Inspection on 12/09/05 for Whitwell

This inspection was carried out on 12th September 2005.

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

Whitwell 12/09/06

Whitwell 28/02/06

Whitwell 08/02/05

Whitwell 28/07/04

Whitwell 16/12/03

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Whitwell 2a Albert Street Boston Lincolnshire PE21 8PE Lead Inspector Sue Hayward Unannounced 12 September 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Whitwell Address 2a Albert Street Boston Lincolnshire PE21 8PE 01205 350946 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs J Tragelles Royal Mencap (Housing & Support Services) Mrs A Naughton Care Home 6 Category(ies) of LD(E) Learning Disability over 65 Both 1 registration, with number LD Learning Disability Both 2 of places PD Physical Disability Both 3 Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 8 February 2005 Brief Description of the Service: Whitwell is a detached house in a residential area in the town of Bostson. It is owned by the Mencap foundation and provides care for up to six residents three who have learning disabilities and three whose main need is due to physical disabilities. At the time of the visit the home had one vacancy. There is garden to the back and side of the property and an enclosed courtyard to the front. Visitors parking is on the main street. Boston has a range of shops and facilities and the home is clsoe to the towns park. Residents have their own single bedrooms, two that are located on the ground floor. There is not a lift so any residents who have rooms upstairs must be able to manage the stairs. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and took place over five hours starting at 10:00 am. The inspector spent time talking to a resident, a relative and two staff who work in the home. Two other staff that provide support to the home when the manager is on leave also visited the home during the inspection and there was some discussion with them. In addition a sample of care records and policies and procedures were inspected and a partial tour of the building took place. What the service does well: What has improved since the last inspection? What they could do better: Whilst record keeping is generally up to date the manager needs to ensure that records of staff recruitment are available for inspection when she is not in the home. Locks on the ground floor bathroom and toilet need to be replaced or repaired to ensure residents privacy. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 6 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. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5 There is a satisfactory system in place for assessing the needs of residents and how they are to be met in the home and ensuring that residents are well informed about the home. EVIDENCE: There is information available that tells people about the home. It is in different forms such as pictures/symbols as well as written to assist those residents who have reading difficulties. There have been no new admissions to the home since the last inspection. The individual records of the two residents seen during this inspection indicated that residents’ needs are assessed on an on-going basis and other professionals are involved as needed, for example district nurses. Risk assessments are recorded and contained signatures and dates showing that they were reviewed regularly. Residents’ individual records contained copies of contracts and terms and conditions of residency agreements. Information on file demonstrated that residents had had information such as this and the complaints procedure explained to them. A relative confirmed that she had been given information and felt that communication between herself and staff at the home was good. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 9 Both resident’ files seen contained care plans and information about their personal preferences. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7 Care plans are drawn up with the involvement of residents if able or their relatives. This helps to ensure the needs and wishes of residents and how they are to be met are identified. Residents are enabled as much as possible to make decisions and choices about their lives. EVIDENCE: Residents files are well organised. Care plans are detailed and also contain symbols to make them more easily understandable for people who have reading difficulties. Care records are reviewed and updated on a regular basis by the home. Information contained on files also indicated when reviews had occurred by the placing authority. A relative confirmed that she had seen and signed the care plan on behalf of her relative. A requirement was made at the time of the last inspection about ensuring that the management of a resident’s epilepsy was part of the care plan. The manager provided the CSCI with a health needs summary, indicating how this was being addressed on 11/02/05. Discussion with staff indicated that they had a good knowledge of the needs and individual preferences of residents and gave examples of how they are met in the home. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 11 A resident made comments that confirmed he is able to choose how he leads his life in the home. For example he said that he enjoyed spending time in his room and it was noticed that he was able to do so. Another example was that he chose not to go on holiday. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12 , 15 and 16 Residents are able to pursue a range of activities and leisure interests both within the home and community. These are based on the preferences of service users who are encouraged to make choices about their preferred lifestyles and routines and their independence is promoted. Visitors are welcomed at the home. EVIDENCE: Discussion with staff, comments from a resident and observations made on the day indicated that staff promote residents independence. For example a resident was preparing his own lunch at the time of the visit. A resident also said that staff help him to clean his room. There are a range of activities and leisure interests. These include trips out. A resident showed a photo album of the differing events and outings that residents had participated in. Comments from a staff member indicated that residents also have opportunities to attend training courses and gave the example that in the past a resident had attended a computer class. Comments Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 13 from staff indicated that if able residents would be supported to pursue job opportunities. A resident’s relative confirmed the type of events that are provided for residents such as birthday parties and trips out. Some residents also attend a day centre. Records reflected residents’ interests and indicated that they have the opportunity to pursue them and are given choices. A resident’s relative confirmed that she is always made welcome at the home and could visit whenever she wished. She felt that she was kept informed and was invited to attend reviews. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The health and care needs of people the service supports and their preferred lifestyles is being met. This is supported by the care planning system and staff’s knowledge of individual needs. EVIDENCE: Records and discussions with staff and residents indicated that residents’ healthcare needs are checked. Both files checked included a health action plan and staff spoken to had a good knowledge of the needs of residents. Records kept demonstrated when visits from other professionals had occurred such as doctors, district nurses and opticians. Care plans were detailed and contained risk assessments in relation for example to manual handling needs. Records were in place for a resident who needs fluid and food intake monitoring and generally these were well kept however it was noticed that one chart had not been dated. A resident’s relative spoken to felt that the needs of her relative were being met in the home. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Residents are protected by the procedures and systems in place for dealing with complaints and adult protection matters. EVIDENCE: The home has a complaints procedure that is also provided in symbol form. A resident was asked whether he would feel comfortable to talk over problems or concerns with staff. He said he would and knew who was in charge of the home. A relative also said that she knew who to raise concerns with and would feel able to do so. Information about how to make a complaint was contained on residents’ files and also indicated that this had been discussed with residents or their relatives. No complaints have been received by the home or CSCI in the last year. A staff member was aware of her responsibility to report any complaints and who to report them to within Mencap. She confirmed that there is always a manager on-call for advice if needed. The home has an adult protection procedure and a copy of Lincolnshire County Council’s Adult Protection policy was also available. The inspector was notified two days after the inspection of an issue that had been appropriately referred to Social Services for investigation. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24. 25, 27 and 30 The home is clean and well maintained however to ensure residents privacy bathroom and toilets must be lockable. EVIDENCE: Those parts of the home seen on this occasion were generally well maintained and decorated, clean and tidy. Since the last inspection some parts of the home have been redecorated and new carpets have been provided for some rooms such as the lounge. It was noted in the previous inspection report that the home has a gardener and that there were plans to make the garden more attractive. This would benefit residents’ as it is currently mainly a grassed area. Staff said that the area most used by residents is the courtyard. Two residents rooms were seen on this occasion. Both were clean and tidy with no obvious safety issues. They both contained items and furnishings, which reflected residents’ individual tastes, interests and needs. A resident spoken to made comments that he found his room comfortable and felt safe at the home. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 17 A ground floor bathroom was seen on this occasion. It was noticed that it was not lockable. In order to ensure residents privacy bathrooms and toilets should be lockable. Staff should use an overriding device only as indicated by residents risk assessments. There is a separate laundry facility. An Environmental Health Officer last inspected the home on 19/01/04. No issues were raised. A maintenance record is kept for staff to record any matters that need attention. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35 The training programme in place ensures staff have the necessary skills and knowledge to care for residents safely. EVIDENCE: Discussion with staff and records confirmed that there is a training and development programme in place, which includes updates in some matters. Records demonstrated that staff had had training such as Basic Food Hygiene, Basic Health and Safety, First Aid, Adult Abuse, Fire Training and Manual Handling. The record demonstrated that two staff had not had a manual handling update since 2003 and as there are residents with manual handling needs in the home it is recommended that this be updated. Records also demonstrated that two staff have achieved a National Vocational Qualification (NVQ) award Level III. Comments from a resident and a visitor about the care provided by staff were positive. Staff were observed to be kind, caring and respectful towards residents throughout the inspection. Staffing levels were discussed. Comments from a staff member verified that during the day there is always a minimum of two staff on duty. At night there is one staff member on duty who “sleeps in”. There is a system at night where Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 19 an emergency on-call person can be called in if necessary. A staff member confirmed that to meet the needs of a resident the staff member on duty at night is currently working a “disturbed night” system. This needs careful monitoring to ensure the health and welfare of residents and staff. A visitor made a comment that she felt staffing levels were sufficient to meet her relatives needs. A resident also commented that he received the help he needed. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 and 42 Regulatory records must be available at all times in the home to demonstrate that residents are being protected. On this occasion staff recruitment records were not accessible. EVIDENCE: A sample of those records required to be available for inspection by law were checked on this occasion. Staff records of recruitment were not available as they were in a locked file. A sample of policies and procedures were also seen. An immediate requirement was made at the time of the last inspection in relation to ensuring that records evidenced that fire equipment checks are carried out in accordance with policies and procedures. The manager responded promptly and written verification was received on 11/02/05 that matters had been addressed. Records of fire alarm tests were seen at the time of the visit and with the exception of one occasion indicated that these are being done on a weekly basis. A staff member said that fire alarms are tested weekly at which time staff follow drill procedure. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 21 Risk assessments are in place in relation to the environment such as electrical items and fire safety as well as those, which are done in relation to individual residents. Service certificates seen on this occasion relating to the central heating system and hoist indicated that both were regularly serviced. Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 2 x x 3 Standard No 11 12 13 14 15 16 17 3 3 x x 3 3 x Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Whitwell Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x 2 3 x C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 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. Standard 27 Regulation 12(4) Requirement In order to ensure the privacy and dignity of residents bathrooms and toilets must be lockable. Any locks fitted must comply with the recommendations of the fire brigade and staff use an overide device only as indicated by service users risk assessment Records must be available at all times to demonstrate that staff have been through a safe recruitment process. Timescale for action 12/11/05 2. 41 17 (3) & 19 Schedule 2 12/11/05 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. Refer to Standard Good Practice Recommendations Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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 Whitwell C53 C04 S2388 Whitwell V248702 120905 Stage 4.doc Version 1.40 Page 25 - 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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