Inspection on 29/02/08 for Whittingham House

This inspection was carried out on 29th February 2008.

CSCI found this care home to be providing an Adequate service.

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 03/09/07

Whittingham House 17/11/06

Whittingham House 18/01/06

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 Sharon Thomas Unannounced Inspection 09:00 29 February 2008 th 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.V360362.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 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.V360362.R01.S.doc Version 5.2 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 whittingham24@tiscali.co.uk Strathmore Care Ms Marietta Masudo Care Home 77 Category(ies) of Dementia (77), Old age, not falling within any registration, with number other category (77) of places Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service: Care Home only - Code PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is 77 17th November 2006 2. Date of last inspection Brief Description of the Service: Whittingham House cares for 77 older people, some who 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. The home has a new extension that has been registered with the CSCI. The home now has a total of There are 71 single bedrooms and 3 double bedrooms. The home has a large dining room, a variety of lounges and a garden area. The Statement of Purpose and Service Users Guide and a copy of the last inspection report are available within the main office. A copy of the Service User Guide is available in each resident’s bedroom. The current scale of charges as of March 2007 ranged from £379.47 minimum to £421.75 maximum per week. Extras charged are for hairdressing, chiropody, toiletries and newspapers etc. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as menus, staff rotas, care plans and staff files. The manager completed an Annual Quality Assurance Assessment with information about the home. Throughout the report this document will be referred to as the AQAA. We sent surveys out to people living in the home; relatives, health & social care professionals and members of staff. The questionnaires returned to us contained positive responses about the home and many were highly complimentary. This inspection visit was unannounced and covered the key standards, which are listed under each Outcome group overleaf. An unannounced visit to the home took place on 29 February 2008 and included a tour of the premises, discussion with the manager who attended the inspection although she was on annual leave and members of staff. Observations of how members of staff interact and communicate with people living there have also been taken into account. On the day of the inspector’s visit the atmosphere in the home was busy. We spoke to staff that work in the home and looked at a number of files and paperwork. We examined information about what services are provided for people using the service. We looked around where people live, the gardens and the grounds. The inspector also used other information that they already knew about the home from information regularly sent to the inspectors’ office. If you would like to know how people are cared for and supported you can read the inspectors report. You can ask the person in charge of the home for a copy, or contact the inspector. What the service does well: Although there is a requirement in this report for care plans to be developed it must be noted that a good degree of effort has already been undertaken to make these documents better. All care plans now contain a risk assessment Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 6 some of which were good, however, a few did not contain the detail required and has the effect of lowering the standard overall. A number of visitors were coming and going throughout the day. One person spoken with said they are happy now their relative has moved to Whittingham House. They have no complaints and say the care is good. One relative said they visited at different times of the day and were always made welcome and offered a drink. They confirmed that they were kept informed about their relative’s health and welfare. The recruitment system used in the home is thorough and makes sure that staff employed are appropriate to work with people, some of whom may be vulnerable. The staff team working in the home are committed to the people living there and appear to genuinely care about their welfare. The menu in Whittingham House provides people with a well-balanced and varied diet. Staff provide home cooked food that is enjoyed by people living there. The location and layout of the dining room enables people living at the service to engage with the cook during the serving of meals. Care staff are friendly and work as a team when required. Senior staff provide good support to the manager and are informed of peoples’ needs. What has improved since the last inspection? What they could do better: Care plans although improving must continue to be developed and contain accurate and up to date information and associated risk assessments. Staff need to be aware of the right of people to be treated with respect and dignity. Activities must be formally developed to address the social needs of the people living there. Particular regard must be paid to the social needs of people with dementia. The Statement of Purpose and Service Users Guide is to be updated to reflect accurately the services provided at the care home. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 7 All care staff must receive training relating to safeguarding adults, and more so staff must be provided with a full range of training on a regular basis. The infection control procedures in the home must be improved to make sure that people living there and staff working there are protected. The manager would benefit from auditing the environment and putting safety features and procedures in place to enhance the safety of people living and working there. The AQAA was returned and we found it brief and gives very little information about the service. It appears that there is a lack of understanding of the purpose of the AQAA. The questions relating to the ‘what we do well’ sections are not well completed. Therefore the AQAA does not give us a reliable picture of the service. 