Inspection on 31/10/06 for Whitmore Vale House

This inspection was carried out on 31st October 2006.

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

Whitmore Vale House 05/12/05

Whitmore Vale House 17/12/04

Whitmore Vale House 24/09/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

1 Marten Road

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

CARE HOME ADULTS 18-65 Whitmore Vale House Whitmore Vale House Churt Road Hindhead Surrey GU26 6NL Lead Inspector Pauline Long Key Unannounced Inspection 31st October 2006 09.15 Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 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 Whitmore Vale House DS0000013830.V317138.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 Adults 18-65. 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. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitmore Vale House Address Whitmore Vale House Churt Road Hindhead Surrey GU26 6NL 01428 604477 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) felicia@whitmorevale.co.uk Whitmore Vale Housing Association Ms Felicia H Yarborough Care Home 20 Category(ies) of Learning disability (20), Learning disability over registration, with number 65 years of age (12), Mental disorder, excluding of places learning disability or dementia (4) Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to four of the residents may be within category LD/MD (Learning Disability/Mental Disorder). The age range of the persons to be accommodated will be: Up to twelve service users may be LD(E) Seven residents will be accommodated in `Treetops`, six in `Rose Flat` and seven in `Wishing Well Cottage`. 5th December 2005 Date of last inspection Brief Description of the Service: Whitmore Vale House is owned and managed by Whitmore Vale Housing Association. Their main office is situated on one floor of the original building. Whitmore Vale House is a care home divided into three self-contained living areas. These are Rose Flat, Wishing Well Cottage and Treetops and together, provide living areas for twenty people with learning disabilities. Rose flat has six bedrooms. Wishing Well and Treetops have seven bedrooms each. Each living area has kitchen, laundry, lounge and dining rooms. Rose Flat and Treetops are located in the original building and Wishing Well Cottage is a detached bungalow built in the grounds at the side of the original house and linked by a service corridor. The fees at the home are £720.58 per week. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of the key inspection, was unannounced and was carried out by the lead inspector for the service. It lasted 4.5 hours, commenced at 09.15 and ended at 13.50. Discussions were had with two of the service users, manager and staff. Documents sampled, included service users files, care plans, staff records, policies, procedures and the preinspection questionnaire. Several comment cards were received at the CSCI office from relatives and other stakeholders and some of their comments are included in this report. A tour of two of the homes units took place. Verbal feedback from one of the service users at home on the day was limited, in view of communication difficulties. However observations of body language, and facial expressions, evidenced a state of wellbeing. Another service user was keen to talk about life in and outside the home. CSCI would like to thank the service users, manager and staff for their hospitality, co-operation and assistance during the inspection. What the service does well: What has improved since the last inspection? All of the requirements made at the previous inspection have been met. Improvements have been made to the overall environment providing a more pleasant environment for residents to spend time for example, bedrooms and sitting rooms have been redecorated, bathrooms, have been refurbished with Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 6 specialist equipment installed. New bedroom furniture has been bought for one service user. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4,5 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure a full needs assessment takes place before any new admission, indicating that the home would be fully aware of a service users needs. Prospective service users have an opportunity to visit and “test drive” the home. Each service user is issued with contract of services provided at the home. EVIDENCE: Service users files evidenced that the home, would carry out a care needs assessments prior to a service user being admitted to the home. The care needs assessments were quite comprehensive, indicating that the home would have a good insight in to a service users needs. The home accepts referrals from social services care management teams, however there were no community care needs assessments on the files sampled. Discussions were had with the manager in this respect, she stated that there were no care manager assessments as the service users had been admitted to the home several years ago. However she stated that any future referrals from social services would only be accepted if accompanied by a care management community care needs assessment. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 9 The manager stated that following a care needs assessment, service users would be encouraged to visit the home in order to “test drive” the services provided. Two service users files were sampled. One had a contract, which had been signed by the service user and a representative of the home. The other service users contract was under review and the manager stated that organisation was working with the local authority care management teams and others in order to facilitate the signing of the document. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan, where their assessed and changing needs and goals are reflected. Service users are encouraged and supported to make decisions about their own lives and to take responsible risks. EVIDENCE: Care plans were sampled, and were found to be comprehensive, with plans around all daily living activities. The care plans gave clear instructions and guidelines to the reader about a service user’s care needs and action plans as to how these needs could be met. Risk assessments were clearly documented and guidelines in place to minimise the risks. All of the documentation had been routinely and recently reviewed. