Care Home: The White House

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What the care home does well People are happy living at the home. They are supported to make choices and do the things they want to do. They have active and full lives and keep in touch with friends and family. Everyone is treated as an individual and given the support they need. The staff are well supported and are happy working at the home. The White House DS0000070484.V377591.R01.S.doc Version 5.3 The manager has an excellent knowledge of the service and the changes needed to improve things for the people living there. What has improved since the last inspection? There have been a number of changes for people who live at the home including increased health needs and the closure of the day centres some of them have used for many years. The staff have supported people well through these changes and have worked alongside them, their families and other professionals to make sure everyone has the best support and information. There have been improvements to the way staff are supported and trained and this has helped them care for people who live at the home better. People have had their own personal achievements and these are celebrated. People who live and work at the home and other important people are able to contribute their ideas and opinions so that the service is managed in everyone`s best interests. What the care home could do better: The home is well managed and meets or exceeds standards for most of the areas we looked at. The manager has a good awareness of where improvements are needed and has a plan for these. We found that there needs to be some improvements to the way in which people`s medication is managed, to make sure everyone is kept safe. We felt that the staff should take part in annual appraisals of their work to help support people even better. We felt that people who live at the home could be even more involved by helping to recruit staff and by having a care plan in a format which they understand. Key inspection report CARE HOME ADULTS 18-65 The White House 91 Heathfield North Twickenham Middlesex TW2 7QN Lead Inspector Sandy Patrick Key Unannounced Inspection 10th September 2009 09:00 10/09/09 The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service The White House Address 91 Heathfield North Twickenham Middlesex TW2 7QN 020 8744 0600 020 8891 0646 whitehouse.care@tiscali.co.uk 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) Richmond Fellowship Foundation International Miss Diana Bidwell Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 5 17th September 2008 Date of last inspection Brief Description of the Service: The White House is a care home for up to 5 adults with a learning disability. Each person has their own bedroom. The home is located close to Twickenham and Whitton town centres and public transport links. The home is staffed twenty-four hours a day. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. People have their places funded by the Local Authority. The people who live at the home pay a contribution out of their benefits. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. The inspection included an unannounced visit to the home on 10th September 2009. We met with all the people who live at the home, staff on duty and the manager. We looked at records, the environment and how people are cared for and supported. We asked the manager to complete a quality self assessment about the service. We wrote to people who live at the home, their families, staff and other professionals and asked them to complete surveys about their experiences. We looked at all the information we had received about the home since the last inspection. This included monthly quality checks made by the organisation and notifications of events, accidents and incidents which had taken place at the home. Some of the things people told us about the White House were: ‘I like the staff and I like the outings. I get the things I like and I stay in touch with my family.’ ‘The White House is my home and I love staying here.’ ‘The White House gives people they support lots of informed choice and care for them in a person centred way.’ ‘The White House staff have created a happy environment for the people who live there and take care of individual needs.’ ‘I am very happy with the home I live in.’ ‘The White House gives the residents a sense of being valued.’ What the service does well: People are happy living at the home. They are supported to make choices and do the things they want to do. They have active and full lives and keep in touch with friends and family. Everyone is treated as an individual and given the support they need. The staff are well supported and are happy working at the home. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 6 The manager has an excellent knowledge of the service and the changes needed to improve things for the people living there. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. The White House DS0000070484.V377591.R01.S.doc Version 5.3 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 The White House DS0000070484.V377591.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information to help them decide whether they want to move to the home. They have their needs assessed to make sure the home is the right place for them. EVIDENCE: Everyone has lived at the home for some time and no one new has moved there since the last inspection. People told us that they had been given information to help them decide if they wanted to live at the home when they first moved there. The manager told us that she planned to involve the people who live at the home in designing a new guide about the service. This guide will be shared with people who are interested in moving to the home in the future. People who are interested in moving to the home have their needs assessed by the local authority and by the manager to make sure the home is the right place for them. The White House DS0000070484.V377591.