Inspection on 29/08/07 for Whittington Care Centre

This inspection was carried out on 29th August 2007.

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

The inspector 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 11/05/06

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 Nancy Bradley Unannounced Inspection 29th August 2007 10:00 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.V340819.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. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 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 Vacant Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Whittington Care Centre is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories:Dementia over 65 years of age DE(E) 45 The maximum number of service users to be accommodated at Whittington Care Centre is 45 11th May 2006 2. Date of last inspection 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. The home has contacts with the local Authorises. Fees range from £327.00 to £590.55 per week. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection and took place over five hours. The inspector spoke with the member of staff on duty. During the site visit the inspector made a tour of the home, spoke with several residents and families. Unfortunately due to the residents mental capacity they were unable to fully express their views. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. There were forty -five residents in the home on the day of the inspection; the home currently has no vacancies. Additionally, time was spent in preparation for the visit, looking at the service history, the previous inspection report and the Annual Quality Assurance Assessment questionnaire. Records were examined relating to the residents and the general running of the home. The Commission for Social Care Inspection did not send out the “Have Your Say” questionnaires. The majority of the residents were unable to contribute directly to the inspection, however during the tour of the home and during lunchtime the inspector observed life at Whittington Care Centre. The Homes Statement of Purpose, Service user Guide and Commission for Social Care Inspection report are all displayed in the main entrance to the home. What the service does well: The home provides appropriate care for several frail residents with the majority of them having serious mental health needs. Positive interactions were observed between residents and staff. Residents are able to personalise their rooms and bring in their own possessions. Families stated they found the home very welcoming and the staff were always available to talk about any concerns. All residents have their needs assessed prior to admission. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 6 Various activities are organised, providing suitable stimulation for residents and enhancing their quality of life. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 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.V340819.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that potential residents’ needs are fully assessed and met prior to admission. EVIDENCE: The records of four residents were examined. The majority of the residents who are admitted to the home have their needs assessed through the care management system. There was evidence on file to show that care needs assessments are reviewed on a regular basis by the referring agency. The Manager assesses residents referred for nursing care and the deputy assesses residents for residential care. All documentation had been signed and dated. Discussions with families during the visit confirmed they had received information from the referring agency about the home before their family member moved in. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 9 Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 10 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): Standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning and review system in place, which ensures that residents’ individual needs are met EVIDENCE: During the visit the care records of four residents were examined in detail. Care plans are compiled following the initial assessment. Residents’ records included an individual care plan covering all the assessed needs of the resident. Care records provide sufficient information for staff to know how to meet residents care needs. There was evidence to show that care plans and risk assessments are reviewed by the home on a monthly base. Residents’ daily records were up to date. Risk assessments were included within the care plan documentation and included moving and handling, tissue viability and nutrition. Discussions with residents and their families confirmed that they had been consulted about the care plans and they had been signed by either family or the Advocacy Service to show agreement. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 11 Direct observation and discussions with care staff confirmed they had sufficient knowledge about the care needs, personal preferences and wishes of the residents. The health needs of the residents were recorded. Information relating to visits from health care professionals such as General Practitioners, Dentists, Podiatrists and Opticians were recorded. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. There was a clear audit trail of all prescribed medication used at the home. The Manager confirmed that only nominated staff who have received training on medication and the qualified nurses can administer residents medication. The checking of medication records highlighted that when the nurse on duty attends meetings medication at lunchtime is administered but not immediately recorded. On the day of the visit administration of medication was recorded two hours later. Staff on duty stated this is a regular occurrence with medication being recorded retrospectively. Fridge temperatures were examined and found to be in a safe range. The staff were observed routinely knocking on residents’ bedroom and bathroom doors before entering. The families and residents spoken with considered that the staff working at the home were good and that their privacy and dignity was respected. Conversations between residents and staff were appropriate and respectful taking account of any residents’ communication needs. Visitors were allowed to visit residents in the communal lounge rooms or in the privacy of their rooms. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 12 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): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides activities and stimulation in line with the wishes and preferences of the residents. The meals offer both choices, variety and cater for any special dietary requirements. EVIDENCE: The families and residents spoken with during the inspection were very positive about life at the home. Staff spoken with and direct observation confirmed that the daily routine is flexible and residents are able to make decisions about how they spend their time. Also they can get up and go to bed when they wish. The home has an Activities Co-ordinator who is employed to work for twentyfive hours per week; this is normally Monday to Friday but can be flexible to meet the needs of the residents. On the day of the visit the residents were having a domino match, colouring and a sing-a-long. The co-coordinator keeps a record of who has taken part in activities. Throughout the home there is themes areas and memorabilia aimed at keeping residents aware of their environment and life. Residents are encouraged to take part in daily activities and staff stated that they respected their wishes if they choose not to take part Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 13 From records examined and discussion with the care staff residents are supported in maintaining links with local churches and follow their chosen faith. The home has a hairdresser who visits weekly. There are no restrictions on family and friends visiting the home and visits are recorded in the daily logs and visitor’s book. Families spoken with during the visit stated they could visit as often as they like and they were invited to join in the Christmas festivities. All residents have access to Advocacy services should they wish to access this independent service. The residents are all encouraged to personalise their rooms as they wish and bring in their own possessions. Majority of families maintain responsibility for residents’ finances. Residents have a choice of two meals and are made aware of the menu by the staff. Catering staff indicated that they had sufficient knowledge to meet individual residents’ dietary needs. Menu records were seen showing a balanced and varied diet, all meals provided by the home are recorded. Drinks and fruit are available throughout the day. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 14 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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to safeguard resident’s welfare and ensure that their concerns are listened to and acted upon. EVIDENCE: The home has its complaints procedure on display throughout the home giving information to both residents and their families. However it is in an area where residents do not have access, the staff on duty agreed to relocate this. The procedure contains the current contact details of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaint if they wish to do so. On examination of the complaints record all complaints are responded to within a twenty-eight day period. Discussions with family members, confirm that the residents are fully informed about the complaints procedure and they would have no hesitation in putting their concerns to the Manager or Social Services. The Commission has received no complaints about the service since the last inspection. On examination of the complaints record the home has not received any formal complaints about its service. The homes policy of Protection of Vulnerable Adults was examined. This is a corporate policy and is not reflective of the homes policy and procedure. As discussed with the Operations Manager at the conclusion of the inspection, this Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 15 needs to be updated to Safeguarding of Adults and to incorporate local procedures operated by Derbyshire County Council. Staff training records examined and discussions with the staff confirmed the majority of the staff have undertaken training in the protection of vulnerable adults. Information was given as to how staff could update their training to incorporate the Safeguarding of Adults. There has been no reported incident of Safeguarding of Adults since the last inspection Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 16 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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ live in a safe and well-maintained environment, which suits their needs and promotes their independence and privacy. EVIDENCE: The Inspector carried out a full tour of the home, accompanied by the staff on duty. All communal areas were inspected together with staff facilities. Residents’ bedrooms were inspected with their agreement and all rooms had been decorated and furnished to their personal choice and were being personalised. On the day of the visit the home was clean and there were no unpleasant odours. There were sufficient rooms for a variety of activities to take place and an area were residents could meet family and friends in private. Residents and families spoken with were pleased with their bedrooms and said that the home was always clean. The home has a sufficient number of staff employed to maintain a good standard of hygiene and general repair. General facilities are comfortable. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 17 The home has satisfactory hygiene procedures in place. Issues raised at the previous inspection regarding the standard of the home have been addressed. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 18 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): Standards 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has recruitment and selection procedures in place that ensures the safety of the residents. EVIDENCE: Examination of staff rotas and discussions with staff confirmed that staff were always available when needed. The staff confirmed that staffing levels were appropriate for the needs of the residents. The home operates with one qualified nurse plus seven care staff in the day and one qualified nurse and three care staff over night. The Manager, and ancillary staff are supernumerary to the overall numbers. The home has a good percentage of staff who hold a NVQ level 2 or equivalent. The home has recruitment and selection procedures in place to protect service users from potential harm these are in line with Southern Cross Health Care procedures. Several staff recruitment records were examined against Schedules 2 and 6 of the National Minimum Standard. Although the information was available, files were not easy to navigate and require a general audit so information is in chronological order. As part of providing a full employment history applicants need to provide an accurate chronology of their work record with the days date month and year. From recent staff recruitment records examined, applicants were only providing the year in one instance. All staff now have an up to date and valid Criminal Records Bureau clearance. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 19 As discussed with the Manager when gaps in employment are investigated this should be fully explored and be formally recorded on interview minutes. Staff training records were examined confirming that staff have undertaken training. This included their induction training with the exception of training on the safeguarding of adults. Training records indicated that several staff were due for refresher training in some areas. There was evidence on record to show annual appraisals are undertaken. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 20 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): Standards 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was generally well managed, with staff seeking the views of the service users on the running of the home. The health and safety of residents is promoted. EVIDENCE: The Manger has only recently been appointed to the post and is looking register with the Commission for Social Care Inspection. The staff spoken with during the visit stated she was approachable and available for advice. Families spoken with during the visit also spoke highly regarding the management of the home. A quality assurance policy is provided, which sets out the standards and procedures for reviewing the quality of care and services provided by the home. This is based on a programme of self-review and consultation with Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 21 residents and their families. This could be further developed with views and consultation being undertaken with GPs. and other stakeholders. The personal finances of four residents were examined. The home currently is operating a pool system for residents’ personal allowances and monies. The administrator stated that this was agreed at the previous inspection, however this was not recorded in the report. Under the present system it was very difficult to verify the amounts being held for each resident. Receipts for monies spent and withdrawals made on behalf of residents must have two staff signatures. The receipts examined during the site visit only had one signature. The inspector agreed to take advice on the current system being operated. However National Minimum Standard 35.3 clearly states personal allowances must not be pooled. The home is holding large amounts of monies for several of the residents. All monies are kept in the home’s safe. The information on the home’s health and safety procedures and maintenance was provided by way of the Annual Quality Assurance Assessment questionnaire. This confirmed that all the relevant checks had been undertaken Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 9 3 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 23 No 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. 2. Standard OP8 OP18 Regulation 13 13 Requirement All medication must be recorded at the time it is administered. The protection policy and procedures must be updated and reviewed to ensure residents are fully protected from harm, to reflect the changes in policy and procedures and to take account of local policies, which are in place. The home must maintain separate financial records for each resident on monies’ held on their behalf. Residents’ monies must be kept separate and not pooled together. Two staff signatures must be recorded when making cash withdrawals on residents’ monies. Timescale for action 30/09/07 30/09/07 3. OP35 Schedule 4. 17 Schedule 4. 17 Schedule 4. 17 30/09/07 4. 5. OP35 OP35 30/09/07 30/09/07 Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 24 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. 4. 5. 6. Refer to Standard OP18 OP29 OP29 OP29 OP31 OP33 Good Practice Recommendations All staff should undertake a refreshing course in the Safeguarding of Adults. All applicant should provide the days date month and year when providing a full employment history. All staff personnel records should be audited, indexed and in a chronological order. A record of all staff interviews should be maintained The Manager should submit her registration for Registered Manager to the Commission for Social Care Inspection. The results of any quality assurance survey should be published. Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derby Area Office South Point Cardinal Square Nottingham Road Derby DE13QT 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 Whittington Care Centre DS0000002097.V340819.R01.S.doc Version 5.2 Page 26 - 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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