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 11 The manager and staff were observed supporting the residents in respect of decision making and choices. Service users who were attending day services elsewhere, were observed coming and going from home, care staff observed, but did not interfere, simply asked how they were and if all was ok, promoting service users independence but ensuring they were taking responsible risks. The home has implemented house meetings, in which the care staff support the service users in expressing their views as to how the home should be run. It was positive to note that the meeting agenda and subsequent minutes had been developed in written and pictorial formats. The minutes of the last meeting held on 10/09/06 were sampled. A further meeting had been booked for November. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,17 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The manager and staff enable the service users to maintain fulfilling lifestyles in and outside the home, and promote contact with family, friends and the local community. The meals at the home are wholesome, nutritious and appealing. EVIDENCE: Some of the service users at the home are in paid employment, for example they deliver the local paper on a weekly basis to homes in the village. Others carry out voluntary work arranged by Whitmore Vale day services at the local community centre. One works at a computer centre in Guildford. All but one of the service users attend the day services which are situated in the grounds of Whitemore Vale House. The manager stated that service users go bowling, horse riding, sailing in the summer, some have been to Spain and the Isle of Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 13 White on holiday and plans in place for one to go to New York in 2007. Various trips to the theatre and to London have also been undertaken. The home is committed to ensuring that the service users maintain their relationships with their family and friends. Some of the service users receive regular visitors. One relative commented that, she was extremely happy in the knowledge that her relative is so well looked after and is indeed very happy at the home. One service user was observed having lunch. Care staff supported this service user, as she required help, this support was offered in a familiar yet respectful manner. The service user was offered choice in respect of what was on offer for lunch. It was positive to note that a member of the care staff joined the service user for lunch with the service user. The service user appeared to enjoy her lunch of fresh crusty bread, fried egg and a yogurt. Menus were discussed and the manager stated that, the menus at the home are decided on a weekly basis and recorded in the diary. Care staff commented that service users accompany them to the local shops to buy the food for the week. Kitchen practices and procedures were sampled. The fridges, freezers and cupboards were well stocked with fresh, frozen food, fruit and vegetables. Food was stored according to food hygiene regulations with good records kept. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The manager and staff have a good understanding of the service users support needs, this was evident from the positive interactions and relationships observed. The physical, emotional and health needs of the service users are well met. Service users are protected by the home’s policies and procedures for dealing with medicines. Services users wishes in respect of ageing, illness and death are handled with respect. EVIDENCE: Care plans included clear guidelines on any support each service user required with personal and health care. Health care records in respect of one service user were excellent. Daily records evidenced visits to by GP’s and various visits to hospital. The care plans sampled had been regularly reviewed and reflected the changing health care needs of one service user. The care plan and daily records in respect of this service user were comprehensive and well documented. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 15 Staff were observed supporting the service users with various aspects of personal care, this support was offered in a sensitive way promoting a service users dignity. The home has clear medication policies and procedures. All of the care staff on duty were aware of the policies and procedures regarding medication. They described the training they received and commented that only those staff who has been assessed as competent were permitted to administer medication. Medication record sheets were checked, and were found to be properly completed, with no gaps in signatures noted. Medication storage was sampled and found to be good. The manager stated that audits were carried out twice a day on the medication administration in and records in order to identify any errors. Since the last inspection three errors in medication administration have been notified to the CSCI. These errors were being dealt with according to the homes medication policies and disciplinary procedures. Medication administration was not observed on the day. The medication policy and procedures have been reviewed and updated and the new versions are due to be implemented in November 2006. The ageing illness and death of service users is discussed with service users and their families as appropriate. Service user records evidenced that plans were in place in the event of a service users death. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The home has robust policies and procedures in place for dealing with concerns, complaints and the protection of the service users. EVIDENCE: CSCI has received no complaints about this home since the last inspection. None have been received at the home. One safeguarding adult referral has been made since the last inspection. Meetings have been held in this respect and the issue has been satisfactorily resolved. Discussions were had with care staff in respect of the homes safeguarding adults procedures. Various scenarios were put to them in respect of abusive situations, they demonstrated a good understanding of the homes safeguarding adults and whistle blowing procedures. Two new members of staff have been recruited since the last inspection and training records evidenced that they had undertaken training in safeguarding adults. The manager has undertaken the local authority multi agency training in this respect. