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Inspection on 12/07/05 for Whitwell Park Nursing And Residential Home

Also see our care home review for Whitwell Park Nursing And Residential Home for more information

This inspection was carried out on 12th July 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The floor covering in one bedroom had been replaced, as required at the last inspection.

What the care home could do better:

Amendments were needed to the medication policy and the complaints policy to ensure residents were safeguarded and were given correct information. The home needed to provide information about local advocacy services for residents and their representatives. Formal staff supervision was required, and staff meetings needed to be held more regularly to ensure staff were properly supported in their work.

CARE HOME ADULTS 18-65 Whitwell Park Nursing And Residential Home 130 Welbeck Street Whitwell Nottinghamshire S80 4TP Lead Inspector Rosemary Veale Unannounced 12 July 2005 9.45am 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 Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Whitwell Park Nursing and Residential Home Address 130 Wlbeck Street, Whitwell, Workshop, Nottinghamshire, S80 4TP 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) 01909 724800 01909 721127 Mrs A Gibbins, Dr E DeSaram Mary Marsh Care Home with Nursing (30) 35 Category(ies) of Learning Disability (35) registration, with number of places Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/12/2004 Brief Description of the Service: Whitwell Park is a modern, purpose built care home situated in village of Whitwell, Derbyshire. The home provides personal care for 5 residents and nursing care for 30 residents with learning disabilities. Residents are accommodated in single bedrooms on two floors. Most of the bedrooms have en-suite toilets. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 5 hours on one day. There were 34 residents in the home on the day of the inspection, 5 requiring personal care and 29 requiring nursing care. Residents and staff were spoken with during the inspection. A tour of the building was undertaken. Care records of 4 residents were examined, plus other records relating to the staffing and management of the home. The pre-inspection questionnaire had been completed and was given to the inspector on the day of the inspection. What the service does well: 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. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 6 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 Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 7 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) 2 Detailed assessment information had been obtained to ensure the home could meet residents’ needs. However, some assessments had not been regularly reviewed which may have an impact on care delivery. EVIDENCE: The care files of four residents were examined. All the files seen contained detailed assessment information, including the assessments and care plans from care managers. There were assessments in each file of risk of developing pressures sores, risk of falls, moving and handling needs, and nutritional needs. Each file contained an assessment written on the home’s documentation, but none of these were signed or dated. Most of the assessments seen had been regularly reviewed up to date. One file contained an assessment of risk of developing pressure sores, (Waterlow assessment), which had the instruction to review 3 monthly but had no recorded reviews after July 2004. The same file had a falls risk assessment which had no recorded reviews after November 2004. All the files seen had care individual plans. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 8 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 9 Care plans and risk assessments were clear and detailed, ensuring that staff were aware of the action required to meet the needs of residents. EVIDENCE: Each of the care files seen had individual care plans. The plans were well written and clear on the action required by staff to meet residents’ needs. The plans covered all areas appropriate to individual residents, such as personal hygiene, continence, mobility, nutrition, mental health and social needs. Two files seen contained detailed and comprehensive information on the care and support required for ensuring the nutritional needs of the residents were properly met. Another file contained detailed information on the action staff should take to assist a resident with challenging behaviour. All the care plans seen had been regularly reviewed up to date. There was no evidence of residents or their representatives being involved in care plan reviews. However, it was clear that residents and their representatives were involved in care manager care reviews held 6 monthly. Staff spoken with were familiar with the care plans and said they were involved in reviews of care, particularly for residents they had been working with on a Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 9 one to one basis. Staff spoken with were knowledgeable about the needs of the residents. During the inspection, staff were observed explaining planned care to residents to ensure their understanding. Individual risk assessments were carried out for each resident, such as the risks involved in domestic activities, outings and smoking. Risk assessments seen had been regularly reviewed up to date. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 10 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) 12, 14, 15, 16 and 17 Residents were enabled to maintain appropriate and fulfilling lifestyles inside and outside the home. EVIDENCE: Residents at the home had been able to attend a local college until recently when the college’s student criteria had changed. The manager said that wherever possible college placements were sought for residents. The home had arranged placement at a farm for some residents and hoped to be able to extend this. One resident spoke of working on the farm and clearly enjoyed this. Social and leisure activities were individually planned for residents. Staff said that activities and routines had to be flexible to take account of residents’ changing needs, wants and abilities. Staff were knowledgeable about the activities enjoyed by residents they were involved with. Residents spoke of different activities they enjoyed, such as shopping, going to the pub, and going away on holiday. Staff felt that there was a good range of activities offered to residents, both in and out of the home. On the day of the inspection, there Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 11 were activities going on such as board games, going out to pick strawberries, walking to the local shops, and helping with domestic tasks. There was an open visiting policy at the home. Details of family history and current family and friends were included in residents’ care records. Relatives were encouraged to become involved in the care of residents as appropriate. One resident was supported to visit relatives at home accompanied by a member of staff. Staff spoken with showed a clear understanding of promoting individual choice and independence for residents. This was observed during the inspection, for example, a member of staff encouraging a resident to carry out personal grooming tasks independently, and discussions between staff and residents about plans for the day. Residents at the home were offered three meals per day, plus drinks and snacks. The menus seen were well balanced, varied, and offered choices at each meal. The lunchtime meal was observed during the inspection. Staff spoken with were knowledgeable about residents nutritional needs, for example, the use of food supplements for a resident who had lost weight. Lunchtime was relaxed with staff offering help in an unobtrusive way. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 12 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) 18, 19 and 20 There was an emphasis in the home on the choices and preferences of residents, demonstrated through the attitudes and awareness of staff. Residents’ physical and emotional health needs were well met with good liaison with local services. The procedure for the handling of medication in the home was generally satisfactory to ensure residents’ safety and welfare. EVIDENCE: The care files seen detailed residents’ preferred routines. Staff were well aware of residents’ preferences, demonstrated in discussion with staff and in observation of the interaction between residents and staff. Some residents had one to one support from staff and it was clear that good relationships had been established. Routines at the home were flexible to suit residents’ daily choices and preferences. The care files seen contained information about the healthcare needs of the individual residents. Each resident had records of monthly health checks, including blood pressure and weight. Residents had been referred to other services as appropriate, such as GP, optician, dentist, speech and language therapist, occupational therapist, and physiotherapist. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 13 Medication in the home was stored appropriately and securely. There were no residents able to self-administer medication. Records were kept of all medication ordered, received, administered and disposed of. The records seen were all satisfactory. The home’s medication policy needed amending to include the instruction that medication must be retained in the home for 7 days following the death of a resident in case of a coroner’s inquest. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 14 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 The complaints procedure was not sufficiently robust to ensure it was clear and effective for use by residents and staff. EVIDENCE: The complaints procedure was seen. This required amending to include the correct title of the Commission for Social Care Inspection, (CSCI), to include timescales for the response to complaints, and to include the information that CSCI can be contacted at any stage by a complainant. The complaints procedure was included in the service user’s guide in an appropriate format for residents, e.g. symbols and pictures. The home had received no complaints since the last inspection and no complaints had been received by CSCI. Staff spoken with said that residents usually raised any concerns / complaints directly with them or with the manager. There was no information in the home about access to advocacy services for residents or their representatives. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 15 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, 26, 28, and 30 The home was clean and comfortable, providing a pleasant environment for residents. EVIDENCE: Residents were accommodated in 6 units within the home, each with its own lounge and dining areas. The home was clean, pleasant and appeared well maintained. The ground and first floors of the home were fully accessible to all residents. The basement of the home was only accessible to staff and provided storage areas, staff room and laundry room. The laundry was well equipped, clean and tidy. The lounge / dining areas were well decorated, cheerful, and comfortably furnished in a contemporary style. There was a smoke room available to residents when accompanied by staff. There was no separate room or area for residents to use to see visitors in private if they wished, however, the manager said that her office was made available if needed. There was a garden and patio area accessible to residents. All residents had single bedrooms, mostly with en-suite toilets. The bedrooms seen were really individual as residents had chosen their own décor and soft furnishings and had personalised their rooms with photographs, pictures and Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 16 other possessions. Residents spoken with were pleased with their bedrooms. All bedroom doors were lockable, though few residents were able to have keys following risk assessment by the home. There was a lockable drawer in each room. The home was clean and free from offensive odours on the day of the inspection. There were sufficient, easily accessible handwashing facilities for residents and staff. Staff had recently undergone training in infection control. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 17 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) 31, 33, 34, and 36 Residents at the home were supported by a competent, effective and well motivated staff team. EVIDENCE: There was a core group of staff at the home who had worked there for several years. The manager said there had recently been some changes in the staff team and new staff had been recruited. The staffing levels at the home were high as several residents required one to one staffing, and others required one staff to two or three residents. Staff spoken with were well motivated, interested, and committed to the residents. They were knowledgeable about the needs of residents and about specific conditions of residents in the home – such as epilepsy. They were clear about their responsibilities, for example, in dealing with challenging behaviour. Staff files were seen and these contained all the required information. One newly recruited member of staff had no Criminal Records Bureau disclosure. This had been applied for and the member of staff was working under direct supervision. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 18 Although there was a policy and system in place in the home for staff supervision, this had not been started. Staff spoken with had undergone six monthly or annual appraisals. Each unit of the home held its own staff meetings, but these were not being held regularly in all the units. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 19 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) EVIDENCE: These standards were not assessed at this inspection. Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 20 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 x 2 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Whitwell Park Nursing And Residential Home Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 21 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. 3. Standard 2 20 22 Regulation 14(2) 13(2) 22(4)(7) Requirement Assessment of residents needs must be kept under regular review Medication must be retained in the home for 7 days following the death of a resident The complaints procedure must include a timescale, (within 28 days), for response to complaints, and correct information regarding the Commission for Social Care Inspection Timescale for action 30/09/05 30/09/05 30/09/05 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. 2. 3. Refer to Standard 22 33 36 Good Practice Recommendations The home should provide information about local advocacy services for residents Staff meetings should be held regularly and records kept of the minutes and action taken Staff should have regular, recorded supervision meetings at least six times per year Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection South Point 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 Whitwell Park Nursing And Residential Home C52 C02 S2098 Whitwell Park V237822 120705 Stage 4.doc Version 1.40 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!