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs recorded so that the staff know what support and care they need. There needs to be further work to help everyone record their needs and wishes in a format which they understand. The staff use different communication methods to make sure everyone has information to make choices about their lives. EVIDENCE: People told us that the staff supported them to make decisions about their own lives and to make choices. People told us that the staff helped to keep them informed by using words and signs which they understood, and photographs and symbols to help explain things. Some of the things people told us were, ‘in my experience the staff at the White House always treat residents as individuals and with respect’, ‘they meet The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 10 all my relative’s needs and he has a dedicated care worker’, ‘the staff seem to know the clients well and are genuinely concerned to ensure they receive the best care’, and ‘they seem to take time to get to know people and support them individually’. The manager told us that staff have had training and support to understand the needs and choices of people who live at the home. She told us that staff had regular discussions about people’s specific needs, wishes and choices. Some people have developed their own ‘person centred plan’, which tells the staff what they feel, need and want in their own words and using symbols, pictures and photographs. The manager told us she wants everyone to have a plan like this. She told us that over the next year she wants staff to support people with this. This is important because it helps the staff think about things from the person who lives at the home’s point of view. It also helps the person who is being supported have more control over the care and support they receive. Everyone has their needs recorded in a care plan which is reviewed regularly. This is a guide for staff so that they know what support they need to give each person. There are assessments to make sure people are kept safe when taking risks. These are regularly reviewed. Information for people at the home is recorded in a variety of formats. There is a photographic staff rota, pictures of menu and food shopping lists and pictures of various community leisure facilities to help people to make choices about what they want to eat and do. The staff should help people think about even more ways they can use photographs and symbols to support people to make choices. We saw the staff using MAKATON signs when communicating to help people at the home understand them more clearly. The staff have had training in different communications techniques and there is written information for them to refer to. People living at the home have regular meetings where they discuss what they have done, their feelings and important issues that affect them all. They also plan menus, activities and holidays. Each person has an allocated worker who helps make sure they are getting all the things they need. People living at the home used to be involved with recruiting new staff. The manager told us that this had recently stopped due to changes in recruitment procedure. Their role in the recruitment of staff is very valuable and should continue. The manager should make sure people are involved in staff recruitment in the future. The manager should also look at ways people can be involved in developing policies and procedures for the service The White House DS0000070484.V377591.R01.S.doc Version 5.3 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. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 11, 12, 13, 14, 15, 16 & 17 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to learn new skills and to have full and active lives which they have chose. They are valued and respected and supported to have meaningful relationships outside of the home. EVIDENCE: People told us that they had support to do the things that they wanted and to learn new skills. The staff support people to plan their own activities, care for themselves, their belongings and environment, to be safe outside and inside the home, to plan and prepare food and to have a positive self image. We saw people being supported to manage their money, to go shopping, to prepare meals and to talk about things which were important to them. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 12 Since the last inspection the day centres which some people attended have closed and this has meant that the staff have had to support people to do different things. One person told us, ‘since the day centre closed down I would like more things to do at home’. The manager told us that people did a wide range of different things. Some people have jobs and some attend college. People are supported to use facilities in the community and to be part of a forum for people who live in the borough of Richmond. Everyone is supported by staff to try new activities and have full and active lives. They have their weekly plans recorded so that they and staff know what they are doing. The manager told us that the staff were supporting some people to have more healthy lifestyles and were helping them to find ways to exercise and keep fit which they enjoy. One relative told us, ‘the White House staff have given my relative a new lease of life and they have grown in confidence since they moved there’. People told us that they stayed in touch with friends and family. Relatives told us that the staff were good at communicating with them and involving them in decisions. There are regular meetings for relatives and the staff stay in contact with relatives to make sure they know about important events. We felt that people who live at the home should be invited to participate in meetings with relatives. Some people who live at the home attend places of worship. The manager told us that people were supported to take part in activities which met their various needs and interests. These include a pamper evening for some of the women who live in the home and attending sports events for people who have an interest in sport. The manager told us that the staff have been supporting people to have more control over the things that they do each day, by helping them to understand how much money they have to spend and how they can chose from different activities and services available. She told us that there are plans to give people even greater choice of activities over the coming year. We saw that the staff treated people with kindness and respect. Everyone appeared relaxed and comfortable and people told us that they liked the staff. People who live at the home are supported to plan and prepare their own food. We saw that planned menus were varied and nutritious. We saw people preparing and eating a meal during our visit. Everyone was give a choice. The kitchen was well stocked with fresh food and fruit. The White House DS0000070484.V377591.