Inspection on 22/06/05 for Whittingham House

This inspection was carried out on 22nd June 2005.

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 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 18/01/06

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 Wednesday 22nd June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Whittingham House Address Whittingham Avenue Southend-on-Sea Essex SS2 4RH 01702 614999 01702 436536 info@strathmorecare.com Dr Davie Vive-Kananda Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Marietta Masudo CRH Care Home 50 Category(ies) of DE(E) Dementia- over 65 (50) registration, with number OP Old Age (50) of places Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate 50 people over the age of 65 of either sex, all of whom might additionally have been diagnosed with dementia. Date of last inspection 3rd December 2005 Brief Description of the Service: Whittingham House cares for 50 older people 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 I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced inspection, which took place over 9 hours 30 minutes. A tour of the premises was conducted and records and documentation inspected. Time was spent with the residents and nine were spoken to individually, along with seven visitors to the home, five members of staff, a visiting district nurse, the service support officer and the manager of the home. Discussion of the inspection findings took place with the manager and the service support officer and guidance was given. The inspector wishes to thank everybody who contributed to the inspection process. What the service does well: What has improved since the last inspection? The home is using very few agency staff, which means the staff know the residents well and their likes and dislikes. The manager said that the staffing of the home has improved and a visitor commented, “there always seem to be enough staff, they are not left unattended in the lounge”. The company has employed a service support officer who is keen to making improvements in the home. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The lack of information recorded at the pre admission assessment could affect the care offered to residents EVIDENCE: Visitors confirmed that they were able to visit the home prior to their relative moving in, and that somebody from the home had been out to them to ensure that it could accommodate their needs. However three pre admission assessments seen did not have adequate information recorded and had not been signed by the resident or relative. One person was recorded as having epilepsy but there was no further information as to whether it was controlled or what medication she took. This could be detrimental to the care received when first going to live in the home. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Shortfalls in the recording of information in the care plans and administration of medication have the potential to place residents at risk. Individual wishes of residents are respected, allowing them to remain independent. EVIDENCE: Individual plans of care are available but the recording of information is not adequate to evidence the care being given. Residents and visitors were very complimentary about the care received in the home with comments, “the staff are very helpful, you can’t fault it” and “they have done wonders for her, I can’t find a bad word about the carers”. One care plan examined was for a person who had been in hospital having had fits, and whose condition had obviously deteriorated. Her relative was seen to be encouraging her to eat and drink, her mobility was reduced and she was incontinent. However her care plan did not reflect this change in her condition and there was no risk assessment with regard to fits, pressure sores, and her mobility. Nutritional records did not evidence amount eaten or any fluid intake, no weight had been recorded and daily records were vague with regard to care given. Discussion with the manager and the service support officer identified a need to support staff in the completion of care plans with suitable training put in place. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 10 Medication is stored in a designated locked room, which was recording a temperature of 39 degrees. This must be addressed. MAR sheets did not have residents photographs on them to identify each individual, especially as a high number of residents are confused. Some bottles of medication had not been signed and dated on opening and medication checked for one resident did not agree with the amount given. The home encourages the residents to remain as independent as possible. One man confirmed that he has his own telephone in his bedroom, has his own money in a locked drawer, and gives his own medication. He also has a key to his room if he chooses to lock it. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Social activities are limited, leaving the residents with long periods unoccupied. Visitors are welcome in the home and residents are supported to maintain their independence. The home supplies sufficient quantity and quality of food to meet the nutritional needs of residents. EVIDENCE: The home has an activities programme and a carer is allocated to provide the activity for the residents. A member of staff said that as the carers have other jobs to do, sometimes the activities are not done. Residents were seen for long periods sitting in the lounge unoccupied and a visitor to the home commented that “activities don’t seem to happen”. Two residents said that they would like more stimulation, and appropriate pastimes must be provided, especially for people with dementia. The home may wish to obtain further advice on appropriate activities for the elderly from the National Association for Providers of Activities for Older People on 01376 585225 Visitors to the home were complimentary and said they are made very welcome. One said, “I come at all different times and I have never been made to feel unwelcome”. Residents confirmed that they are able to choose when they get up and go to bed, and whether they want to stay in their room or go to the communal lounge. One lady was being taken to the local park for a picnic with her family. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 12 The residents were generally complimentary about the food in the home and this was supported by the visitors. One resident said, “ the food is lovely, there is a choice and enough of it”. One resident’s condition had deteriorated and needed assisting with her meal. It had been documented that she had a poor appetite over the previous few days but was offered a meal with large pieces of meat, when a pureed meal or soup might have been more appropriate. Lunch was seen and the food looked wholesome and nutritious. Two care staff were seen to assist residents with their meal. One sat on the arm of the chair and the other stood in front of the resident. Neither spoke to the residents during the meal. This was seen by the service support officer and bought to the attention of the manager. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The complaints procedure of the home is satisfactory. Refresher training is required by some staff to protect the residents from abuse. EVIDENCE: The home has had one complaint, regarding medication, since the last inspection that was substantiated. The home has a satisfactory complaints policy, and residents and visitors confirmed that they felt any complaints would be dealt with appropriately. Evidence was seen of Protection of Vulnerable Adults from Abuse training for staff, but two members of staff were not clear on the Whistle Blowing procedure. The manager was made aware of this after the inspection. There have been no POVA issues at the home since the last inspection. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 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 standard(s) 26 Areas of the home have an offensive odour making it an unpleasant environment in these areas. EVIDENCE: A tour of the home was conducted with the service support manager, but the environment was not looked at in depth. The service support manager confirmed that she had recently been employed by the company to identify areas in the home that require improvement, including furniture and fittings and she was hoping to refurbish certain areas. This is good practice. One visitor spoke about her relative’s room saying, “it is a bit tired, it needs some attention”. Two bedrooms were identified as having an unpleasant odour, and stains on the carpet. The manager confirmed that the home has a carpet shampooer and this is used on a regular basis around the home. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Shortfalls on staff records do not provide the safeguards to offer protection to residents. Staff training is provided in a planned way to give them the skills to care for residents. Some staff work long hours, which could be detrimental to their health and the care they give to residents. EVIDENCE: Records were examined for four members of staff. There was no contract of employment in these records, and no starting date of employment. References had been applied for, however on one file the previous employer had failed to complete the form, and another file had only one reference, which was from a personal friend. The manager confirmed that she is in the process of sorting these files to ensure all required documentation is in place. The training records for staff, evidenced a plan to meet individual needs and staff spoke positively about the training offered by the home. The training coordinator goes to the home weekly to update the staff and records. The staff rota was examined and showed that some staff are working excessive hours, and long days. The manager confirmed that staff cover sickness and holidays and the home rarely use agency staff. Staff spoken with confirmed that they choose to work these hours and they would cut down if they felt too tired. One member of staff said that she has reduced her hours this week as she was feeling tired and another said that she prefers to be working in the home as she lives alone and gets lonely. The manager must monitor this situation to ensure that this is not detrimental to staff health or to the care given to the residents. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: This area was not looked at in detail. The manager is a qualified nurse and is hoping to commence her NVQ 4 in management later this year. However she has done managerial training at Chelmsford College and has also done training this year in medication, counselling and to be a fire marshal. The fire officer visited the home on 9/5/05 and the requirements relating to this are being implemented by the provider. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x x x x Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 18 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 3 Regulation 14 Requirement The registered person must complete a pre admission assessment form to ensure that a residents needs will be met. The registered person must prepare a written plan as to how a residents needs will be met. The registered person must store, record and administer medication appropriately. The registered provider must develop activities in the home. Timescale for action 1/9/05 2. 7 15 1/9/05 3. 9 13(2) 1/9/05 4. 5. 12 18 16(m) 13(6) 1/9/05 The registered person must 1/8/05 prevent residents being placed at risk of harm or abuse. The registered provider must keep the home free of odours. 1/9/05 6. 7. 26 29 16(k) 19 The registered person must 1/8/05 obtain information in respect of a person before employing them. Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 19 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 15 27 Good Practice Recommendations The registered person should offer assistance in eating sensitively The registered person should monitor staff working long shifts/long hours to ensure it is not detrimental to their health or resident care. The registered person should maintain a safe environment for residents. 3. 38 Whittingham House I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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 I56 I06 S15486 Whittingham V232339 220605 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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