Care Home: Whitehall House

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What the care home does well The manager gives people good up to date information on the service that he provides and the assessment of needs that is carried out before a person moves into the home ensures that their needs can be met. The care plans are written in a person centred way and the home supports people to take risks to enable them to live their lives as independently as possible. Whitehall House gives people good healthcare support and encourages them to live a healthy lifestyle. People take part in the running of the home and help in making important decisions. Members of staff are well trained and get good support from the manager who is very experienced in running a home. The manager makes sure that people`s views and opinions are included when making any changes to the service and the home is run safely. What has improved since the last inspection? This is the home`s first inspection. What the care home could do better: The manager should make sure that staff have a thorough induction and that it meets the Skills for Care standards; this will enable staff to gain all of the knowledge they need to work with people living in the home. All staff would benefit from regular supervision and to make sure that they feel fully supported in their work, the manager should provide them with supervision at least six times each year. CARE HOME ADULTS 18-65 Whitehall House 40 Whitehall Lane Grays Essex RM17 6SS Lead Inspector Pauline Marshall Unannounced Inspection 6th January 2009 10:05 Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitehall House Address 40 Whitehall Lane Grays Essex RM17 6SS 01375 407054 01375 407035 ade@aksupportedhousing.com 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) AK Supported Housing Ltd Mr Ademola Abiodun Aremu Care Home 2 Category(ies) of Learning disability (2), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service: Care Home – PC to service users of the following gender: Both whose primary care needs on admission to the home are within the following categories: Learning Disability - code LD Mental Disorder, excluding learning disability or dementia - MD 14th January 2008 Date of last inspection Brief Description of the Service: Whitehall House is registered to provide a service for up to two people with a learning disability, or a mental disorder. The property is a terraced house situated in a quiet residential street on the outskirts of Grays, South Essex. On the first floor the home has two bedrooms without ensuite’s and an office with locked storage and medication cabinet. There is a modern lounge/diner, galley style kitchen and large bathroom on the ground floor. The utility room leads out to a small courtyard style garden, which is fully fenced for security; there is a covered seating area and a shed that stores a table and chairs for use in fine weather. There is on street parking opposite the home and there is public transport nearby. The manager provides people wishing to use the service with copies of the home’s Statement of Purpose and Service User Guide. Fees range between £1100.00 and £1250.00 per week according to an individual’s assessment. There are additional charges for hairdressing, newspapers, sweets, toiletries, personal transport, chiropodist, gym fees and any personal items or therapies. Whitehall House DS0000070516.V373637.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 stars. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection that lasted for four hours and we looked at all of the key standards. The home’s first inspection took place on 14th January 2008 and nobody was living in the home at that time. People moved into the home at the end of July 2008. Discussions took place with the manager, one support worker and one of the people living in the home. We looked at a sample of files (including those of staff and people living in the home) and some of the records that the home is required to keep. The inspection covered all of the key standards and included a tour of the building. The manager completed his annual quality assurance assessment (this will be referred to in this report as the AQAA) and the information from this has been reflected throughout the report. The AQAA is a form required by law for the manager or provider to carry out a self-assessment of how well the outcomes of people using their services are being met. Surveys were sent to the manager to distribute to the two people who live at the home, two health and social care professionals that are involved with the home and four of the home’s support staff. At the time of writing this report both surveys were returned from people living in the home and they were positive about the service they received. Two surveys were returned from health and social care professionals and three from the support staff that work at the home. There were a few comments on them, which we have included in the main body of the report. What the service does well: The manager gives people good up to date information on the service that he provides and the assessment of needs that is carried out before a person moves into the home ensures that their needs can be met. The care plans are written in a person centred way and the home supports people to take risks to enable them to live their lives as independently as possible. Whitehall House gives people good healthcare support and encourages them to live a healthy lifestyle. People take part in the running of the home and help in making important decisions. Members of staff are well trained and get good support from the manager who is very experienced in running a home. The manager makes sure that peoples views and opinions are included when making any changes to the service and the home is run safely. Whitehall House DS0000070516.V373637.