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. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 8 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.V360362.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, and 6: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People choosing to live at Whittingham House cannot be fully confident they will receive accurate information about the home prior to admission. The statement of purpose and the resident guide do not give clear relevant information about the home. People can be confident that their needs will be assessed before admission and that the home will be able to meet their needs. EVIDENCE: The manager’s AQAA states that the Statement of Purpose and Service User Guide have been updated, however on the day of the inspection we were informed that these documents had not been developed and that these would be complete with up to date information in the near future. The lack of accurate information may lead to a prospective service user not having Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 10 information that will allow them to make an informed choice. This had been a requirement at the previous inspection and will remain outstanding. Two files of the people most recently choosing to live in the home were looked at on the day of the inspection. These files contained an assessment from the local social services department and a copy of the homes own pre-admission assessment. The assessments cover a range of needs including the person’s physical health, dependency needs, mental health and social needs. Upon discussion the manager is able to demonstrate knowledge of people’s needs and abilities. The manager’s AQAA does not provide any information on the home’s pre-admission process. The senior on duty confirmed that the placement co-ordinator and manager and/or senior would undertake the preadmission process. The person would always receive a visit either in their home or at their place of residence. This process ensures that the person has been assessed and then the placement co-ordinator and the manager can make the decision as to whether or not the home can meet the needs of the individual. Standard 6 is not applicable, as Whittingham House does not provide intermediate care. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans used in the home are not fully developed. Overall people’s healthcare needs are met and the management team has systems in place that measures individual risk. Overall people can be confident that they will be treated with care and respect. EVIDENCE: From a sample of records examined we could see that the information in the pre-admission assessment is not always reflected in people’s care plans. Care records showed that further development of the care planning process is needed, so that staff are provided with clear directions on the best way to give care to different people. The previous inspection required the home to improve the information contained in care plans. In the care plans that we looked at there was evidence that this had been addressed to some extent. However some of the care plans looked at needed more up to date accurate information so that staff could read them and provide the care that was needed by the Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 12 individual. Staff need to record any change in need and identify the care that is required in more detail. We found that not all of the information recorded within an individual’s preadmission assessments is being transferred to the care plan document. This has to be developed so that information is not lost and is appropriately followed through as this could have a detrimental affect for the individual. The manager’s AQAA states that the staff team is continuing to improve the care plans and this was confirmed from discussion with senior staff. Two people living in the home spoken with state that they get “all of the care that they need” and “staff give the best that they can”. The care plans we examined provided evidence that risk assessments have been developed and contain a range of information about the risks that people face in their daily lives. One person’s risk assessment had not been updated and vital information regarding the changed needs of the person could have placed the person at risk. The manager’s AQAA does not make any reference to the medication systems used in the home. Staff training records confirmed that all staff administering medication have received training around the safe storage and administration of medication. There is improved in-house training. The management team has good procedures in place around the storage, recording and administration of medication, which should ensure people are protected. No controlled drugs are currently used in the home. People spoken with were all complimentary about the care they receive and our observations confirm that people overall appear happy, and well looked after. Someone in the home who completed a survey some months before this inspection visit said, “I have lived here for more than a two years now and am very well looked after and the staff know what I need”; another said they receive “thoughtful care”. Care was provided in an orderly but task centred way. Staff did not appear to have the time to spend time with the people that they were caring for. Time was spent undertaking tasks for people and people did not seem to be very involved in this process. One carer was observed taking a comb and brushing an individual’s hair without asking permission to do so. The person in question made it very clear that they were unhappy with this intervention and became agitated. There were several incidents through out the day where care staff did not involve the person in the care that they were being provided with. When spoken with one person confirmed that staff “tend to do things for me as apposed to doing things with me”. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in Whittingham House have limited opportunities to participate in activities that are appropriate to their needs. Routines in the home are not person centred and do not benefit the people living there. Overall people have a varied diet that they enjoy. EVIDENCE: The previous inspection required the proprietor to improve the activities and leisure pursuits that are on offer to people living there. We found that there was no formal activity programme on offer on the day. There is no evidence that an activity co-ordinator had been employed by the home. The manager has previously confirmed that this post would be created by November 2008. However given the shortfall in this area the home may benefit from bringing this date forward. At one point during the inspection the music in the lounge was turned up and the inspector had to ask the staff why this was the case and point out that some people were becoming distressed at the volume. We noted that the main lounge had both the music on and the television on at the same time. Most people using this lounge have dementia and it became clear that this over stimulation and noise was causing some of them to become agitated Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 14 and distressed. It appeared that staff have a limited understanding of the needs of people with dementia. The lounges in the area had the seating set out in a very institutional manner with the seating set out around the edge of the room. As a matter of good practice the manager stated that the staff were fully aware that seating should be set out in small clusters. However the manager stated that staff overrode this request and kept putting the seating back to suit their own needs as opposed to the needs of the people living in the home. There was evidence that some social activities take place in the home. Specific activity for people with dementia is not provided and activities like reminiscence would benefit and stimulate people living in the home. Three people spoken with in their rooms said they had a choice about taking part in activities and said they generally enjoyed spending time in their rooms watching television, reading the daily newspaper and completing crosswords. One person stated that there was “nothing interesting to do in the home” and that they had informed the staff and ”nothing had been done”. The menus were examined and confirm that there is always a choice of hot meals available including chicken, fish and a variety of other traditional meals. The cook working on the day said they ask people in the morning what their preferences are for lunch. There are fresh fruit and some fresh vegetables available daily and food stocks are delivered weekly. Care plans do not contain sufficient information about peoples dietary requirements including their likes, dislikes, allergies, where the person likes to eat their meals and the level of assistance required. People spoken with had differing views about the food. Two people said “very good cooks with a choice of menu” and “The meals are varied and of a high standard” while two said, “the food is bland and overcooked with little taste” and “the food is plain and not attractive, we have no say in the menu”. Food stores were examined and there is evidence of a variety of fresh and frozen food available. The dining room has an open plan layout with the kitchen, which ensures that meals are served up fresh and hot. We observed the lunchtime meal for people at Whittingham House and this is strictly a taskorientated occasion where food is served and people are assisted to eat; it was not a social relaxed time for people. Staff spoken with said that they feel that meal times are “stressful as so many people need help” and “we don’t have time to make this a social occasion”. The manager’s AQAA for this outcome group does not provide enough information to demonstrate what the service offers people in terms of activity and lifestyle choices. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall people living in Whittingham House are kept safe by the procedures used by staff around complaints and protection. EVIDENCE: The manager’s AQAA states that people are protected and complaints are addressed, although the manager states that this takes place there is limited information on how this is achieved. A survey completed by someone in the home said, “The staff always listen and do their best to solve our problems” and another “Have no complaints to make”. Another resident spoken with on the day said, “If l have a problem, l talk to staff who will sort it out”. The manager said that staff have received in-house Protection of Vulnerable Adults (POVA) training as part of their induction. Most of the staff spoken with were aware of their responsibilities to report any suspicions of abuse or poor practice, however a few members staff were vague about this issue and it was later found that these staff had not received up to date refresher training. All staff spoken with stated that they would report anything to the manager or senior staff. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 16 The AQAA states that all staff are knowledgeable about safeguarding adults. The recruitment process has been improved and enhanced Criminal Record Bureau Checks (CRB) are obtained before employing staff. A sample of records that we examined confirmed that confirmation of CRB certificates are in place. Personnel records also confirm that all staff have received training around safeguarding matters, but many staff in the team have not been provided with 2 yearly refresher training. If staff are not reminded through this training, of how to protect the people in their care people may be potentially placed at risk. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall Whittingham House provides people with a comfortable environment although improvements to maintenance and cleanliness need to be made to ensure people are safe. EVIDENCE: Since the previous inspection visit the proprietor has successfully finished and opened the new extension to the building. The extension is well decorated and comfortable and will no doubt be an asset once it is fully occupied. However the new furnishings and décor of this part of the building have the effect that it highlights the poorer standard of the existing part of the home. When touring the premises it came to our attention that the sluice rooms in the home need to be locked, and on the day of the inspection we witnessed a very confused individual exiting a sluice room with unknown liquid on their Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 18 hands. The manager must be aware of the risk of infection to people and ensure that sluices are secured. Various parts of the home suffered from a very strong smell of urine particularly in the reception area. Carpets through many areas of the home are worn and tatty, as are many pieces of furniture. The existing dining room is in need of redecoration and some investment. The laundry area was examined on the day and the laundry assistant was present. When we entered the laundry area two bins containing soiled clothing has excrement in many areas of the surface. The laundry assistant was not wearing protective clothing and when questioned about the risk to both themselves and others, the member of staff dismissed the issue and carried on undertaking their duties. The laundry area was not well maintained on the day there was no evidence that infection control procedures were in place or in practice. The Manager’s AQAA states that the home is undertaking on going building works, double glazed windows installed, rooms re-decorated, etc. continuing redecorations, carpets and furniture replacements, etc. The document did not detail any information Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in Whittingham House do not benefit from a staff team that is fully trained and supported. Staff training in the home is disorganised and does not demonstrate that staff receive a full programme of training to enable them to carry out their roles. The recruitment procedure provides the safeguards that ensure appropriate staff are employed. EVIDENCE: On the day of the inspection we discussed staffing levels with the manager. She explained that she uses her observation and knowledge of people’s needs to assess staffing levels. The staff rota was examined and confirmed that there were enough staff on duty to address the needs of the number of people living in the home. This will need to be reviewed as the home moves toward full occupancy. In addition to carers there is also a cook, domestics and the manager and her deputy. Rotas examined confirm these staffing levels and our observations on the day of the inspection also show that staffing levels are sufficient. Out of a total of 14 care staff, 2 have a National Vocational Qualification (NVQ) at Level 2. This issue was discussed on the day, as the number of staff without the qualification is not acceptable. The number of staff having achieved this qualification is very much lower than the recommended National Minimum Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 20 Standard of 50 , however the training co-ordinator and the manager both show a commitment to supporting people to complete the award. All of the staff working in the home on the day were spoken with. Three members of staff spoken with were positive about working at Whittingham House. One person said, “working here is rewarding, it is a friendly home. The other staff are supportive”. Although records examined did not have much evidence of formal training, the training co-ordinator manager was able to demonstrate how in-house ‘on the job’ training is very much part of how the home is managed. The training co-ordinator confirmed that the whole training programme is being developed and gaps in staff training identified and provisions made for this. The information around training would benefit from being accurately recorded to demonstrate the training that is provided. On the whole staff were happy with the level of training given, however some staff stated that they did not get, ”enough relevant training” and they did, “not feel that the training that we get is good enough”. The recruitment process that is used in the home is thorough. The personal files of three of the most recently employed staff were inspected. They had evidence that the required checks had been obtained (two satisfactory references, CRB/POVA checks) and copies of birth certificates, passports, and photographs obtained before the individuals commenced employment at the home. All had received a statement of terms and conditions of employment. Staff spoken with confirmed that they were not allowed to start work in the home, “until all of the security checks had been made”. One person who had previously completed a survey said, “I find any help and advice that I want is always given” and one relative stated, “I can’t fault the care given to people at the home. Staff are friendly and helpful”. The information in the manager’s AQAA for this outcome group was limited and said that “staff are trained and their aim is to recruit more staff”. Staff spoken with on the day said that sometimes they “feel stretched especially if another member of staff goes off ill” and “I don’t like the rota as we work for long stretches at a time and don’t get 2 days off like other homes”. The rota examined on the day reflected that staff do undertake a 6 working day shift, which according to the manager is how the organisation works. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, and 38: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the management team is competent, however, improvements need to be made in a number of the systems used in the home so that people living there can be confident that Whittingham House is run in their best interests. EVIDENCE: The manager is qualified or has the necessary experience to run the home. She is aware of and works to the basic processes set out in the National Minimum Standards. The manager is aware of the need to keep up to date with good practice and continuously develop management skills, although she may not have the leadership skills that this requires. Training, development and supervision of staff is inconsistent and staff lack strong management leadership. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 22 The manager has some understanding of person centred planning but might have difficulty in translating this into practice to make a difference to the staff team or outcomes for people using the service. There is little focus on equality and diversity issues in many of the outcome areas. On the day of the inspection the Quality Assurance system was discussed with the manager. Records confirm that there is a process in place for gaining the views of people using the service. Surveys are sent to relatives and a few were completed and returned. Although the manager seeks the information there was little evidence of what the manager does with the information, if it is acted upon, and if the service is improved by the information they receive. Records examined show that appropriate maintenance checks are carried out. These include a Portable Appliance Testing certificate, emergency lights, electrical installation, gas certificate, lifting equipment, bath seat lifter and a current Local Authority environmental services premises inspection. However as previously described in practice, the sluice rooms need to be made safe and secure and the infection control procedures in the laundry need to be improved. The personal allowance finance records of three individuals were examined and confirm that the process is robust to make sure people living at the home are financially protected. Individual records and small amounts of money are stored separately and securely. Receipts are available and documents examined are in order. Although some staff stated that they are provided with regular supervision, a number of the staff confirmed that this is not carried out on a regular basis. This has the effect that staff practice is not fully monitored and reviewed and staff do not receive the full support of the management team. Regular supervision has the affect of making sure that if staff have shortfalls in the way that they care for people, that this will be taken up and reviewed, so as to minimise the risk to both the people they care for and themselves. As previously reported in this report the manager stated that she had difficulty in ensuring staff carried out her instructions for example regarding the seating arrangements in the home. This reflects an inability in the manager to enforce measures that would counteract poor care practice within the home. The AQAA was returned and we found it brief and gives very little information about the service. It appears that there is a lack of understanding of the purpose of the AQAA. The questions relating to the ‘what we do well’ sections are not well completed. Therefore the AQAA does not give us a reliable picture of the service. Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 23 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 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Whittingham House DS0000015486.V360362.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 4 and 5 Timescale for action The Statement of Purpose and 31/05/08 Service Users Guide must be developed and updated to reflect the services provided at the care home so that prospective clients can make an informed choice as to whether the home can meet their needs. The care plans used in the home 31/05/08 must be developed to contain detailed and comprehensive information. This must be clear enough for staff to understand and use on a daily basis. Care plans must be updated as soon as a change in need occurs. Care plans must reflect how the needs of residents are to be met and residents supported. Previous timescale of 14/10/07 not fully met. The manager must carry out risk 31/05/08 assessments for all areas relating to Health & Safety so that the risks are identified and all necessary precautions are put in place to minimise the risks and keep people safe. DS0000015486.V360362.R01.S.doc Version 5.2 Page 25 Requirement 2. OP7 15(1) 3. OP8 13 (4) (b) (c) Whittingham House 4. OP12 16(m) and (n) 5. OP18 13(6) 6. OP19 14 (9) 6. OP26 14 (2) 7. OP30 18(1)(c) and (i) The activities provided in the home must be appropriate and specific to the needs of people living there. Particular regard must be given to people with dementia. Previous timescale of 14/10/07 not fully met. All senior/care staff receive training or refresher training relating to safeguarding adults. To ensure that people living in the home are offered protection. The home must be maintained to ensure the comfort and safety of the people living there. People would benefit from various areas being redecorated and recarpeted. The proprietor must provide a safe environment for people to live in. Laundry practices must ensure the safety of people who live there and people who work there. All staff must receive appropriate training and refresher training in relation to the work they perform so that they can provide a safe and effective service. 31/05/08 31/07/08 31/08/08 31/07/08 31/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP10 OP28 OP14 Good Practice Recommendations Staff in the home should treat people with respect and must respect people’s right to privacy and dignity The home should work toward having 50 of care staff with an NVQ qualification. People should be given choices on a daily basis in regard to how they live their lives. DS0000015486.V360362.R01.S.doc Version 5.2 Page 26 Whittingham House Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V360362.R01.S.doc Version 5.2 Page 27 - 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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