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 29, 30 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 this home is good and meets the needs of the service users providing a pleasant place to live. Service users have the specialist equipment required to maximise their independence. The home is clean and hygienic. EVIDENCE: Whitmore Vale House is an older property and therefore presents challenges for the providers in respect of the ongoing need for updating and refurbishment. Several improvements have been made since the last inspection, the building now benefits from a new roof, various communal rooms and service users bedrooms have been redecorated and were very pleasant. One service user commented that he liked the colour of his bedroom and that he was getting a new carpet in the near future. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 18 Two of the bathrooms have been refurbished and although well adapted for service users needs were domestic in design and quite pleasant. Specialist bathing equipment has been installed in order to meet the needs of ageing service users. Carpets have been replaced in some of the bedrooms, the entrance hall and stairs are due to be re-carpeted, the new carpet had been delivered. New bedroom furniture has been bought for one service user. One service user’s bedroom was sampled, it was clean bright and tidy and there was evidence of many personal items. Specialist equipment had been supplied in order to protect the service users health and safety and risk assessments relating to the equipment had been carried out and documented. A specialist hoist has also been sourced in this respect. The home was clean and hygienic with no evidence of malodours. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Service users are protected by the recruitment practices and procedures at the home. The home employs an efficient, trained and supervised staff team in sufficient numbers, who provide a good quality of care to the service users. EVIDENCE: The home employs a diverse staff group. There were 2 care staff, and the manager on duty on the morning shift. All but one of the service users was out at day services. The manager stated that, due to the on going health needs of one of the service users there was always two care assistants on duty to ensure these needs were met. One relative commented that staff, were excellent, caring, honest, patient understanding. The staffing rotas and pre inspection documentation, evidenced a high usage of agency staff, a relative commented that it would be better if the staff did not change so much. The manager stated that staff recruitment was a challenge for the home, but recruitment was ongoing. However, she commented that continuity of care is maintained by using the same agency staff, who, are familiar with the service users. All agency staff who, work at the home are expected to undertake a Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 20 degree of induction training. The staffing levels on the day were adequate to meet the dependency levels of the service users. Two new members of staff have been employed at the home since the last inspection. These staff recruitment files were sampled and evidenced good recruitment practice, with all of the appropriate checks carried out and documentation in place. Training in the home is given a high priority, care staff stated that they are offered many opportunities to attend statutory training and other training in line with current good practice. The manager commented that two members of the staff team were undertaking an NVQ (National Vocation Qualification). There is a formal one to one staff supervision programme in the home. Records were sampled and evidenced that staff had received some formal one to one supervision meetings with a manager. The manager commented that she was aware that there were shortfalls in this respect, however she was confident that the deputy manager and herself would be in a position to address the shortfalls and meet the required number of staff supervision meetings. There was also evidence of regular staff meetings the last one being august 06. A further meeting had been arranged for 1/11/06. Staff commented that they have regular team meetings with the manager and that she was always there on a daily basis if support was required. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 38,39,40.41,42 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident that their views are listened to. Their rights and best interests are safeguarded by the homes record keeping policies and procedures. EVIDENCE: The manager had an open and inclusive style of management. From observation of her interactions with the service users and the staff, it was clear that there was an atmosphere of openness and respect. One service user commented “I like Floss, she makes me laugh she is very funny” The staff expressed confidence that they could take any issue to the manager and it Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 22 would be dealt with in a timely manner. Observations evidenced competent and confident staff, who, appeared relaxed in her presence. Record keeping has a high priority at this home, through out the site visit, records were sampled and were found to be well documented and routinely completed. All of the homes policies and procedures are under review. The homes medication and safeguarding adults policies and procedures review has been completed and as a result new policies and procedures will be implemented on 14th November 2006. Health and safety checks are routinely carried out at the home and clear records kept. All equipment in use on the day of the site visit had been properly maintained. The water temperatures in one of the bedrooms and two of the bathrooms was sampled and was found to be satisfactory. Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 3 X 3 3 3 3 3 X Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Whitmore Vale House DS0000013830.V317138.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Whitmore Vale House DS0000013830.V317138.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!