Inspection on 17/05/06 for Whitworth House

This inspection was carried out on 17th May 2006.

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.

Other inspections for this house

Whitworth House 12/11/07

Whitworth House 07/02/07

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 Unannounced Key Inspection 17th May 2006 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.V293264.R01.S.doc Version 5.1 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.V293264.R01.S.doc Version 5.1 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 Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (9) of places Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 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.V293264.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service users report that their own experience of care remains good. However this positive experience could easily be undermined if the home continues to operate a very lax management style. The proprietors continually report that they have significant difficulties in operating diligent managerial practices although it is positive to note that they have now secured an independent consultant who will work with them on making improvements. For this reason the Commission is prepared to allow more time for the home to demonstrate that progress is being achieved in these areas. What the service does well: What has improved since the last inspection? What they could do better: The risk assessments must be expanded upon and must outline in every case why individual service users are not able to control their own medication. Each member of staff must have a written training and development plan. Staff individual supervision still requires improvement. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 6 The home has still yet to implement a proper quality assurance programme and annual development plan. It is also necessary for a full and proper health and safety at work risk assessments to be completed. 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. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 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.V293264.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, & 6 This home provides enough information for potential service users and their relatives to make an informed decision about moving in to the home. EVIDENCE: The statement of purpose was written last year. This includes reference to the Home’s policy regarding the shared room, and reference to there being insufficient space for a visitor’s room in the home. The statement of purpose was written with the assistance of the National Care Homes Association and is a well formulated document. The service user guide is also well written and gives the people who live at the home the information that they would wish to know. This guide is now being issued to all service users. As referred to at previous inspections, a contract is available to each service user; this has now been completed for new service users who have been admitted since the previous inspection. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 9 No new permanent service users have come to live at Whitworth House since the previous inspection. The referral information for a service user who has come into the home for respite care was seen and all of the necessary pre placement information had been received. The home has, since the previous inspection, admitted one service users for intermediate care. This is a very specific short term placement for no longer than three weeks and all of the necessary information was received by the home. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 The Service users still cannot feel entirely confident that their personal care needs and physical and emotional health needs are properly documented by the home. This poses a continuing risk to ensuring that the service users have the opportunity to maintain their dignity, have their rights respected and continue to enjoy a good quality of life. Service users can have less 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 shown signs of deterioration, having formerly show signs of improvement. Updating of care plans, and establishing these for more recently admitted service users has again improved, however the home must be mindful that this must be consistent and not deteriorate again. There remains a need for a system of more rigorous risk assessment as the ones that are currently written are still Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 11 limited to risks of falls and manual handling and must be expanded upon to include other areas of risk. The home is still able to demonstrate, 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 also keeps some records of service users healthcare appointments. Although it is still not at all clear whether these fully reflect what actually occurs and the standard of these records varies considerably between quite detailed to almost non-existent. 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. However, it is still not documented in every case why individual service users are not able to control their own medication, which must be recorded. A local pharmacist provided training of 4 staff in all aspects of handling and administration of medicines in November last year. Staff who have not had this training are not permitted to give medication. An updated copy of the agreement to provide advice from the local pharmacist currently visiting the home is also available for inspection. The Inspector was told that the staff are all very clear that the proper and most appropriate procedures will be observed at any time that a service user passes away. It had been previously noted that service users who have made their wishes known have these recorded in their care plan, and this is now the case for newly admitted service users. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The service users can be confident that the home continues to actively encourage and support them to keep and maintain personal relationships and friendships. The home also encourages service users to receive visitors. EVIDENCE: There was some indication from two service users who chatted during the previous inspection that they would appreciate more opportunities to engage in activities outside of the home. This has been explored further with the service users asking to visit particular places of interest and the manager of the home has agreed to arrange this. 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. These comments also indicate that the staff team of the home 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 observation of a mealtime showed that service users are provided with a wholesome diet. It was also Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 13 commented upon that the service users have an opportunity to influence what is on the menu. Two service users complimented the home on the food that is provided and said that they enjoyed the lunch on the day of this visit. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 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 or neglect. EVIDENCE: The home has not recorded any complaints since the last inspection, and indeed none since 1994. The service users who briefly spoke said 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. 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. No complaints of abuse have been made to the Commission and the service users made none during this visit. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Service users can continue to feel confident that they do live in a comfortable, clean and well maintained house that meets their needs. EVIDENCE: A handrail is provided at the side of the patio doors out to the garden. A short banister rail, which was 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 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 remains clean and tidy and is free of unpleasant odours. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Service users can feel confident that there will be enough staff on duty to cater for their needs. However the safety of the service users may be seriously compromised if the home fails to properly carry out background checks when new staff are recruited. 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. EVIDENCE: The proprietors have assured the Commission at the previous inspection that staff were undertaking the NVQ level 2 award, with further staff awaiting the opportunity to start this qualification when the training agency used is able to accommodate them. There is now more documentary evidence of this. One member of staff has obtained NVQ 2, one is working towards it and has credits in place and three others are confirmed with places to commence this qualification in June 2006. All of the staff files were examined at this inspection visit and all now contain an enhanced CRB Disclosure certificates for their employment at this home. The staff files are still limited in terms of other information such as Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 17 confirmation that references are from previous employers, interview notes and training achievements and needs. This continues to be that must improve. 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. There is still a lack of accessible documentary evidence about the home being able to meet this requirement that has been repeatedly made but has still not been addressed. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 & 38 Although the proprietors, one of whom is also the registered manager, are assessed as fit person in law to own the home they still clearly find it very difficult to grasp the concept of managing a professional care service. Service users cannot feel entirely confident that the home is run with their best interests at heart. Much more still needs to be 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, with the exception that a full health and safety at work risk assessment still needs to be completed in relation to how staff work with service users. This is yet another outstanding requirement from previous inspections. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 19 EVIDENCE: In April 2005 the home obtained a full set of policies and procedures that the proprietors had obtained from a consultancy company. There is still a need for the management and staff of the home to familiarise themselves with these and to ensure that they actually adhere to them. This was again discussed with the proprietors, one of whom is also the manager, and progress must be made. To assist open and specific future planning for the home, a Business and Development Plan should 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. Individual service users again expressed highly positive satisfaction with the home. There is still a need to ensure that service users meetings seek their views about how the home is run. As mentioned in previous inspection reports there is still no specific Quality Assurance system in the home. A format has been purchased although this has yet to be implemented. The proprietors again accept the need for a QA system to be developed, focussing on the participation of service users, professionals, relatives / friends and others and for the feedback and material to inform a structured plan for the year ahead. There is some indication of the home having made further moves towards trying to achieve this objective, however, this work must now be completed any further delay. An annual Review/ Development Plan still needs to be developed and this must still include a programme of proposed redecoration and renovation on a cyclical basis. There remains no properly established 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 previously informed the inspector that regular supervision sessions with staff are taking place, but there remain 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 a proper supervision structure must be in evidence without any further unnecessary delay. It was reported at the previous inspection 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 Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 20 entirely appropriately maintained, or being kept up to date and accurate. The proprietors had made some strides in the right direction at that time; unfortunately there is much that remains to be implemented and consistent and long lasting improvements must be made. The proprietors were previously able to provide all documentation concerning the maintenance and servicing of the home’s equipment and services. The home has still not reviewed the Risk Assessments fully covering all aspects of the home’s conduct under the Health and Safety at Work Act. The home is in breach of the law in regard to the failure to implement the requirements of this act. The following health and safety checks have been carried out within the last year: Fire Alarm System: 24/05/05 Fire Extinguishers: 24/05/05 Gas Safety Check: 09/06/05 Legionellosis: 17/02/06 Portable appliances: 21/06/05 The home is generally good at making sure that the people who live and work here are kept safe from fire and other hazards. The proprietors must be mindful of not allowing the checks that are coming up for renewal to fall outside of their due date. Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 21 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 3 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 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 X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 1 3 3 1 1 1 Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 13 (1) (b) & 13 (4) ( c) Requirement Risk assessments that are currently written are limited to risks of falls and manual handling and must be expanded upon to include other areas of risk. It must be documented in every case why individual service users are not able to control their own medication. Proper healthcare records must also be kept. The staff files must contain evidence of proper references, interview notes and training achievements and needs. Timescale for action 17/05/06 2. OP9 13 (2) 17/05/06 3. OP29 19 (1) (a) & (b) 17/05/06 4. OP30 18 (1) ( c ) (i) All staff must have an individual 17/05/06 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) An Annual Review / DS0000025868.V293264.R01.S.doc 5. OP33 24 (1) 17/05/06 Version 5.1 Page 23 Whitworth House Development plan must be evolved, involving consultation with service users, and be in line with a proper quality assurance system. 6. OP36 18 ( 1) (a) The home must ensure that staff receive regular formal supervision, and that this is evidenced in records of supervision sessions. 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. Risk Assessments must be reviewed and augmented to fully cover all aspects of the home’s conduct under the Health & Safety at Work Act 1974. 17/05/06 7. OP37 17 (1) (a) 17/05/06 8. OP38 13 (4) (a) 17/05/06 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.V293264.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Whitworth House DS0000025868.V293264.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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