Inspection on 12/11/07 for Whitworth House

This inspection was carried out on 12th November 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Whitworth House 07/02/07

Whitworth House 17/05/06

Whitworth House 10/01/06

Whitworth House 02/08/05

Whitworth House 08/03/05

Whitworth House 14/10/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Whitworth House 11 Whitworth Road South Norwood London SE25 6XN Lead Inspector James Pitts Key Unannounced Inspection 13th November 2007 10:35 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 Whitworth House DS0000025868.V354387.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. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitworth House Address 11 Whitworth Road South Norwood London SE25 6XN 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) 020 8771 7675 020 7924 5293 Mr Thomas Sawyer Mrs Christiana Sawyer Post Vacant Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (9) of places Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2007 Brief Description of the Service: Whitworth House is situated in a residential street in South Norwood. The home can accommodate up to nine older service users, all but two having their own bedroom and all sharing a lounge and dining area. The home has a passenger lift, which does help to alleviate some of the difficulties, which some more frail service users may have when negotiating the stairs. The home is very close to a local Anglican Parish Church and a reasonable variety of shops on the near by high street. A mainline railway station is within a few minutes walk and so travelling further a field either by train or the good local bus services is not too difficult for those that wish and are able to. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the home’s second inspection in the current inspection year. The first random inspection took place in May of this year. Since then the Commission has received comments via questionnaires from 8 people who have used, or are using, this service and four relatives. Comments have also been made during visits. Without question all of this feedback has been complimentary about the caring that is displayed by the staff team at the home and that there is a high degree of satisfaction with the service. It has previously been noted by the Commission that this positive experience could easily be undermined if the home continued to have difficulty in operating diligent managerial practices. It is evident that the proprietors still find it a challenge to fully apply all of the principles of good management, although slow progress has continued to be made in many areas. This inspection report encompasses information that was obtained at both this visit and the previous random inspection. Records have been examined and conversations with various people have been held on each visit and information that has been reported to the Commission has also been considered. What the service does well: What has improved since the last inspection? The staff files now contain evidence of proper references & interview notes and training achievements and needs. Risk Assessments have now been reviewed and augmented to more fully cover all aspects of the home’s conduct under the Health & Safety at Work Act 1974. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Whitworth House DS0000025868.V354387.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 Whitworth House DS0000025868.V354387.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 3 & 6 were assessed at this inspection. The people who use this service can be assured that the home provides enough information for potential service users and their relatives to make an informed decision about moving in to the home. The necessary information about the needs of any person wishing to move into the home, whether permanently or for short term respite care, is also usually received. EVIDENCE: One person has been placed at the home since the random inspection in April of this year. The referral information for this person was seen during this inspection and it contained the necessary pre placement information. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 9 The home has not, since the previous inspection, admitted anyone for intermediate care. It should, however, be noted that previously the home has been seen to obtain all of the necessary information before anyone is considered for a short term respite care placement. Whitworth House DS0000025868.V354387.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 7, 8, 9, & 10 were assessed at this inspection. The Service users cannot feel confident that their personal care needs and physical and emotional health needs are properly documented by the home. This is particularly the case where significant changes occur that require a reassessment of their care and support needs. Service users can have more confidence that their health care needs will continue to be attended to and that will receive the support and treatment that they need. EVIDENCE: It has been reported at previous inspections that care plans had been of varying quality, not only in terms of their detail but also the consistency with Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 11 which these were being monitored. Updating of care plans, and maintaining these to an acceptable standard continues to demonstrate the improvement that was commented upon at the previous key standards inspection. The home is again reminded to be ever mindful that this must continue and not deteriorate again. There continues to be a more rigorous risk assessment system than was previously the case. The ones that are written go beyond merely risks of falls and manual handling and include other areas of risk. One significant concern has arisen as the result of an allegation of neglect that was made about the care of one person. This person had suffered a series of falls and it was alleged that the home had been neglectful by not raising this with the placing authority, and that as a result this person had been placed at unnecessary risk. The investigation threw up different view points about what had actually occurred, although at the very least the home could not provide evidence that they had taken all the actions required to address this concern. Where the level of care and support that is required by anyone who lives at the home reaches the point where this service can no longer provide a safe environment this must be vigorously pursued with the placing authority and evidence of this must be available. As a result of this particular allegation, the two placing authorities reviewed their respective clients who are placed here. The manager stated that these reviews indicate that aside from the person who is referred to earlier, the home is able to care for the remainder