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Inspection on 13/06/05 for Whitstable Nursing Home

Also see our care home review for Whitstable Nursing Home for more information

This inspection was carried out on 13th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Staff care well for Service Users encouraging them to retain their independence.

What has improved since the last inspection?

The environment is generally cleaner.

What the care home could do better:

The environment needs to be improved. Some of the furnishings and fittings are old and worn. Some bathrooms were inaccessible due to the inappropriate storage of aids and furniture. There needs to be suitable space available for the storage of aids and adaptations. Some Service Users have their doors pinned back during the day, the home must discuss this practice with the fire officer to ensure safe practice. Staff giving supervision should have appropriate training to do so. Appropriate bumpers for bedrails should be purchased.

CARE HOMES FOR OLDER PEOPLE Whitstable Nursing Home 27-28 West Cliff Whitstable Kent CT5 1DN Lead Inspector Tina Thomas Unannounced 13 June 2005 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 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. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Whitstable Nursing Home Address 27-28 West Cliff, Whitstable, Kent, CT5 1DN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 26543 01227 453737 Unique Help Group Ltd Ann Elizabeth Denne Registered Care Home 34 Category(ies) of Care Home for Older People registration, with number of places Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 08/10/04 Brief Description of the Service: Whitstable ursing Home is a large detatched property located within Whitstable town centre. It has easy access to local eminities and sea front. The homes accomodation is situated on two floors. There is a stair lift and a passenger lift to enable people to access the first floor. There are 20 single and 7 double rooms. The lounges and dining room are situated on the ground floor. The home has some parking space for visitors and there is also on road parking. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted between 3.00pm and 7.00pm. The Unique Help Group has been recently purchased. The new Registered Individual is Mr K Rajakathan. Letters have been sent to relatives to inform them of the change. The Manager verbally informed people that live in the home of the changes. The Inspection was conducted with the assistance of the Registered Manager, the new area manager and the groups co-ordinator. The Inspector gathered evidence by speaking with people that live in the home, the staff and the management. The Inspector viewed documentation, which included Service Users care plans, and toured the building. What the service does well: What has improved since the last inspection? The environment is generally cleaner. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 6 All Service Users have their needs assessed prior to entering the Home. Service Users or their relatives know that their needs will be met. Prospective service users can visit the home, with their relatives or representatives prior to assess the suitability of the home. The Home does not have Service users that require intermediate care. EVIDENCE: Service User files showed that each Service User was visited by the Matron prior to moving into the Home. The matron conducts a full holistic assessment of the Service users needs. Service Users know their needs will be met. Their care plan is discussed with them and they sign agreement to it. Prospective Service Users are welcome to visit the Home, or any home within the group. The Inspector spoke with one service user who had visited the home prior to making their choice of Home. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 9 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 standard(s) 7, 8,10 Each Service User has an individual care plan, which ensures that Service users care needs are fully met. Service users feel they are treated with respect and their privacy is upheld. EVIDENCE: The Inspector viewed a selection of care plans. They were holistic in nature and contained information relating to health, personal and social care needs. The plans clearly set out how staff are to meet the needs of people living in the home giving clear outcomes. People who live in the home sign agreement to their plans or if they are unable a representative signs the plan. Service Users health care needs are met. None of the people in the home have pressure areas. The Home has suitable equipment for the prevention of pressure areas. Service users are weighed regularly. The home has suitable risk assessments in place, such as nutritional, cognitive, and falls risk assessments. All documentation in the care plans was regularly reviewed and updated. Each Service User if they choose has a family tree. The Inspector spoke with a number of Service Users who expressed that staff were respectful. The Inspector spoke with people who live in the home expressed that staff always knock on the door before entering. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 10 Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13,14 Service Users find the lifestyle experience matches their expectations. Social, cultural, religious and recreational interests and needs are met. Service users maintain contact with people of their choice, and the local community as they wish. EVIDENCE: The Inspector spoke at length with several service Users. They expressed that the lifestyle in the home matched their expectations and met their needs. The Home has a video and DVD player. One Service User discussed how they enjoyed watching videos with the staff. Other activities advertised were: weekly mini bus trips, pottery, shopping days, and bingo. The Inspector spoke with the people who live in the home regarding visits from their friends and family. They reflected that their visitors could visit when they chose to. The visitor’s book confirmed that people had visits at a selection of times. People that live in the home also reflected that they could see their visitors in the privacy of their own bedrooms or in communal areas. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 12 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 standard(s) Not inspected at this inspection EVIDENCE: Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 13 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 standard(s) 19, 20,21,22,24,26 The Home is not well maintained in all areas. The Home is not safe in all areas. The home has suitable equipment to maximise the independence of the people who live in the home. Not all Individual rooms are welcoming, or comfortably furnished. The Home is clean and hygienic EVIDENCE: Some areas of the home are adequately maintained, others are poorly decorated and the furnishings have become aged. The new owner is aware of the shortfalls and it has been agreed that an action plan regarding this will be put in place. (Requirement 1 Part A). The Home has a pleasant garden with appropriate garden furniture. All communal rooms were observed to have domestic type furniture and lighting The Inspector observed that some Service Users doors were pinned back with doorstops, and that some doors stating ‘fire door keep locked’ were left open. A Requirement has been made that the Home should seek further advice from the fire officer regarding these matters. (Requirement 2 Part A). Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 14 The Registered Manager told the Inspector that people who live in the Home, mostly like to use the assisted bath called the parker bath. The Inspector viewed other bathrooms; some were restricted due to the inappropriate storage of aids or furniture. A requirement has been made that the home finds suitable storage space for aids and equipment. (Requirement 3 Part A) The Inspector observed that the Home has suitable aids and equipment so as to promote the independence of the people living at the home. As already mentioned the home has an assisted bath. Several of the rooms have overhead hoists. The Inspector observed care staff using a stand aid hoist. The Inspector asked one person if the hoist was comfortable when used, they agreed that it was and they also expressed that they felt that their dignity was never compromised when staff helped them to transfer from chair to wheelchair with it. The inspector observed that some bedrails need suitable bumpers. A good practice recommendation has been made regarding this matter. Some individual rooms are furnished with aged furniture and fittings and decoration and carpeting is poor in certain areas. However, people who live in the Home who spoke with the inspector said that they were happy with their rooms. The inspector observed that generally the House is clean and free from offensive odours. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, Service Users needs are met by the number and skill mix of staff. EVIDENCE: On the day of inspection there were 24 people living in the home. In the morning there were 6 carers on duty, two trained staff and the Manager, additionally there was 1 cook, 1 assistant cook, and two cleaners. In the afternoon, there were 3 carers, 2 trained staff and the Manager. The Inspector spoke to people who live in the home who expressed that staff never appeared unduly hurried when giving them personal care Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32, 36,37,38 The Home is managed by a person who is fit to be in charge. Service users benefit from the management approach in the home. Staff are appropriately supervised. Record keeping, policies and procedures are adequate to safe guard Service users. Health and safety is sometimes compromised. EVIDENCE: The Matron is a Registered Nurse; she is currently undertaking Level 4 N.V.Q in Management. The Deputy manager is also undertaking N.V.Q 4 in management. The manager has developed ‘open culture’ in the home. People living in the home expressed that they felt able to speak freely with all the staff. There are documented meetings for both staff and the people living in the home. Supervision is in place for all staff, a good practice recommendation has been made that all staff who give supervision should be suitably trained (good practice recommendation 2 Part A). Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 17 Records within the home are well maintained, examples are care plans, risk assessments, accident book and visitors book. Records are stored appropriately, secure, up to date and in good order. Health and Safety is sometimes compromised in the home, examples are inappropriate storage of aids and equipment, and the practice of pining back fire doors. Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 2 2 3 x 3 x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x 3 3 2 Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 19 yes 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. 1. Standard 19 Regulation 13 Requirement The Provider must create an action plan regarding the decor and renewal of furnishings and fittings, giving suitable timescales The Provider must seek advice from the local fire office re the practice of pinnig back Service Users doors, and the practice of leaving doors statingfire door keep shut open Service users must be able to access toilets and bathrooms. Equipment must be suitbley stored Timescale for action 13/12/05 2. 19 sch 4 ,14 13/09/05 3. 21 23 13/09/05 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 22 36 Good Practice Recommendations Suitable bumpers should be provided for bedrails when necessary. Staff giving supervision should be suitably trained Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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 Whitstable Nursing Home v231308 h56-h05 s26127 whitstable nh v231308 130605 stage 4.doc Version 1.30 Page 21 - 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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