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given the support and care they need to stay healthy and the staff work closely with other professionals to make sure they receive the best care. People are supported with dignity. The staff help people to have the medication they need, although there needs to be some improvements to record keeping to make sure everyone is kept safe. EVIDENCE: People told us that the staff supported them to stay healthy, and to look after themselves. One person said, ‘they make sure I eat healthy food’. Everyone is registered with a local GP and other health care professionals as needed. The staff have regular contact with professionals to make sure everyone’s health needs are met. There are records of health care appointments and guidelines from professionals are included in people’s care plans. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 14 Some of the things health professionals told us were, ‘I have worked with one person at the White House, the staff I met were friendly and ensured I spent enough time with the person and staff to complete a full assessment of need’, ‘I made recommendations to the staff and they followed these’ and ‘the White House provides an excellent environment which deals successfully with the practical issues for the day to day care of residents and at the same time respects them as individuals’. Since the last inspection some people have developed complex health needs. The staff have managed these really well and have worked with others to make sure people receive the best support and care. They have monitored changing health and have adapted the way they care for people so that they are safe and have their needs met. The manager has worked closely with other professionals to assess changing needs and has organised specialist training for all the staff so that they have the best knowledge and understanding of different health needs. The manager told us she had invited relatives to be part of this training so that they also had the information they needed to help them understand their relative’s changing needs. There is an appropriate medication procedure and all staff are trained so that they can administer medication safely. Medication is securely stored and people who are able to are supported to manage their own medication. In general we found that medication records were accurate. However the instructions for administration of one type of medication were ‘as directed’. The manager needs to make sure the instructions are clearer. There were a small number of gaps on records which did not clearly show whether medication had been administered or not. The manager needs to make sure staff always complete records. The amount of some medication held at the home was not recorded and therefore it was difficult to audit supplies and administration of this. These things could put people at risk because they mean that medication may not have been correctly administered. Records must accurately record directions, each administration and how much is held at the home to reduce the likelihood of errors which put people at risk. The manager told us that she had information from different resources to help people to cope with loss and bereavement. She told us that she and the staff were going to use this information to give people support. People are supported with personal care needs. These are recorded in their care plans. The staff have information on treating people with respect and dignity and showed an understand of this when they were supporting people. The White House DS0000070484.V377591.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are able to make complaints and feel confident that these will be dealt with. Procedures designed to protect people are in place and the staff are aware of these and their responsibilities in keeping people safe. EVIDENCE: Everyone told us that they knew what to do if they were unhappy about anything. There is a formal complaints procedure and a record of all concerns and complaints and how these have been dealt with. There have been no complaints since the last inspection of the service. The organisation has their own procedures on abuse and whistle blowing and the home has a copy of the local authority safeguarding adults procedure. The manager is aware of this her responsibilities under the procedure. All the staff have had appropriate training in this area. The staff support people who live at the home to look after their own money. There are procedures to make sure this is kept safe and that records are accurate and well audited. We checked some records relating to this and found that they were accurate and all expenditure could be accounted for. The White House DS0000070484.V377591.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a pleasant and well maintained environment. comfortable and their home is clean and fresh. EVIDENCE: People told us that they liked the environment, especially their bedrooms and the garden. Since the last inspection some areas of the home have been redecorated, a bathroom has been refurbished and there have been improvements in the garden. The manager told us that the organisation employs maintenance workers who offer support with repair and decoration. She told us that there were plans for further decoration and to make the garden more accessible over the next few months. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 17 They are Everyone has their own bedroom and these are furnished and decorated to reflect personal choice. Communal areas of the building are also personalised, comfortable and homely. The home was fresh and clean throughout on the day of our visit. A cleaner is employed to work 6 hours a week. People who live at the home and staff are responsible for making sure the home is clean throughout the week. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by well supported, trained and appropriately recruited staff. EVIDENCE: People told us that the staff were kind and friendly and cared for them. Some of the things people told us were, ‘the care workers show great attention to their needs and also foster a friendly atmosphere’ and ‘the staff and residents trust one another’. The staff told us that they were well supported and given training opportunities. One of the staff told us, ‘there is an excellent relationship between the people who live at the White House and the staff who support them’. During our visit we saw that the staff on duty were friendly with everyone and that the atmosphere was relaxed and positive. Everyone shared jokes and the people who live at the home appeared comfortable with the staff and had the support they needed to do the things they wanted to do. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 19 Some staff said that they would like more individual supervision and team meetings. Some staff felt that they would like more information when they first started work at the home. We spoke to the manager about the support new staff received. They work alongside existing staff until they feel ready and they are given verbal and written information. There is a low staff turn over and no members of staff have left the organisation in the last year. The manager told us that the organisation was trying to recruit a deputy manager to work at the home. This person will help provide further leadership and support for all staff and will work alongside them to support people living at the home. The manager told us that she had been unable to give all the staff regular individual supervision and hoped that the recruitment of a new deputy manager would provide more individual support for staff. The deputy manager would also be able to provide support to new staff if they felt they needed extra support. The manager told us that the staff had been working together with the organisation’s area manager to look at their own practice and how they can learn from the way they have worked. She said that this ‘reflective practice’ had been a really helpful way for staff to improve their skills and improve the support that people who live at the home receive. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed service where quality is monitored and there are plans for continuous improvement. People who live at the home, staff and other stakeholders are able to contribute their ideas and opinions to help improve and run the service in the best interest of everyone. EVIDENCE: People told us that they were able to make decisions about the running of the home and that the manager listened to their opinions. The manager has worked at the home for over two years. She is appropriately experienced and qualified. She has worked in other residential homes in the The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 21 past. She has consistently demonstrated an excellent knowledge of the service and the people who live there. She has been proactive in seeking support and working with other professionals to make sure everyone’s needs are met. She has plans for further improvements and how to achieve these. People who live and work at the home and other professionals told us that they found the manager supportive, approachable and open to ideas. Some of the things people told us were, ‘there is very good relationship between managers and the staff’, ‘very open minded management approach’ and ‘the management is always positive and responds well to suggestions made’. There are regular meetings for people who live and work at the home and for families. Everyone is able to contribute their ideas and opinions at these. We saw that people were well informed about the service. The organisation’s area manager visits the home each week and supports the manager to develop the service. He meets with the staff to give them training and to lead discussions on care practice. He makes a monthly quality check of paperwork, environment, and the support for staff and people who live there, making recommendations for improvement and change. The manager meets with other managers in the organisation to discuss practice issues and look at policies and procedure once a month. In 2008 a new organisation took over the management of the home. They have a clear organisational structure and plans. The manager told us that the organisation was supportive and that the new structure was positive for the home. The staff make regular checks on health and safety and these are recorded. Checks are also made on fire safety, electrical equipment, gas and water safety. We saw evidence that action has been taken to address any areas of concern. The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 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 3 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 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 4 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 3 4 4 3 X X 3 X Version 5.3 Page 23 The White House DS0000070484.V377591.R01.S.doc 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. YA20 Standard Regulation 13 Requirement Timescale for action The registered person must 31/10/09 make sure the staff always complete medication administration records accurately and that instructions for administration are clear. There must be recorded evidence of all medication stock held at the home. Because accurate and clear records are evidence that the staff are supporting people with their medication needs and keeping them safe. 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 YA8 Good Practice Recommendations The staff should continue to look at ways to make records, DS0000070484.V377591.R01.S.doc Version 5.3 Page 24 The White House including care plans, policies and procedures accessible to the people who live at the home. more 2. YA8 The manager should make sure people who live at the home are involved in the recruitment and selection of staff. The manager should invite everyone to participate in meetings with relatives so that they are involved in these discussions. The manager must make sure all new staff feel that they have had the information and support they need to work competently at the home. The manager should make sure all staff have the individual support and opportunities for supervision that they need to feel confident in their roles. 3. YA15 4. YA36 5. YA36 The White House DS0000070484.V377591.R01.S.doc Version 5.3 Page 25 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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