of those who live here. The home is still able to demonstrate, although still through limited individual healthcare records, that service users are in regular contact with General Practitioners, Community Nurses and other health care specialists whenever they need to be. The home continues to keeps records of service users healthcare appointments. Medicines are still ordered monthly so that there is not too much kept at the home at any one time. Each of the service users has staff assistance to remember when they need to take their medicines. The staff then sign the correct medication records to show that this has been done. It is now documented in every case why individual service users are not able to control their own medication. A local pharmacist continues to provide training to staff in all aspects of handling and administration of medicines. It remains the case that staff that have not had this training are not permitted to give medication. There is a written agreement with the local pharmacist who supplies medicines to the home to also provide advice about handling, administration and storage of drugs. Both the people who use this service and their relatives continually report through both questionnaires and conversations that the staff of the home treat the people who live here with dignity and respect. Whitworth House DS0000025868.V354387.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 14 & 15 were assessed at this inspection. The people who use this service can be confident that the home has, and continues, to improve upon the opportunity to engage in activities and social events. The home also continues to actively encourage and support each person who lives here to keep and maintain contact with family and friends. EVIDENCE: At the previous key standards inspection there was some indication from two service users that they would appreciate more opportunities to engage in activities outside of the home. This was successfully explored further and service users are currently more satisfied with the nature and range of activities that are on offer. Visitors continue to be very welcome to the come to the home, which was confirmed by the comments that were received by the Commission from some of the service users and relatives of those who live here over the current inspection year. These comments also indicate that the staff team of the home Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 13 are very clearly committed to respecting the privacy and dignity of service users, which is acknowledged with significant praise from both service users and their relatives. The menu’s, comments from service users and relatives indicate that service users are provided with a wholesome diet. It was also commented upon that the service users have an opportunity to influence what is on the menu. This menu currently rotates on a four weekly cycle and is altered in line with the changing seasons. Whitworth House DS0000025868.V354387.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 16 & 18 were assessed at this inspection. Service users can feel confident that if they were ever to have any concerns about the home that these would be properly addressed. Service users can still feel safe in the knowledge that the staff of the home do all that they can to ensure that service users are protected from abuse. EVIDENCE: The home has not recorded any complaints since the last inspection, and indeed none since 1994. The service users regularly say at inspection visits that they have no complaints about how they are cared for and neither had any relatives who have been in contact with the Commission in the last year. The home has a proper complaint procedure. It is also noted that this home as a history of receiving very few, if any, complaints and that none have been made to the Commission to date. The record of complaints was available to see during this visit, as too were letters of compliments from relatives of some of the people who have lived at the home. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 15 The manager continues to have a good understanding of their duty to protect vulnerable adults. The home’s protection from abuse policy is clear and includes the need to refer any allegations of abuse to the local authority care management team. As referred to under the “Health & Personal Care” section earlier in this report an allegation of neglect was recently made about the home. It was evident that at the very least the concern about a person becoming more frail was not vigorously pursued with the placing authority, even though this authority had on previous occasions said that the person continued to be suitably placed at the home. Whitworth House DS0000025868.V354387.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 19 & 26 were assessed at this inspection. The people who use this service can continue to feel confident that they do live in a comfortable, clean and well maintained house that meets their needs, although staff information should not be displayed in any way that impinges on the creation of a truly homely environment. EVIDENCE: A handrail is provided at the side of the patio doors out to the garden. A short banister rail, which was previously thought to be needed on the left hand side of the short staircase from the ground level down to the kitchen, cannot be put into place, as this is a stud wall and will not support a rail whilst someone puts weight on it. This means that the home is mindful of the need to supervise Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 17 service users when going down this small flight of stairs, although as there are no service user facilities in the area in question this would not occur frequently. The home is well decorated, comfortably furnished, clean and is free of unpleasant odours. One area of concern is that the siting of health and safety posters and some administrative documents in the dining rooms is too intrusive and these must be removed and placed elsewhere that is not used by the people who live here. Whitworth House DS0000025868.V354387.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 27, 28, 29, 30 were assessed at this inspection. Service users can feel confident that there will be enough staff on duty to cater for their needs. The safety of the service users is now more assured as the home has carried out the proper background and recruitment checks on new staff. The good level of care that the service users and relatives have historically said is provided by the home could still be jeopardised if the manager does not make sure that proper training and development programmes are in place for the staff or that staff are properly supervised. EVIDENCE: The proprietors have now provided evidence that almost all of the staff have either achieved or are studying for the NVQ level 2 award. There is complete documentary evidence of this. Over half of the staff team are presently qualified to NVQ2 or higher. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 19 All of the staff files were examined over the course of both the random and this key inspection and enhanced CRB Disclosure certificates are in place. The staff files are still limited in terms of other information, but confirmation that references are from previous employers and training some achievements are noted. It is once again stated that all staff must still have an individual training and development profile, to be included on their staff files. This should detail the NTO workforce training targets and evidence that staff are fulfilling the aims of the home and are able to meet the individual and changing needs of service users. Whitworth House DS0000025868.V354387.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 31, 32, 33, 34, 35, 36, 37 & 38 were assessed at this inspection. Service users can feel more confident that the home is run with their best interests at heart. However, more is now being done by the home to show that they are seeking the views of the service users and other interested parties. Service user’s financial interests are safeguarded by the home’s policies and practice. Service users can feel confident that their health, safety and wellbeing are well catered for. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 21 EVIDENCE: In April 2005 the home obtained a full set of policies and procedures that the proprietors had obtained from a consultancy company. To assist open and specific future planning for the home, a more complete Business and Development Plan must still be put into place. This would assist the proprietors and others to see where the business is going and how it intends to achieve its stated goals. This requirement remains outstanding from previous inspections and must be addressed without further delay, although it is noted than some progress has previously been made. Individual service users continually express a highly positive degree of satisfaction with the home. There is now more evidence that service users meetings seek their views about how the home is run. As mentioned in previous inspection reports there was no completed specific Quality Assurance system in the home. A format was purchased although implementation of this has taken an unacceptably long time to complete. A more comprehensive annual Review/ Development Plan still needs to be developed. There is still a lack of a properly implemented formal system of staff supervision or appraisal (Staff supervision is a time that each member of staff can meet individually with the manager to discuss how they are progressing in their work and to resolve any employment and training matters). The proprietor / manager have stated repeatedly at inspections that regular supervision sessions with staff are taking place, but there still remains very few records to show that this occurs at least six times each year, which is required. Staff continue to be supervised and monitored on an informal, ongoing verbal basis, but the supervision structure that was developed last year must be commenced and achieve consistency. It was reported at the last three previous inspections that not all of the records required by Schedules 3 and 4 of the Care Homes Regulations 2001 for the protection of service users and for the effective and efficient running of the business are not entirely appropriately maintained, or being kept up to date and accurate. The proprietors have made continuing strides in the right direction, but yet more needs to be done to ensure that this is fully complied with. The proprietors were able to provide all documentation concerning the maintenance and servicing of the home’s equipment and services. The home has reviewed the Risk Assessments fully covering all aspects of the home’s conduct under the Health and Safety at Work Act, which was most recently completed on 31/08/07. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 22 The following health and safety checks have been carried out within the last year: Fire Alarm System: 25/05/07 Fire Extinguishers: 15/05/07 Gas Safety Check: 12/06/07 Legionellosis: 03/05/07 Portable appliances: 03/07/07 The home is good at making sure that the people who live and work here are kept safe from fire and other hazards. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 23 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 1 1 3 Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 14 (2) (b) Requirement Where the level of care and support that is required by anyone who lives at the home reaches the point where this service can no longer provide a safe environment this must be vigorously pursued with the placing authority and evidence of this must be available. Timescale for action 12/12/07 2. OP25 23 (2) (a) The siting of health and safety 12/12/07 posters and some administrative documents in the dining rooms is too intrusive and these must be removed and placed elsewhere that is not used by the people who live here. All staff must have an individual 12/11/07 training and development profile, to be included on their staff files. This should detail the NTO workforce training targets and evidence that staff are fulfilling the aims of the home and meeting the changing needs of service users. (30.1) (Previous timescales of 17/05/06, 22/08/06, 07/02/07 & 3. OP30 18 (1) ( c ) (i) Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 25 14/07/07 were not met) 4. OP33 24 (1) An Annual Review / Development plan must be evolved, involving consultation with service users, and be in line with a proper quality assurance system. (Previous timescales of 17/05/06, 22/08/06, 07/02/07 & 14/07/07 were not met) 12/11/07 5. OP36 18 ( 1) (a) The home must ensure that staff receive regular formal supervision, and that this is evidenced in records of supervision sessions. (Previous timescales of 17/05/06, 22/08/06, 07/02/07 & 14/07/07 were not met) 12/11/07 6. OP37 17 (1) (a) Records required by Schedules 3 and 4 of the Care Homes Regulations 2001 for the protection of service users and for the effective and efficient running of the business are not entirely appropriately maintained, or being kept up to date and accurate. This must occur. (Previous timescales of 17/05/06, 22/08/06, 07/02/07 & 14/07/07 were not met) 12/11/07 Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 26 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 OP33 Good Practice Recommendations Service user meetings should seek their views about how the home is run. Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Whitworth House DS0000025868.V354387.R01.S.doc Version 5.2 Page 28 - 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!