Inspection on 09/05/07 for Whitstone House

This inspection was carried out on 9th May 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitstone House 10/05/06

Whitstone House 31/01/06

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 Debra Allen Key Unannounced 9th May 2007 09:30 Whitstone House DS0000027409.V339637.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 Whitstone House DS0000027409.V339637.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. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitstone House Address 49 Norwich Road Dereham Norfolk NR20 3AS 01362 698762 01362 699792 whitstone@nacha.org.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 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.V339637.R01.S.doc Version 5.2 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. 10th May 2006 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 one of the main roads 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 four adults with a learning disability and is managed by the same organisation. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection took place over a period of four and a half hours during which time a tour of the premises was carried out and discussions were held with four members of staff, including the manager. Records relating to health & safety, recruitment and individuals living at Whitstone House, were also inspected. Nine relatives’ surveys and six service users’ comment cards were returned prior to the inspection which were very positive and contained comments from relatives such as:“I received a telephone call and a hand-made card from my relative on mother’s day.” “There is great support amongst the staff of each other.” “My relative could not be in a better place, it is a very homely and comfortable environment.” “They do wonderful work and my relative has done some wonderful art work this year.” “The staff have a respectful relationship with the people in their care and have a good balance between professionalism and genuine caring.” “My visits are events that I thoroughly look forward to and enjoy a great deal.” One requirement and one recommendation have been made as a result of this inspection. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 6 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Whitstone House DS0000027409.V339637.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 Whitstone House DS0000027409.V339637.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): 1, 2, 3 & 5 Quality in this outcome area is good. Service users have their needs and aspirations assessed on an ongoing basis and they know that these will be met. Each person has a contract and service user’s guide. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions since the last inspection but appropriate information is available, by way of the statement of purpose to enable people to make informed choices and the manager confirmed that the service had an in-depth assessment procedure in place. Of the nine relative’s surveys returned, seven people stated that Whitstone House always meets the needs of their relative and two people said it usually did. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 9 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, 9 & 10 Quality in this outcome area is good. Service users needs are reviewed and updated on a regular basis and they are supported to make decisions and take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three people’s care plans were looked at on the day of inspection and each of these was found to contain very clear and detailed information relating to how each person needed and wanted to be supported. Regular reviews were seen to have taken place, ensuring changing needs are met. Although the general format of the care plans was the same, the specific information contained in each one was very different and reflected people’s individuality. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 10 Of the care plans looked at, evidence was noted with regard to service user involvement. One person was seen to have signed their plan, while confirmation, that the information had been read and explained, was recorded on the others. Risk assessments were very clear, with a very positive and ‘enabling’ approach – i.e. what measures needed to be taken to help someone to be able to carry out day-to-day tasks or enjoy activities as safely as possible. All the risk assessments seen had been reviewed regularly and were updated as and when required. Full explanations were recorded if restrictions had been imposed on people due to the risk factor being too great – i.e. drinking alcohol whilst taking certain medication. All the service users’ records and personal information was seen to be stored securely, thereby ensuring confidentiality is maintained. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Service users have opportunities for personal development, are part of the local community and engage in appropriate leisure activities. Service users are supported to have appropriate personal relationships. Service users are offered a healthy diet and enjoy their meals and mealtimes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans looked at contained individual activity schedules and evidence was seen, through daily notes and other information on file, of involvement in a number of areas such as art, walking, cooking and kitchen skills, sensory room, music, horse-riding, swimming, working at the allotment, computer skills, literacy & numeracy. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 12 It was noted from one person’s care plan, that they go to football matches and are able to continue supporting their favourite football team. Most people attend day-centres during the week and have a variety of choices in order to relax when they return home in the evening. One of the relative’s surveys returned included comments, such as: ‘Whitstone helps my relative to develop’, ‘I am very pleased with the activities my relative is involved in. There was great deal of evidence available to support the fact that service users are able to maintain personal relationships and one person responded to the service user survey by saying that ‘being able to go home regularly’ is good. All six people who returned their surveys ticked ‘yes’ to say they have lots of things to do. A number of relative’s surveys also included comments praising the home for supporting their family member to visit, write letters and make or receive telephone calls and keep in regular contact. One person wrote: “…Normally I ring to say I would like to visit but on the odd occasion I have popped in unannounced, I have always been welcomed and able to have a little quality time…” The main menus rotate over a two-week period and were seen to offer a varied diet, which was wholesome and nutritious. Examples include Gammon with Pineapple, Chicken, Braising Steak, Meat Pie and various roast meats. A selection of desserts was also seen and a statement was seen with the menus confirming “Service Users not liking Hot Dish or Dessert of the Day will be given an alternative choice” and all six people who returned their surveys ticked ‘yes’ to say they choose what to eat. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Service users receive personal support in the way they prefer, their physical and emotional healthcare needs are met and they are protected by the home’s policies and procedures for dealing with medication, although MAR sheets did have occasional gaps. