Inspection on 31/01/06 for Whitstone House

This inspection was carried out on 31st January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitstone House 09/05/07

Whitstone House 10/05/06

Whitstone House 11/10/05

Whitstone House 03/03/05

Whitstone House 20/05/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Whitstone House 49 Norwich Road Dereham Norfolk NR20 3AS Lead Inspector Clive Lucas Unannounced Inspection 31st January 2006 10:30 Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 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 Whitstone House DS0000027409.V279926.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 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. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whitstone House Address 49 Norwich Road Dereham Norfolk NR20 3AS 01362 698762 01362 699792 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) Norfolk Autistic Community Housing Association Limited Mrs Marie Ann Large Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to eleven (11) adults, of either sex with Learning Disability, not falling within any other category, may be accommodated. 11/10/05 Date of last inspection Brief Description of the Service: Whitstone House provides a service for up to eleven people with learning disabilities and autistic spectrum disorders. The Home is managed by the Norfolk Autistic Community Housing Association. The Home is situated on the main road into the market town of Dereham. The Home is a large, double fronted detached building in keeping with other buildings in the area. The service users have single bedrooms and share the communal areas. There is parking to the front of the Home. The large garden at the rear of the Home is fenced to prevent access to the main road. The Home has an indoor swimming pool in the garden. Within the garden area there is also a smaller house, which is separately registered as a Home for three adults with a learning disability and is managed by the same organisation. Whitstone House provides a service for up to eleven people with learning disabilities and autistic spectrum disorders. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. The deputy manager and two member of staff were spoken with, records were looked at and the inspector spent time with staff and service users preparing lunch and taking part in art activities as part of day care. What the service does well: 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 Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 6 contacting your local CSCI office. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 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 Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 It was not possible to form a comprehensive judgement, as key records were unavailable. The Statement of Purpose still requires a little more work and the service user guide is good. EVIDENCE: The previous inspection report required that a review be undertaken of the Statement of Purpose, and a copy of the reviewed Statement of Purpose be sent to the Commission for Social Care Inspection. To date this has not happened. The registered manager must ensure that the Statement of Purpose be revised to ensure that it contains al of the information required; a copy of the revised Statement of Purpose should be sent to the Commission for Social Care Inspection. It was a requirement of previous inspections that the registered person ensure that full assessments be obtained or undertaken. At the time of the last inspection there had only been one new service user move into the home. The assessment for this person was not available as a senior member of staff had kept it in their personal locker and gone off sick. Attempts had been made to obtain the key for the locker, but these had been unsuccessful. These records had still not been retrieved at the time of this inspection. The registered manager must ensure that these records are retrieved, or duplicates are provided. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 9 Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Service users are supported in taking risks. EVIDENCE: Risk assessments are made for aspects of service users’ lives at the home, for example walking in the community, washing and bathing, travelling in vehicles, shopping, pub visits. These help staff to support service users in taking responsible risks and develop their interests and independence. The risk assessments looked at had been regularly reviewed. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Service users are able to exercise choice in their daily lives. They are offered a healthy diet and are encouraged to be as involved in preparing meals as they are able to. EVIDENCE: Service users are able to exercise choice in their daily lives, as far as their ability allows. Examples were given by staff of times when service users were able to choose leisure activities. Records evidenced that service users have choice about rising and bedtimes, as well as when they can stay in their rooms. Service users are able to smoke outside of the building if they choose, but at present none do. One service user used to have beer kept in the home, but due to specialist medical advice that he should not consume alcohol while on his current medication, this has been changed to alcohol-free beer. Service users are able to visit local pubs with staff, either in small or large groups. Menus are well balanced. The inspector observed service users being supported in preparing their lunch and choosing what they wanted. One Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 12 service user who was unable to take part in preparing his lunch was still able to choose what he wanted. Cupboards in the kitchen have symbols on the doors to help service users identify where items are. Staff said that service users are able to choose alternatives for their main meal if they do not want what has been prepared, but the cook is aware of individual preferences. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Personal and healthcare support is provided. EVIDENCE: Staff advised that service users are able to choose who helps them with personal care. Shopping for clothes is done individually and those service users who can exercise choice over clothing, toiletries and hairstyle are encouraged to do so. There are currently no service users who manage their own healthcare. Staff will monitor service users wellbeing and will arrange for medical help or consultation as required. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 There is a culture of listening to concerns, but training in adult protection is needed for those staff who have not yet received it. There is some additional work required to the complaints information. EVIDENCE: An administrator oversees personal finances. If she is not present when service users require their money, it is taken from a float and the administrator sorts out the paperwork when she is in. The administrator was not present during the inspection, so this area could not be fully looked at. Training in the protection of vulnerable adults has been provided for some staff, but not all. The registered manager must ensure that all staff have access to this training. Staff said that they would be able to raise any concerns that they had about the protection of vulnerable adults. In order to ensure that service users and their relatives or representatives are able to raise any complaints it was recommended at the last inspection that a complaints leaflet be developed, which would be more user friendly than the whole complaints procedure. This is still being worked on. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The home is clean and hygienic. EVIDENCE: Staff advised that it is rare for them to have to manage soiled bedding, but that if necessary the bedding would be changed during the night, and that protective clothing is available if necessary. The areas of the home looked at were observed to be clean and hygienic. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 34 and 35 Training is provided. Good progress is being made in NVQ training, but there are gaps in some other areas. The new rota should be beneficial to staff and service users. EVIDENCE: There is a core staff team who have been at the home for some time and are well experienced. 50 of staff hold NVQ 2 or above; there is a programme for other staff to undertake this. One team leader is in the process of becoming an NVQ assessor. Staff’s training records now have a front-sheet that states what essential training they have done and what is outstanding. This makes it much easier to see who is in need of training; it showed that several staff require training in areas such as Food Handling and Health and Safety. The registered manager must ensure that staff are appropriately trained to perform their jobs. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 17 The deputy manager said that a new rota has been introduced. This rota removes the need for staff to work two 14-hour days every other weekend. Staff confirmed that the new rota is in place. An additional visit to the home on 7 December 2005 found that the recruitment checks not previously sought had been obtained. The one exception to this was one Criminal Records Bureau check, which had been returned for additional information to be provided. Frequencies of staff supervision were not looked at on this occasion, but will be at the next inspection. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 Health and Safety is promoted, but some areas of training are required. Monitoring by the manager should include a review of the quality of care, to improve the care of service users. EVIDENCE: It was a requirement of the last inspection that the registered manager must ensure that a review of the quality of care be undertaken as specified in regulation 24 of the Care Homes Regulations 2001. This has not yet happened and should do so within the timescales of this report. A Health and Safety file is kept in the staff office. This file contains information on issues such as the health and safety policy, the COSHH policy, product information safety data, medication and control of infection. The Health and Safety Officer said that the manager takes Health and Safety seriously and things get done. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 19 The Fire Officer visited in May 2005. There were no issues raised in his report. There have been three fire evacuation drills in the past 12 months; fire equipment checks take place roughly every week (but not when the Health and Safety Officer is on leave). No service users require manual handling. See comments in section on staffing regarding training in Food Handling and Health and Safety. The Health and Safety Officer said that all upstairs windows had restrictors to prevent them opening so far as to be a danger. One window was noted to be fully open. The inspector drew this to the attention of the deputy manager, who undertook to rectify it straight away (it appears the restrictor had been broken off). The registered manager must ensure that all upstairs window restrictors be checked. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 20 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 2 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X 2 X X 2 X Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 21 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 YA1 Regulation 4&6 Requirement The registered manager must ensure that the Statement of Purpose be revised to ensure that it contains all of the information required; a copy of the revised Statement of Purpose should be sent to the Commission for Social Care Inspection. (Previous timescale of 31 July 2004 not met) The registered manager must ensure that the records referred to in section 1. Choice of Home, are retrieved, or duplicates are provided. (Previous timescale of 14 November 2005 not met) The registered manager must ensure that all staff have access to adult protection training. The registered manager must ensure that staff are appropriately trained to perform their jobs. (Previous timescale of 31 December 2005 not met) The registered manager must ensure that a review of the quality of care be undertaken as specified in regulation 24 of the DS0000027409.V279926.R01.S.doc Timescale for action 31/03/06 2. YA2 14 31/03/06 3. 4. YA23 YA32 18 18 31/05/06 31/05/06 5. YA39 24 31/03/06 Whitstone House Version 5.1 Page 22 6. YA42 12 Care Homes Regulations 2001. (Previous timescale of 31 December 2005 not met) The registered manager must ensure that all upstairs’ window restrictors be checked. 28/02/06 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 Refer to Standard YA22 Good Practice Recommendations It is recommended that a complaints leaflet be developed, which would be more user friendly than the whole complaints procedure. This leaflet could also be available in Widget format. The leaflets could be readily available to service users and their families as well as provided on request. Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Whitstone House DS0000027409.V279926.R01.S.doc Version 5.1 Page 24 - 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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