Inspection on 11/05/06 for Whittington Care Centre

This inspection was carried out on 11th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Whittington Care Centre 17/07/09

Whittington Care Centre 30/06/09

Whittington Care Centre 29/08/07

Whittington Care Centre 19/10/05

Whittington Care Centre 21/01/05

Whittington Care Centre 09/08/04

Whittington Care Centre 26/02/04

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

CARE HOMES FOR OLDER PEOPLE Whittington Care Centre 40 Holland Road Old Whittington Chesterfield Derbyshire S41 9HF Lead Inspector Ivan Barker Key Unannounced Inspection 11th May 2006 09:00 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 Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whittington Care Centre Address 40 Holland Road Old Whittington Chesterfield Derbyshire S41 9HF 01246 260906 01246 269999 whittington@highfield-care.com 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) Southern Cross Care Homes Limited Ms Ememline Bingham Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 20 EMI PCN residents and 25 EMI PC Date of last inspection 19th October 2005 Brief Description of the Service: The Whittington Care Centre is situated in Old Whittington, which is north of Chesterfield. The home is registered to provide 45 places for elderly people with dementia needs and provides nursing and personal care. The home is on two floors Each of the floors has lounge, dining and bedroom facilities. There is a secure garden area, which offers pleasant facilities and is accessible by all residents within the home. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on the ‘key standards’), and the previous requirements. The person present at the inspection was: Mrs E Bingham, registered manager. Within this inspection, which occurred over a four-hour period, the inspector toured the building, examined requirements relating to the previous inspection, spoke with service users, and staff and examined some documentation. What the service does well: What has improved since the last inspection? Since the registered manager was away on maternity leave there had been two acting manager, in a short period of time. Both managers had implemented changes within the home. Since the registered manager had returned she had reviewed these changes. Also the 2 requirements from the last inspection had been acted upon and resolved. All the staff, spoken with by the inspector, welcomed back the manager by their expressions of ‘we are glad she is back’ and expressed their faith in her ability to take up the challenges of returning, managing and the home. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 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. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 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 Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 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): Standards 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Accurate assessments will ensure that the home has sufficient information to be aware of the service user’s needs prior to admission. EVIDENCE: The home received service user assessments from the Social Services Care Managers or the Hospital staff prior to admission. The manager assessed all service users, referred for nursing care. The deputy manager assessed the ones referred for personal care. The inspector was shown evidence of the assessments of the service users who he case-tracked. The documentation for assessment was extensive. The documents were signed and dated. Regarding Standard 6, the manager advised the inspector that the home did not provide intermediate care. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 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): Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Accurate care plans and the staff being aware of the service user’s care needs will contribute to the delivery of care. The system for the administration of the medication was adequate, and there was a safe and secure environment for the medications, except for the fridge storage. There were no omission within the medication administration records and these factors will contribute to the medications being administered in the correct manner. EVIDENCE: On examination of the care plans, from the service users who were being case tracked, the inspector established that all 3 plans were up to date, and had been evaluated on a monthly basis. The care plan evaluation record had daily, weekly and monthly re-evaluations. There was also a daily record sheet. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 10 The inspector discussed the service users’ care needs with care staff, who were knowledgeable about the service users’ needs. Risk assessment were included within the documentation and included moving and handling, pressure area, and nutritional risk assessments. The inspector spoke with the service users who were being case tracked. Unfortunately because of their mental capacity, they were unable to fully express their views. However the inspector did establish by questioning the service users that they were satisfied with their care. On auditing the storage of medications, the fridge was found to be operating above 8 degrees centigrade, since the 1st March 2006. The fridge contained medications, which should be stored below this temperature. On examination of the medication administration the inspector observed that the medication administration records were up to date with all the records signed as appropriate. The service users, who were receiving nursing care, had their medication administered by the qualified nurse. The service users who were receiving personal care had their medications administered by staff, who had obtained a medication administration certificate. Visitors were allowed to visit the service user in the communal areas or in the privacy of their own room. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 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): Standards 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Various activities were organised within the home, which would provide stimulation to service users and enhance their quality of life. Service users were given the opportunity to exercise their right of choice regarding the provision of meals, and the activities. EVIDENCE: The manager informed the inspector that an activities co-ordinator was employed and worked 25 hours per week. This was normally Monday to Friday and flexible as required by the service users. The activities programme was displayed. The manager produced the activity co-ordinators records which indicated what activities had occurred and who participated in the activity. Fortunately, on the day of inspection, the activity co-ordinator was present, and undertaking a sessions titled ‘Back in the old days’. The inspector was able to observe the session and the service users’ participation and enjoyment of the session. On discussing the activities with the service users, the inspector was informed that they were satisfied with the sessions, and commended the activities coordinator. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 12 Regarding the meals, the manager informed the inspector that there was a choice of meal and two meals were provided for the service user to view and make a choice. To achieve this practice the staff had to provide larger quantities of food rather than producing meals to order. The inspector accepted that if the home wished to ‘over cater’ that was the company’s choice, so long as service users were offered a choice of meal. The manager informed the inspector that this was the best practice for the service users because of their mental capacity, and a visual prompt at mealtime was the best way of allowing them a choice. The inspector fully appreciated the manager’s view and the practices. The inspector received positive comments from the service users, who were being case –tracked. The general comments were that the food was ‘good and plentiful’. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 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 the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. As far as could be established the home had a complaints procedure in place, which was operating according to the company policy and complaints were resolved within the expected timescales. The home was able to evidence that the staff had received Adult Protection training. Therefore staff would be aware of their responsibility regarding the protection of vulnerable adults and this may provide protection for service users. EVIDENCE: The complaints procedure was displayed and available to the service users and relatives. On discussing complaints with the service users, they informed the inspector that they were ‘happy’ with their care. No complaints were addressed to the inspector, at the time of this visit. The home had policies and procedures relating to the Protection of Vulnerable Adults. The manager was able to provide training records that indicated that all staff had received Adult Protection training. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 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 the following standard(s): Standards 19 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The environment, monitored at this inspection, had not been maintained to the required standard to provide a safe, environment for services users, as two storage areas had been created which were not protected by the necessary fire protection. EVIDENCE: The home operates as two units. One unit for the provision of service users requiring personal care, and the other unit providing service users with nursing care. On touring the home the inspector found that the home was well maintained, well decorated throughout and odour free. However on the upper floor (non service user area), the maintenance man’s room contained paint, varnish, glue and other flammable substances. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 15 The room had no fire detection system and the door to the room had no fire resistance. On discussing this matter with the manager, she was surprised to find such amounts of flammable substances stored within the room. It was accepted that some paint was water based, but other substances were flammable. It was agreed that as an interim measure the flammable substances were relocated to an outside shed. On the first floor there was a room, which had a shower and half completed shower cubicle. The flooring to the room was torn. Inside the room was a wardrobe and other items of furniture. The manager advised the inspector that this room, at present was undesignated, but clearly had been created into a ‘store-room’. Again the room had no fire detection, as it had previous been a low risk area, i.e. shower room, and the door did not meet the required fire resistance. The manager agreed to the Fire Authority for their advice on the possibility of requiring a fire or smoke detectors and the fire integrity of the doors. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 16 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): Standards 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The staff recruitment process should have provided protection for the service users. However the omission of not obtaining a CRB prior to the staff being in post may place service users at risk. The manager was able to provide evidence that staff had received training, which should reflect on the quality of care being delivered to the service users. EVIDENCE: On examination of the rota the following was indicated. Am shift. 1 qualified nurse plus 7 care staff. Pm shift. 1 qualified nurse plus 7 care staff. Night shift. 1 qualified nurse plus 3 care staff. The deputy manager was included in the figures stated above. Plus, the manager and activities co-ordinator. There was also ancillary staff consisting of: 1 Administrator Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 17 2 1 1 1 1 Housekeeping staff Laundry staff Cook Kitchen Assistant Nutritional assistant, who assisted with the provision of meals. On examination of the 3 staff files, all 3 contained the required documentation, except 1 member of staff’s file did not have any evidence of a Criminal record bureau check. On raising this with the manager, she requested the administrator to assist in the inspection process. The administrator provided the manager with the CRB form that had been returned from the Criminal Records Bureau, because of inconsistency in two dates. Since the inspection, the manager contacted the inspector to advise him that the inconsistency had been clarified and the form re-submitted. The member of staff was on annual leave and the manager expected the check to be returned, prior to the member of staff returning to work. In relation to Moving and Handling, Fire training and Adult Protection, the manager showed the inspector the training records that indicated these and other specific clinical training had occurred. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 18 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): Standards 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The management of the home does comply with the requirements of the Care Homes Act, and woks well as a team. Extensive quality assurance systems were in place that should assist the manager and operation manager to measure the home against expected outcomes. EVIDENCE: Within the management structure of there being a registered manager and deputy manager, the home was well managed and had good working practices. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 19 The registered manager had returned from maternity leave, and had begun reviewing the period during her absence and implementing some changes. The company had quality assurance systems, which were implemented by the manager and validated by the operations manager. The quality assurance monitoring system was extensive and monitored areas such as care plans, risk assessments, complaints, and service provision. On examination of the staff supervision records, the inspector established that staff had received supervision. The standard required supervision to occur six times a year. The home was on course to achieve this number of supervisions. Regarding the service users’ personal monies the home operated a basic credit and debit system, but involved the storage of monies in separate envelopes. On examination of the system, examining the accounts of the service users who were being case-tracked, the inspector observed that the money in the envelopes was correct to the accounting record. As far as could be established there were no health and safety issues except for the fire issues, raised within the previous section of the report. Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 21 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 OP9 Regulation 13 Requirement Timescale for action 11/06/06 2. OP19 12 and 23 3. OP29 18 and Schedule 2 The registered person must ensure that there is safe storage of medications, which require refrigeration. The registered person must 11/06/06 ensure that the rooms identified within the body of the report, are not used as storage areas, within providing the necessary fire protection. The registered person must 11/06/06 obtain a satisfactory CRB check for the staff, prior to their employment. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Whittington Care Centre DS0000002097.V294234.R01.S.doc Version 5.1 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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