Inspection on 06/09/06 for Whitwell Park Nursing And Residential Home

This inspection was carried out on 6th September 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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitwell Park Nursing And... 10/09/07

Whitwell Park Nursing And... 23/11/05

Whitwell Park Nursing And... 12/07/05

Whitwell Park Nursing And... 16/12/04

Whitwell Park Nursing And... 01/09/04

Whitwell Park Nursing And... 24/09/02

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

CARE HOME ADULTS 18-65 Whitwell Park Nursing And Residential Home 130 Welbeck Street Whitwell Worksop Nottinghamshire S80 4TP Lead Inspector Nancy Bradley Unannounced Inspection 6th September 2006 08.30 Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 Whitwell Park Nursing And Residential Home DS0000002098.V310517.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 Adults 18-65. 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. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitwell Park Nursing And Residential Home Address 130 Welbeck Street Whitwell Worksop Nottinghamshire S80 4TP 01909 724800 01909 721127 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) Mrs Ann Gibbins Dr E DeSaram Mary Marsh Care Home 35 Category(ies) of Learning disability (35) registration, with number of places Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2005 Brief Description of the Service: Whitwell Park is a modern, purpose built care home situated in the 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 DS0000002098.V310517.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection was unannounced and took place over eight hours. The inspector spoke with the Registered Manager and care staff. During the site visit the inspector made a tour of the home and spoke with service users. There were 33 residents in the home on the day of the inspection, with a new admission pending. Additionally, time was spent in preparation for the visit, looking at the pre inspection questionnaire. The inspector observed throughout the visit how the staff were meeting service user needs. The inspector spoke with the family of one service user. Records were examined relating to the service users and the general running of the home. The fees range from £627.90 to £1311.56per week with additional charges made for hairdressing toiletries magazines and transport. What the service does well: What has improved since the last inspection? What they could do better: More management hours are required to ensure the Registered Manager can meet the home’s stated purpose, objectives and the needs of the people who live and work there: • The arrangement for formal staff supervision. • Review of polices and procedures. • Arrangements for the review of informal and formal quality of care. • Establishing reviews of care needs assessments. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 the following standard(s): Standard 1 and 2 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Arrangements are in place to ensure that service users needs are fully assessed and met prior to admission. EVIDENCE: The home has a Statement of Purpose available to service users, prospective service users and referring agencies about the service. This needs to be updated to fully reflect and inform service users about the service provided. The majority of the service users who are admitted to the home have their needs assessed via social worker or through the care management system, which highlights their additional needs, and the need for additional staffing hours. The assessments then form part of the service user plan compiled by the home and had been signed by the service user’s. These were comprehensive and up to date and reflected the involvement of service user and significant others. However several of the care needs assessments have not always been reviewed by the referring Authority. The Registered Manager agreed to address this area. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 9 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 the following standard(s): Standard 6,7 and 9 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There is a care planning and review system in place, which ensures that service users individual needs are met. Service users are supported to achieve an independent lifestyle and participation in all aspects of the life at the home is encouraged EVIDENCE: During the visit care plans of all four-service users were examined. The staff for each service user has compiled the care plans and evidence was seen of care plans being reviewed on a regular basis, this includes all the key staff involved in the care of the service users. Care plans included services users individual lifestyle preferences and choices; the interventions prescribed by outside healthcare professionals were appropriate. Daily records are also maintained on each service user. Due to their level of disability some service users were unable to agree and sign their care plan, although they were involved in compiling the care plan where possible. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 10 All service users have access to the Advocacy service should this be required. Several of the service users have been resident at the home for some time and it is evident that the staff know them well. From observations, examination of records and through discussions with the care staff it is evident that service users are encouraged to make choices and decisions about their lives, and are involved in all aspects of life in the home. Individual risk assessments have been complied up on each service user, such as the risk involved in the daily domestic activities, outings, and smoking. Risk assessments are reviewed and updated at regularly intervals. As discussed with the Registered Manager care plans need to have a definite date for review, service user records need to be in chorological order, and archived as appropriate. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 11 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 the following standard(s): Standard 12,13,15, 16 and 17 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There were arrangements in place to enable service users to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. The home provides a well-balanced and nutritious diet. EVIDENCE: The relationships observed between care staff and service users were open and good-humoured. The service users are encouraged to take pride in their appearance and their preferred style of dress is respected. During the visit the inspector spoke with the care staff about the activities service users were engaged in and the arrangements for these. The care records of four service users provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and outside in the community. The service users are unable to work due to the level of disability, and have attended the local college in the passed. However the Registered Manager Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 12 stated that this may not be available to them in the future. The home has employed a activities co coordinator who works full time focusing on arranging individual activities for service users. The service users’ personal goals, choices and preferences were identified and there were properly recorded risk assessments in place for each service user in relation to the activities they were engaged in. The care staff take the service users on holiday each year and they were due to go away to Skegness in the next few days. All holidays are tailored to the individual needs and abilities of the service user. Information on service users’ records indicated that contact with family and friends were appropriate. From examination of the menus the home is providing a healthy well-balanced and nutritious diet. However the home needs to fully record all meals provided this should include any variations to menus, breakfast and suppers. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 13 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 the following standard(s): Standard 18,19 and 20 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The health needs of service users’ are well documented ensuring that individuals receive regular health checks. Service users receive personal support in a way, which promotes, their independence Policy and procedures relating to the receipt, checking and storing of medicines requires reviewing in line with the required standards. EVIDENCE: The service users care records seen detailed their preferred routines and the staff were well aware of their preferences, and demonstrated this in discussions with each other. Interactions and conversations with service users ware appropriate. Several of the service users had a one to one support from their care worker and it was clear that good relationships had been developed. Routines at the home were flexible to meet the service user individual needs, with one service user getting up when they wished to From records examined and from discussions with staff, this showed that service users’ health and personal needs were being met Service users were generally healthy and records showed that staff promptly contacted the appropriated medical services. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 14 All service users attended services within the community including optician, podiatrists, and dentist. 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 medication used at the home. However on examination of the administration of medication records one member of staff had failed to record the medication administered on the day. The Registered Manager conducted an audit, which confirmed the medication had been given and the records had not been fully completed. The Registered Manager agreed to take this up immediately with the member of staff and contact the Commission for Social Care Inspection to confirm this. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 the following standard(s): Standard 22 and 23 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Arrangements are in place to safeguard service users’ welfare and ensure that their concerns are listened to and acted upon. EVIDENCE: The complaints procedure was examined. This requires amending to include the correct details for the Commission for Social Care Inspection and the Commission for Social Care Inspection can be contacted at any stage by the complainants. The home has not received any complaints since the last inspection and the Commission has received no complaints for this service. The service users and d their families spoken to during the visit confirmed that they would take concerns they had to the Registered Manager. The homes policy on the protection of adults was examined. This needs to be review and updated to reflect the change of policy to the Safeguarding of Adults. Records were seen showing that the majority of staff had undertaken training in the safeguarding of adults and that this was an ongoing programme. The Registered Manager stated that the physical intervention techniques used were with in the Department of Health guidelines. The home has systems in place for the managements of service users’ money. Records were held separately for each service user and these were kept securely. Service users were seen requesting monies during the visit and those able to sign did so. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 the following standard(s): Standard 24 and 30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The general standard of the home and the environment are good providing service users with an attractive and comfortable place in which to live EVIDENCE: The inspector conducted a tour of the home and all communal areas were inspected together with the staff facilities. The tour of the home showed that the home is well maintained and furnished to a satisfactory standard. The facilities are homely, comfortable and free of unpleasant odours as was the case on the day of the visit. Staff have received training on infection control. As annual maintenance programme for renewal of the fabric and decoration of the premises needs to be produced and implemented with records kept. This will assist with the overall maintenance of the home. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 32,34 35 and 36 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to this service. The home has a recruitment policy in place, which ensure the safety and protects the service users. However this requires strengthening in some areas. Importance is given to the staff training needs. The staff appeared to be well supported in their day-to-day work however this could be further strengthened with the development of a formal system of supervision. EVIDENCE: The staffing levels at the home were high, as several staff service users require one to one staffing, and the other staff working with one or two service users. The majority of the care staff are registered nurses working with care workers for support. The Registered Manager stated that several staff are working towards a NVQ level II and III. However the percentage of staff holding a NVQ level II and II is below the 50 required under standard 32.6. There is a staff recruitment policy and procedures in place and from records examined all staff are required to have a current and valid Criminal Records Bureau check, two references. All recruitment records are held by the home in a secure cabinet. Several staff records were examined, and although the majority of the information was available staff requirement records do require attention. Staff Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 18 recruitment records need to meet the requirements under Schedule 2 of the National Minimum Standard for Care Homes for Adults (18–65) 2001. The staff recruitment records did highlight the following issues: • No records of interviews on file. • Copies of birth certificates /passport on file to prove identity. • No copies of qualification certificates on file. • Full employment history. • Documentary evidence of any relevant qualifications • Criminal Records Bureau clearance for some staff did not include POVA and POCA. The staff training records were examined. There is a programme of training in place, which includes fire safety, moving, and handling, managing aggression and violence and caring for people with epilepsy. From discussions with staff training is given a high priority in the home and they are encouraged to attend relevant courses. Although there is a policy and procedure for the supervision of staff the Registered Manager confirmed that this does not always take place. Staff confirmed that they do have an appraisal and this is linked to their Personal Development Plan. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 37,39 40 and 42 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Systems are in place to ensure that service users have a voice and their views are listened to. EVIDENCE: The Registered Manager has considerable knowledge and experiences in caring for adults with a learning disability and challenging behaviour. She has been with at Whitwell Park for a number of years. As discussed at the visit the Registered Manager does not have a recognised managers award, which all managers of care homes are required to achieve. Since the last inspection the Registered Managers have developed a policy for monitoring care provided by the home. However due to the limited communication levels of some of the service users they are unable to complete questionnaires and take part in residents meetings. The home is looking to review the care on an informal level. The Registered Manager stated they receive positive feed back from the families. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 20 Samples of policies were examined and has discussed with the Registered Manager several need to be reviewed and updated. The staff have access to all the policies and procedures. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to the Commission for Social Care Inspection Systems were in place for the monitoring and maintaining the hot water temperatures. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 3 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 3 X 3 X Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 22 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 YA2 Regulation 14 Requirement Timescale for action 31/10/06 2. 3 YA20 YA22 13 Schedule 3 6 Schedule 1 19 Schedule 2 and 4 All care needs assessment must be reviewed regularly and copies of the reviews must be made available to the home. All medication administered must 30/09/06 be recorded correctly. The complaints procedure must be updated to show the correct details of the Commission for Social Care Inspection. All staff employed must comply with the home policy and procedures on recruitment as detailed in Schedule 2 of the National Minimum Standards for Younger Adults 2001 All staff must have regularly supervision in line with the National Minimum Standard 36.4 A formal quality assurance system must be developed to include the views of services users and their representatives. 31/10/06 4 YA34 31/10/06 5. 6 YA36 YA39 18 24 Schedule 4 31/10/06 31/10/06 Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 23 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 7 8 9 10 11 Refer to Standard YA1 YA1 YA23 YA34 YA34 YA34 YA34 YA34 YA34 YA37 YA40 Good Practice Recommendations The Statement of Purpose should be reviewed and updated to fully reflect the service available The Commission for Social Care Inspection should be informed of any change to the Statement of Purpose The protecting adults policy and procedure must be updated and reviewed to ensure service users are fully protected from harm. When gaps in employment history is investigated this should be formally recorded on interview minutes. All staff should be given a copy of the code of conduct published by the General Social Care Council (GSCC) Staff with a Criminal Records Bureau over three years should have their clearance renewed to include POVA and POCA. The Registered Person should ensure that individual staff interview records are signed and dated. All staff should ensure that they provide copies of all qualifications. The Registered Person should ensure that the full employment history includes the days date month and year of employment. The Registered Managers should commence an approved management qualification. All polices and procedures relating to the home should be reviewed and updated. Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 24 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 Whitwell Park Nursing And Residential Home DS0000002098.V310517.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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