Care Home: The White House

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What the care home does well The home has a family atmosphere and this was confirmed by the staff`s knowledge of the people who use the service, and comments from family, friends and people living there. The assessment documentation covered all areas of needs along with medical and social history, hobbies/interests and particular preferences such as times of rising and retiring, and food likes and dislikes. A life history of the person is taken, which is very informative and can assist with the social care plan. What has improved since the last inspection? There are twenty carers employed and 75% have achieved NVQ level 2 and above. All rooms were very individual and since the previous inspection they had all been re decorated with the person who lived in the room choosing the colour scheme. A new shower room had been installed on the first floor giving people who use the service the choice of a bath or shower. CARE HOMES FOR OLDER PEOPLE The White House High Street Brotton Saltburn-by-Sea TS12 2PJ Lead Inspector Val Daly Key Unannounced Inspection 12th June 2008 09:30 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 The White House DS0000000094.V366172.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. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The White House Address High Street Brotton Saltburn-by-Sea TS12 2PJ 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) 01287 677106 Mrs A Jackson Mr R Jackson Mr R Jackson Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2006 Brief Description of the Service: The White House is a two storey detached Victorian house converted for use as a care home in 1985. The building stands in extensive private gardens and occupies an elevated site set well back from the road. The home is within easy reach of local community facilities and is accessible to public transport. Accommodation is provided in twelve single and two double bedrooms, none of which have en-suite facilities. The main lounge, affording a pleasant view of the gardens, is appropriately furnished and contains television, music, books etc. A second lounge is a designated smoking room. The dining room also overlooks the garden. The home is registered to provide residential care for 16 persons over the age of 65 years. The weekly fees are £421.76 The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was a key unannounced inspection and was completed by an inspector in one inspection day. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. A number of records were looked at including assessments of people who use the service and plans of care, staff recruitment records, complaints and maintenance records along with the annual quality assurance assessment. A person, who uses the service, two members of staff and the manager, were engaged in discussion about living at The White House. The manager had completed an Annual Quality Assurance Assessment prior to the inspection. The AQAA is the services self-assessment of how they think they are meeting the National Minimum Standards. This information is received prior to the inspection and it is then used as part of the inspection process. On the day of the visit a senior carer and the manager provided the information and documentation required. The Commission for Social Care Inspection sent a number of surveys to the home for people who use the service to complete. Six were completed and returned. Comments received can be read within the report. This was a positive inspection; people were open and friendly and welcomed discussion about the home. What the service does well: The home has a family atmosphere and this was confirmed by the staff’s knowledge of the people who use the service, and comments from family, friends and people living there. The assessment documentation covered all areas of needs along with medical and social history, hobbies/interests and particular preferences such as times of rising and retiring, and food likes and dislikes. A life history of the person is taken, which is very informative and can assist with the social care plan. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The White House DS0000000094.V366172.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 The White House DS0000000094.V366172.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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs assessed. EVIDENCE: Care managers carry out assessments prior to a person moving into the home to ensure their needs can be met. The home manager also carries out his own assessment, meeting with the prospective person, either in his or her own home or in hospital. This information was viewed in the files of two people who use the service. The assessment documentation covered all areas of needs along with medical and social history, hobbies/interests and particular preferences such as times of rising and retiring, and food likes and dislikes. A life history of the person is taken, which is very informative and can assist with the social care plan. A person who used the service interviewed informed the inspector during discussion that their relatives had visited the home before they moved in. Relative comment cards stated that they had enough information before deciding if the home was right for their family member. The home does not provide intermediate care. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 9 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): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Two care files were examined and they each contained an individual plan of care. The plans were evaluated and reviewed regularly. Information was also included in the daily record on how the person likes to spend their day. There was evidence that the person’s health care needs were being met. Risk assessments were in place where needed, for one person, using the stairs and for another using the stairlift. The plans of care are agreed and signed by either the person who uses the service or their relative. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. For people wishing to manage their own medication a risk assessment and management process was in place. Staffs The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 10 who administer medication had received safe handling of medication training. A person interviewed said ‘the girls were all lovely, kind and respectful’. Comment cards from relatives and people who use the service stated ‘If there is anything I need it is provided for me’. ‘The staff communicate with all residents really well and are all friendly and easy to talk to’. ‘General care of my family member and her needs is excellent’. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 11 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): 12, 13, 14 & 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use services are able to make choices about their lifestyle. A variety of food is offered. EVIDENCE: At the time of the inspection the activity co-ordinator had recently left the home. However care staffs were continuing with activities and the manager was in the process of employing another person to take over that role. People who use the service enjoyed bingo, cards, dominoes, crafts, motivation with hand, eye co-ordination. The home has a secure garden area with colourful flowers and bushes and seating for people to enjoy in the better weather. People who use the service are able to receive communion if they wish. One person spoken to said they were not really interested in religious services or communion. People who use the service said their relatives were able to visit at any time and were always made to feel welcome. The menu showed that a variety of food is offered to residents and more alternatives are available. The cook said she had slowly been introducing new The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 12 meals and lasagne and a mild curry were popular. A person spoken to said they enjoyed the food and were given choices by staff prior to the meal being served. They also said if they did not want the main meal an alternative would be offered. The majority of people in the home eat their meals in the dining room but they are able to eat in their rooms if they wish. The tables in the dining room were nicely set with special cutlery where needed. A daily menu was on display for the people who use the service. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 13 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): 16 & 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People know how to complain and the home has an appropriate procedure in place, however this requires further development. Training for staff in adult protection has taken place, keeping people who use the service safeguarded. EVIDENCE: One person interviewed said that they would talk to a member of staff if they had any worries. Comment cards from relatives of people who use the service stated ‘We have not raised any concerns but I would go to the manager or a member of staff if we needed to’. There had not been any complaints made to the home since the previous inspection. The home has a Whistle Blowing policy in place. The Tees Wide policy and procedure is in place to be followed in the case of an allegation of abuse. There was evidence in the staff training file to show that staff had received training in Adult Protection’. A member of staff interviewed said that she had received training regarding safeguarding people as part of her NVQ course and was aware of the procedure to follow. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 14 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): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The White House is comfortable, homely and well maintained. EVIDENCE: A tour of the home was carried out. People’s bedrooms contained personal possessions and were comfortable and homely. All rooms were very individual and since the previous inspection they had all been re decorated with the person who lived in the room choosing the colour scheme. One person interviewed said she loved to sit in her room watching the world go by. She also said that her room was cleaned and tidied every day whilst she was in the dining room having breakfast. There was a new shower room on the first floor giving people who use the service the choice of a bath or shower. The home throughout was very clean and tidy without any odours. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 15 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): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The vetting and recruitment practices are robust. Staffs is trained and qualified and relevant information that safeguards people who use the service is in place. EVIDENCE: The home has a rota in place, which is flexible for the needs of the people who use the service. There is a policy and procedure in place for the recruitment of staff. Staff records showed that the required information, references and CRB checks were in place prior to staff commencing work in the home. The manager plans and organises the staff training. The home has a very stable staff group and only recently after working in the home for a number of years, two members of staff had left to further their careers. At the time of the inspection there were two new carers due to commence employment and a thorough comprehensive induction programme was in place for them. There are twenty carers employed and 75 have achieved NVQ level 2 and above. Since the previous inspection staff had undertaken training in many areas such as NVQ, Fire Safety, The Mental Capacity Act, Continence Care, COSHH, Moving and Handling and Continence Care. The manager said the staff group also undertake a distance-learning course every year, and had completed Dementia Awareness. A member of staff interviewed confirmed she had received the training. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 16 A relative comment card stated’ As far as I can observe, the care staff are efficient, can handle and guide residents when movements have to be made but above all everyone is very kind and patient to the extreme’. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 17 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): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home regularly reviews aspects of its performance through a programme of self-review, which include seeking the views of people who use the service, staff and relatives. Finance systems are robust. EVIDENCE: One of the providers has been the manager of the home for many years. He is qualified and competent to run the home. The manager has a quality assurance system in place and questionnaires are available for visitors to complete. An action plan is formulated if any issues or concerns are raised. Formal meetings for staff and people who use the service are held regularly. A carer interviewed felt that the manager listened to her thoughts and points of view. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 18 Records showed that the home has a formal supervision and appraisal system for staff in place and the documentation was found to be up to date. Resident’s finances and records were kept appropriately with signatures in place. A number of Health and Safety records were examined. Documentation showed that water temperatures are taken and documented prior to a person having a bath. Staffs receive regular training in Health and Safety and there is a full training plan in place. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP16 Good Practice Recommendations The complaints procedure should include information regarding the Contracts and Commissioning Department of the Local Authority. The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 The White House DS0000000094.V366172.R01.S.doc Version 5.2 Page 22 - 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. 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