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans looked at contained very descriptive pen-pictures and gave very clear explanations with regard to how people wanted and needed to be supported with their personal care. Once again, there was evidence of an ‘enabling’ approach, rather than ‘doing-things-for people’. Evidence was also seen, in the care plans, of involvement and support from external professionals such as GP, community nurse, psychiatrist, chiropodist, dentist and optician. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 14 None of the service users are currently able to self-medicate but they are protected by the home’s policies and procedures for dealing with medication and staff are well trained in this area. The home uses a Monitored Dosage System (MDS) for most medicines. However, the Medication Administration Records (MAR) that were seen did have occasional gaps or unexplained omissions. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 15 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): 22 & 23 Quality in this outcome area is good. Service users feel their views are listened to and acted on and they are protected from abuse, neglect and self harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no formal complaints since the last inspection. All six service users, who returned their surveys confirmed that they felt safe at Whitstone House and that they knew who to tell if they were unhappy. Six relatives confirmed that they knew how to make a complaint, but three said they would like to know the procedure in case they did ever need to complain. Information contained in the care plans described various communication methods and examples were seen of how different people expressed their feelings and how they could be supported, listened to and understood if they were unhappy. Discussions with staff members confirmed their understanding of adult protection and training has been received in this area. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 16 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, 25, 26, 27, 28 & 30 Quality in this outcome area is good. Whitstone House provides a homely, comfortable and safe environment, which is clean and hygienic. Service users’ bedrooms, toilets and bathrooms are individual and private and shared spaces complement their individual rooms. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was carried out with the manager and a number of service users’ individual rooms were seen. Each of these was very different, very personalised and reflected individuality. One person has a full en-suite bathroom. All areas seen on the day of inspection were found to be clean and hygienic with no unwanted odours. People have the choice of different communal areas to go to if they want, such as lounge, conservatory or dining room and each of these rooms was in good order, comfortable and had a very homely feel. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 17 The service has benefited from the refurbishment of one of the bathrooms and the manager confirmed that the wall and floor in one of the corridors is due to be ‘made good’ in the foreseeable future. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 18 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, 34, 35 & 36 Quality in this outcome area is good. The home has robust recruitment policies and procedures, staff are competent, appropriately qualified and receive regular support and supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In-depth discussions were held with two staff members and both said they felt the team worked very well together and gave positive feedback with regard to the support and training received from the organisation as a whole. The training records were seen and evidence of courses attended included first aid, fire safety, health & safety, food hygiene, moving & handling, total communication, POVA, react and Autism. Three personnel files were looked at and all contained the relevant records such as application form, contract, confirmation of identification and clear, enhanced Criminal Records Bureau (CRB) disclosures, therefore confirming that the home/organisation has robust recruitment procedures. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 19 The rotas were also looked at and appeared to have appropriate ratios to meet the needs of the residents. Despite an unusually high level of staff absence recently, the home has managed to maintain good staffing levels. The deputy manager confirmed that the rota system is regularly reviewed and that staff members are allocated a 9-4 shift every three weeks in order to carry out specific administrative or key/co-worker duties. Communication coordinators are allocated two administration days. Evidence was seen to show that staff received one-to-one support and supervision on a regular basis. The staff members spoken to also confirmed this fact. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 20 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): 37, 38, 39, 40, 41 & 42 Quality in this outcome area is good. Whitstone House is a well run home and the service users benefit from the ethos, leadership and management approach. Service users’ views underpin the self-monitoring, review and development of the home. Service users’ rights and best interests are safeguarded by the home’s policies, procedures and record keeping and their health, safety and welfare are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has worked at Whitstone House for a number of years and is currently in the process of completing her NVQ 4. The deputy manager is also undertaking his NVQ 4. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 21 There appears to be a good management & senior support structure within the home and a good number of staff are NVQ trained which enhances the ethos and management approach of the home for the benefit of the service users. A formal ‘in-house’ quality assurance process has now been developed and the manager confirmed that there is further work in progress to ensure the service continues to meet the needs of the service users and that their views are taken into consideration. In addition, Whitstone House is assessed annually by an external assessor, following which it receives an Autism Accreditation Report. The financial records were examined for three service users and found to be accurate and up-to-date, with copies of receipts, bank statements and a record of income and expenditure. Policies and procedures were looked at and found to be in good order. They are also regularly reviewed and updated to ensure the service users’ best interests continue to be assured. Health and safety is promoted within the home and records looked at confirmed that fire alarm and safety tests are carried out on a regular basis. Cleaning materials/hazardous chemicals were seen to be stored appropriately in a locked cupboard. Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 3 4 X 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 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 3 3 3 X Whitstone House DS0000027409.V339637.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 Requirement Medication Administration Records must be fully completed at all times and any gaps or omissions explained accordingly. Timescale for action 09/05/07 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 relatives are reminded of the home’s complaints procedure. 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