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Inspection on 06/02/06 for Whitstable Nursing Home

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

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

The home prepares good in-depth holistic plans of care.

What has improved since the last inspection?

.All doors have been fitted with self closing devices in case of fire. New beds, wardrobes and chairs have been purchased. Fire damaged rooms have been converted into three en-suite bedrooms.

What the care home could do better:

Some staffs attitude towards the rights and needs of service users need addressing

CARE HOMES FOR OLDER PEOPLE Whitstable Nursing Home 27-28 West Cliff Whitstable Kent CT5 1DN Lead Inspector Tina Thomas Announced Inspection 6th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 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 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) 01227 265443 01227 453737 Unique Help Group Limited Ann Elizabeth Denne Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2005 Brief Description of the Service: Whitstable Nursing Home is a large detached property located within Whitstable town centre. It has easy access to local amenities and sea front. The homes accommodation 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 DS0000026127.V273989.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that was conducted over a two-day period. The inspector was assisted throughout the inspection by the acting manager Mr. George Anayat and the area manager Mrs Eileen Laherty. Since the last inspection the home has had a fire, which was investigated by Kent Fire Brigade. They have made a decision not to prosecute the home. Christchurch College have made a decision that following evidence of poor practice to remove student nurses from the home. Following this, the Manager resigned and a number of staff have left. Mr Anayat is currently acting as manager. The inspector spoke with staff that were very supportive of his efforts during what has been an especially difficult time for the home. There were issues that the inspector identified during the inspection, which had already been identified by the acting manager and area manager. They were both working on these issues to reinforce best practice. The rooms that were fire damaged have been renovated into en-suite bedrooms, decorated to a very high standard. During the inspection the home was in receipt of a number of new furniture and fittings. The provider’s wife was choosing new soft furnishings for the home on the day of inspection. There is evidence that although most staff are working to improve the situation at the home some staff do not work to best practice in line with the groups own policies, Some staff do not fully action instructions given to them by senior staff, some staff are not compliant with company policy and some staff inappropriately discuss with visitors, events around staff leaving, including the past manager, and the plans of the new provider. The acting manager and area manager are currently addressing these issues through the supervision and disciplinary process. What the service does well: The home prepares good in-depth holistic plans of care. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 DS0000026127.V273989.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 was assessed at the inspection of 13/06/05 and found to be met. The home does not offer the care described in Standard 6. EVIDENCE: Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 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 the following standard(s): 7,9 Each Service User has an individual care plan, which ensures that Service users care needs are fully met. The home needs to improve some areas of its policies and procedures regarding medication. Standards 8 and 10 were not assessed at this inspection. They were both met at the last inspection of 13/06/05 EVIDENCE: Plans of care were viewed and found to be of good quality. They showed staff how to meet the physical, mental and social needs of the people that live in the home. They were well reviewed and had appropriate risk assessments. The inspector viewed the policies and procedures regarding medication that are used at the Whitstable Nursing Home. The policies being used are not those that were created by the Unique Help Group and are not appropriate. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 10 The area manager agreed that the home would with immediate effect use the more fuller policy of the group. Controlled medication must be stored in the appropriate medication cupboard. Requirement 1 Part A Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 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 the following standard(s): 13, 15 Standards 12, and 14 were assessed at the last inspection of 13/06/05 and found to be met. EVIDENCE: Some relatives expressed concern that the homes activity person had left just prior to the inspection. The Provider is looking at the best way to correct this situation. The acting manager is monitoring the situation to ensure peoples social needs are being met. The home provides people that live there with a good balanced diet. The acting manager has created a dinning area so as to encourage mealtimes to become a social occasion. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 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 the following standard(s): 16,18 Service users and their relatives are not confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: On the week prior to the inspection the Commission received concerns from three sets of relatives. Some of the concerns were initiated by some staff inappropriately discussing with visitors, events around staff leaving, including the past manager, and the plans of the new provider. The visitors expressed that they did not feel confident in approaching the acting manager or the new Provider. To address this the acting manager has enforced that he is approachable, the Provider has addressed the concerns of visitors at a service user/visitor meeting and the area manager has been available to support service users, visitors, staff, provider and manager. The home has a suitable complaints policy. The home must keep more detailed accounts of investigations and meetings with relatives Requirement 2 Part A. The inspector viewed the complaints book and found that a member of staff had written inappropriate comments and made inappropriate judgements regarding one service user. The area manager agreed that this would be addressed at supervision and monitored. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 13 The inspector spoke to staff that were aware of the issues of adult abuse and protection. Visitors that made comments to the commission stated that staff were generally very kind to the residents. However, Student nurses made a complaint regarding the work practice of some of the staff within the home. It was observed that following the complaint the area manager conducted a full investigation in line with the homes own whistle blowing and complaints policy. The inspector observed inappropriate recorded comments by one senior member of staff and failure to work within group policy(medication). Failure to work within policies, written to protect the people within the home, and using inappropriate attitudes may put service users at risk. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 26 The home is safe and there is an ongoing programme to improve the environment. Staff do not always ensure that the home has appropriate aids or equipment. The home is clean, pleasant and hygienic. EVIDENCE: The new provider has commenced an ongoing programme of refurbishment to the home. New wardrobes, beds and seating were delivered during the inspection. The Providers wife was choosing new soft furnishings on the day of inspection. Since the fire in the home, self closures have been applied to all doors. The Provider has worked together with the fire officer to ensure future safety. The inspector observed that once again taped on sponge was covering bed rails. At the last inspection it was recommended that appropriate bumpers be ordered. The inspector was present when this was authorised by the area manager. However, this was not actioned. A requirement has now been made regarding this matter. (Requirement 3 Part A) Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 15 The home is clean and free from offensive odours. The home has suitable sluicing facilities. A recommendation has been made that the sluices contain Disposable gloves and protective eyewear. (Recommendation 2 Part A). Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 16 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): 27,29 Service users are protected by the homes recruitment policies and procedures. EVIDENCE: The home is sufficiently staffed to meet the needs of the people that live there. A number of relatives expressed to the commission that they were concerned because they had been told inappropriatly by care staff that the Provider would be cutting staff numbers including night staff. The Provider has confirmed that this is not correct. He has confirmed that three staff will remain on duty each night while peoples needs and the number of people living at the home remain the same. The Provider has found it necessary to ensure that the staff skill mix is correct and that staff work in an effective manner. The inspector viewed staff files and found that they held suitable information. Each member of staff has completed an application form, had an interview, and had two references from previous employers and a CRB check. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 17 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): 31,38 The home does not have a registered manager. The health and safety of service users and staff are promoted and protected EVIDENCE: The registered manager has resigned from her post at Whitstable Nursing Home. The home is currently being managed by an acting manager Mr. George Anayat who is a registered general nurse. Mr Anyat had recognised prior to the inspection that there are work practices within the home that need to be changed. These include the understanding of some staff of current best practice. He has endeavoured to instigate change. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 18 As previously mentioned there has been a fire at the home and a report of poor practice. The Provider has acted accordingly and worked with fire officers to minimise risks for the future. Environmental risk assessments have been updated. Staff have been sent on additional training and poor work practice has been addressed through the supervision process. Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 19 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 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 x x 3 x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x x x x 3 Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 20 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 OP9 Regulation 13 Requirement The home must have suitable policies and procedures regarding the safe handling and storage of medication More comprehensive records must be kept regarding investigations together with actions taken. The home must supply suitable aids and appliances to meet service users needs. Timescale for action 02/04/06 2 OP16 22 02/04/06 3 OP22 16 02/04/06 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 Refer to Standard OP22 OP26 OP36 Good Practice Recommendations Suitable bumpers should be provided for bedrails when necessary. Disposable gloves and protective eye wear should be available in sluice areas Staff giving supervision should be suitably trained Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 21 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 Whitstable Nursing Home DS0000026127.V273989.R01.S.doc Version 5.1 Page 22 - 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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