home included “no complaints” and “my relative looks after my interests”. Individuals spoken to said they felt able to either speak to staff or managers directly about any issues they may have or through their relative. Records are kept of any concerns or complaints received and we saw that these were well maintained. These showed that action had been taken in response to issues raised by people living there or their representatives. The complaints policy and procedure is displayed in the home and is part of the guide for the people living there. Whitgift Foundation The DS0000019047.V353103.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, 24 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, comfortable and well maintained. Bedrooms are personalised and feel very homely. EVIDENCE: People are provided with a very pleasant, comfortable and well maintained place to live. Bedrooms seen were all personalised to the individual with many containing peoples own furniture and pictures. There is a large dining room and an activity room although other sitting areas are limited. The organisation plans to extend the home to create more communal space and additional bedrooms in the near future. People spoken to were happy with their rooms. Comments from individuals included “a nice room”, “ok”, “quite nice”, “fine” and “it’s all I need”. Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 16 Areas of the home could be developed to be even more friendly and interactive for the people living there. Ideas such as pictures on doors, memory boxes and rummage boxes should be considered. The bathrooms are very clinical in their appearance. It is recommended that these areas be looked at to see how they could be made more homely for the people living there. The home was very clean and hygienic when we visited. Whitgift Foundation The DS0000019047.V353103.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 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are generally enough staff on duty to meet the needs of people using the service. There is a good staff training and development programme in place. People living at the home are protected well by the recruitment procedures. EVIDENCE: Feedback about the way the staff carried out their duties was generally positive. Comments included “good”, “nice”, “very good” and “polite and respectful”. A number of people did also say that the quality of care varied depending on the staff member with comments including “the odd one or two are not so good”, “some are very good and some are not so good” and “some are nice, some are not”. This was discussed with the deputy manager at the time of our visit. We saw that staff have access to a good programme of training. Mandatory training is provided in a number of topics such as safeguarding adults, manual handling, First Aid and Fire Safety. Additional training is provided on specialist areas such as pressure area care and diabetic footcare. The majority of the Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 18 care staff have completed the NVQ Level 2 award and some are progressing to study for the Level 3. As stated previously, staff who support individuals with eating must be trained to do so. We have also strongly recommended that the service look at developing more training around dementia care and person centred care. Care staff need to see social and emotional care as an important part of their job. The staff team could also look at the routines in place to see if there are areas where they could move away from any task based care to a more person led approach. The activities co-ordinator should also have opportunities to attend training in areas such as reminiscence and providing activities for people with dementia. Whitgift Foundation The DS0000019047.V353103.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, 33, 35, 36 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well run. There are good arrangements to make sure that the health and welfare of people using the service is protected. EVIDENCE: The manager has been in post since 2003 and is supported by two deputy managers in the day to day running of the service. Feedback from people using the service included “it’s run pretty smoothly”, and “the bosses are very nice”. Staff spoken to said that they felt able to approach their manager with any problems if necessary. Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 20 A formal quality management system is operated to regularly look at the service provided. Questionnaires had been sent out to individuals and their representatives in July 2007 and the results of these reviewed. A meeting had also been held at the home in July 2007 for people to attend if they wished to. Minutes of previous meetings included discussion about the food, name badges and staff. We were told that the people who live there do not want a meeting to be held every month and that this is kept under review. We have recommended that this is recorded in the minutes of each meeting. A system for staff supervision is in place but we saw that this needs some improvement to make sure that all care staff have a recorded supervision session with their line manager at least six times a year (pro-rata for part-time staff). Health and Safety checks take place to make sure people are kept safe and we saw that good records are kept of these. Whitgift Foundation The DS0000019047.V353103.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 3 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Whitgift Foundation The DS0000019047.V353103.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 OP15 Regulation 12 (4) 18 (1) (c) Requirement Timescale for action 01/03/08 2. OP36 18 (2) In order to make sure that people are supported to eat in a dignified and respectful manner, all care staff must receive training in how to do this. In order to ensure that care staff 01/04/08 receive regular support and guidance to help them do their jobs well, formal staff supervision should take place at least six times annually (pro-rata for part-time staff) with full records kept. 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. Refer to Standard OP1 OP3 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as audiotape or pictures. The assessment format should be reviewed to make sure that good quality person centred information is captured. DS0000019047.V353103.R01.S.doc Version 5.2 Page 23 Whitgift Foundation The 3. OP7 This can then be used to inform the care plan from when the individual moves in. The home should look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and less task based. Care plans need to give specific information about how the person likes the care and support to be delivered. 4. 5. OP7 OP12 6. OP12 The content of daily notes should be discussed to make sure that good quality and useful information is being recorded. Life story books could be developed with the individual and their family or friends. These books should be used to help communication and engagement. Staff may wish to develop their own life story books to share. Care staff should look at the routines in place to see how they could move away from task based care to a more person centred approach. The organisation should review the hours allocated to activities and how they are provided. It is strongly recommended that further specialist training courses be made available to the activities co-ordinator. Mealtimes on the first floor should be made a more positive occasion and an opportunity for people to interact. Practices such as protected mealtimes, varying numbers / times of meals, and staff eating with people who live there should be seriously considered by the home. The menus for the home should be presented in different formats such as large print and pictures. The environment could be made more user friendly particularly in the first floor unit. Ideas such as pictures on doors, memory boxes and rummage boxes should be considered. The bathrooms should be looked at to be less clinical in appearance. All care staff should receive training in dementia care and person centred care. Comments made by individuals during this inspection about the consistency of care provided by individual staff should be discussed within the team. Additional training may need to be identified to help improve this area. Minutes of user meetings should record any discussion DS0000019047.V353103.R01.S.doc Version 5.2 Page 24 7. OP15 8. OP19 9. 10. OP21 OP30 11. OP33 Whitgift Foundation The about the frequency of future meetings and the date of the next one to be held. Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Whitgift Foundation The DS0000019047.V353103.R01.S.doc Version 5.2 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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