Inspection on 18/01/06 for Whittingham House

This inspection was carried out on 18th January 2006.

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

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

Other inspections for this house

Whittingham House 06/01/10

Whittingham House 27/01/09

Whittingham House 29/02/08

Whittingham House 03/09/07

Whittingham House 17/11/06

Whittingham House 22/06/05

Whittingham House 03/12/04

Whittingham House 14/07/04

Whittingham House 10/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Whittingham House Whittingham Avenue Southend On Sea Essex SS2 4RH Lead Inspector Christine Bennett Unannounced Inspection 18th January 2006 10:15 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 Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Whittingham House Address Whittingham Avenue Southend On Sea Essex SS2 4RH 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) 01702 614999 01702 436536 Strathmore Care Ms Marietta Masudo Care Home 50 Category(ies) of Dementia - over 65 years of age (50), Old age, registration, with number not falling within any other category (50) of places Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2005 Brief Description of the Service: Whittingham House cares for 50 older people, some of whom may additionally have dementia, in a residential area of Southend on Sea, close to local amenities and bus routes. The home is purpose built on two floors with a passenger lift to enable access to both levels. There are 44 single bedrooms and 3 double bedrooms, 35 of which have en suite facilities. The home has a large dining room, a variety of lounges and a large garden area. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place on 18th January 2006 over 8 hours 15 minutes. The inspection process included a tour of the premises, inspection of random records and documentation, discussion with the manager, 4 members of staff, 3 visitors to the home and the district nurse. Time was spent amongst the residents and discussion held with 3 of them Discussion of the inspection findings took place at the end of the day with the manager. The inspector would like to thank everybody involved in the inspection process. What the service does well: What has improved since the last inspection? The home is in the process of having an extension built, and the existing building will be having improvements made to it as part of the plan. The medicines in the home are stored at a better temperature and were well recorded. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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 Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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): 3, 6 No progress has been made to improve the admission procedure to ensure that the home receives a detailed assessment well in advance of a person moving into the home. Without this, there is no assurance that care needs can be met. EVIDENCE: There has been no change to the pre admission assessment of prospective residents since the last inspection. Admissions are arranged by the company’s head office, and paperwork relating to residents and their needs are often only received by the home shortly before arrival. This assessment has not been adequately documented to give the information required to ascertain if it is a suitable admission, and if the individual needs can be met. The home does not provide intermediate care. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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 There are shortfalls in the recording of information in care plans, which could mean that care needs are not being met. Medication is handled appropriately ensuring the residents health needs are being met. EVIDENCE: Discussion with staff confirmed that they had a good understanding of individual needs and residents and their visitors spoken with were happy with the care that was being given. One member of staff said, “there is a general willingness of the carers to do their best” and a resident commented, “the staff are rapidly improving”. One visitor said that the staff sometimes seem to give orders rather than talk a resident round. The District Nurse said the staff are always cooperative and she had no concerns about the home. Care plans examined did not cover all aspects of the residents’ care needs. One care plan had identified that the resident was at risk of pressure sores but no management plan was in place. Another care plan showed that a resident had had a large weight loss but there was no other mention in the care plan about any measures that were being taken to try to manage this problem. The care planning system adopted by the home was discussed with the manager as the completion of these records has been inadequate when viewed at previous Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 10 inspections. One member of staff confirmed that if an unfamiliar staff member comes to the home, they do not consult the care plans, but rely on a verbal handover. The storage of medication was satisfactory at an appropriate temperature. Random medication checked was accurate and records were found to be in good order. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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): 12 Social activities are dependant on the care staff having the the time and ability to occupy the residents. EVIDENCE: One member of the care staff is assigned each morning and afternoon to organise the activities for the home. A weekly programme is planned but the manager confirmed that not all the care staff are comfortable in this role and said that when the home expands in the future, this is an area that would need to be reviewed. One resident said, “There is nothing here for me as far as entertainment goes”, and one member of the care staff described the entertainment in the home as “monotonous”. Staff were seen to spend time talking to individual residents during the afternoon in the lounge, and this obviously gave great pleasure to the residents concerned. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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 The complaints procedure of the home is satisfactory. Appropriate arrangements are in place to protect residents from abuse. EVIDENCE: One complaint has been received by CSCI since the last inspection and this had been investigated through the home’s complaints procedure. Residents and visitors confirmed that they thought the manager was approachable and that any concerns would be dealt with appropriately. All staff spoken with had a good understanding of different types of abuse and how to report it. There have been no POVA issues at the home since the last inspection. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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 the following standard(s): 19, 26 The home is clean and tidy, but areas need to be upgraded to improve the surroundings for the residents. EVIDENCE: The home is in the process of having a large extension built, and at present the grounds are not accessible to the residents. It is intended that all the windows are to be replaced in the existing building as part of the refurbishment. Also toilets in the main area leading to the dining room are to be relocated, which is more hygienic and should help with odour control. The registered provider had arranged meetings with the staff, residents and their relatives to discuss the extension and any disruption anticipated, and a copy of the proposed plans was on display in the main hall for perusal. The laundry was not in use at the inspection, due to building work, and is being undertaken at one of the company’s other homes. Water tested in two of the bathrooms is being delivered in excess of 44 degrees and could be potentially harmful to residents, but water from other hot water taps is being delivered cold. One bathroom, which is not in use must Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 14 have weekly documentation in place to confirm taps are run, for the prevention of legionella. Some furniture is worn and needs replacing and some areas of the home are in need of redecoration. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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 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 Shortfalls on staff records do not provide the safeguards to offer protection to residents. EVIDENCE: Shortfalls were found on staff recruitment records. The manager confirmed that she had already examined all staff records and had identified the shortfalls in individual cases. The head office of the company was going to contact all staff to ask them to provide documentation to rectify the omissions. This requirement is outstanding from the last inspection. The manager said the home is fully staffed, and the staff rota was examined. Some staff are still working excessive hours but the manager said that this is monitored through staff supervision to ensure that staff do not become too tired. Staff spoken with confirmed that they choose to work overtime and are able to take extra time off if required. The home operates with eight care staff in the morning and seven in the afternoon and evening, and four staff for night duty. The manager’s hours are included in these numbers, but she is off duty at 6.15pm, which leaves a shortfall of one person from 6.15pm until 8.15pm on the days that she is working. A visitor to the home said that the home appears short staffed at times saying,”sometimes have to wait quite a while, sometimes take a long time to answer”, while another visitor said the home seems to have enough staff. The manager should look at the dependency needs of the residents and ensure she has enough staff and review the deployment of staff. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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 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, 33, 35, 38 The manager provides leadership and guidance, ensuring the safety and welfare of staff and residents. EVIDENCE: The manager is a qualified nurse and has been the manager of the home for 6 years. She has a qualification in supervisory management, and is currently exploring if this equates to an NVQ level 4 in Management. One visitor to the home said, “the manageress is excellent”, and a staff member described a problem that the manager had sorted out. Money held by the home on residents’ behalf was checked and found to be in good order. It was stored securely and any transactions recorded appropriately. There was good evidence to suggest that a quality assurance programme is in progress. Regular residents meetings are held and minuted, and a relatives Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 17 survey was conducted in the summer of 2005. Staff meetings are also held, and a quality audit was carried out for April/May 2005. Information collated should be published and a copy of any report should be made available to residents and to CSCI. The manager was not aware of a Business and Development plan for 2006. Monthly audits on the home (Regulation 26) have not been received by CSCI since the last inspection.. Documentation indicated that fire drills and instruction had taken place regularly, and health and safety issues were well managed. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14 Requirement The registered person must complete a pre admission assessment form to ensure that a residents needs will be met. This is a repeat requirement The registered person must prepare a written plan as to how a residents needs will be met. This is a repeat requirement The registered provider must consult with residents about their interests and develop activities in the home. This is a repeat requirement The registered person must ensure as far as possible the safety of residents. This refers specifically to the regulating of water temperatures. Timescale for action 01/04/06 2. OP7 15 01/04/06 3. OP12 16(m) 01/04/06 4. OP25 13(4)( c ) 01/04/06 5. OP27 18(1)(a) The registered person must 01/04/06 ensure that at all times there are staff working in the home in such numbers as are appropriate for the health and welfare of the residents. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 20 6. OP29 Sch 2 7. OP33 24 8. OP33 26 The registered person must 01/04/06 obtain information in respect of a person before employing them, as detailed in Schedule 2. This is a repeat requirement The registered person must 01/04/06 review the quality of care provided by the home as part of it’s quality assurance, and supply a report to CSCI and residents The registered person must 01/04/06 prepare a written report, as detailed in this regulation, on the conduct of the home and supply a copy to the manager and CSCI at least once a month 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 OP19 OP31 Good Practice Recommendations An annual programme of redecoration should be produced, and worn furniture replaced The registered manager has an NVQ 4 in management or equivalent. Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Whittingham House DS0000015486.V273364.R01.S.doc Version 5.0 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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