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. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with good up to date information about the service and a well-managed assessment process ensures that people’s needs are met. EVIDENCE: The manager reviewed his Statement of Purpose and Service user Guide in December 2008 and has developed a pictorial Service User Guide as a result of his review. Although the service was first registered on 30th August 2007 it was not operational until the end of July 2008 when the first person moved in. One of the people using the service said that the information they received about the home “was good and helped them to choose”. The assessment documentation was examined and it contained sufficient information to inform the care plans. The completed assessments covered all areas of health and social care needs and looked at people’s likes and dislikes. The manager has recently devised a new needs assessment form that has provision to record carer’s/relatives requests and details of special friends. The new form will be used for any further admissions. Each of the care files examined contained a signed and dated copy of the person’s contract, detailing their terms and conditions with the home . Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive appropriate individualised care based on identified needs. EVIDENCE: Both care files were examined and they contained very detailed information on how staff was to support people. The care plans clearly showed staff what to do and what not to do. Staff spoken with said “the care plans are clear and easy to follow”. The daily notes were very detailed and informative and made reference to health appointments that had been attended, detailed notes of these were kept on the care file. The manager said in his AQAA “we involve people in the running of the home”. One person spoken with confirmed this and said “I decide what I want to eat, what I want to do and where I want to go and the staff support me in this”. Each of the care files contained risk assessments for all areas of risks and there were clear management plans showing how the risks were to be Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 10 managed. One person spoken with talked about how staff helped them to live an independent life and how staff had worked with them to manage various every day risks such as going to the pub in Romford and coming home late at night on public transport. The person said “I am able to play pool with my friends and make sure that the staff know when I might be home late, I will phone them from a payphone, as I don’t like using a mobile”. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are well supported to live a lifestyle that meets their identified needs and preferences. EVIDENCE: People living at Whitehall are very involved in the running of the home and are able to decide for themselves what activities they want to take place. The care file showed that one person was an active member of a local gym and that another regularly visits the pub and plays pool. One person spoken with said, “I do everything that I want to do and go out quite a lot and I have lots of friends“. Staff spoken with said, “we support people to live as normal a live as possible and this involves taking some risks”. People living at Whitehall House are expected to participate in all aspects of running the home including cleaning, tidying and food shopping. The care files showed that people living in the home participated in planning the weekly Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 12 menu, buying the food shopping and choosing the foods that they wanted. One person spoken with said, “I help do the menu but I often prefer to buy my own food like chicken curry, I like to eat what I want and I can here”. Staff spoken with also confirmed that people are involved in menu planning and food shopping. The manager said in his AQAA that people are involved in the weekly menu and the food shopping. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal care in a way that suits them and their health care needs will be fully met. The home’s medication policy and practice will protect people from the risk of medication errors. EVIDENCE: From an observation of the staff member interacting with one of the people living in the home it appeared that support was offered in a way that the person preferred and when spoken with the person said, “I am able to do a lot for myself but if I need any help with anything the staff are always here and they will do what I want them to do”. The care files examined contained the details of regular health visits that had taken place and the records showed the outcomes of the visits and any follow up instructions. Staff spoken with had a good knowledge of each person’s health issues and there was information that had been downloaded from the Internet on both care files about each individual’s diagnosed illness. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 14 The manager is a qualified nurse and all of the staff has received medication training. A check on the medication showed that it had been correctly administered and recorded on the MARS (medication administration sheet) and was securely stored in the locked medication cabinet in the office. The medication policy clearly outlines the home’s procedure and the staff member spoken with was fully aware of the home’s medication policy and practice. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know that their concerns will be dealt with and that they will be protected from harm and abuse. EVIDENCE: The home has been in operation since the end of July 2008 and has not had any complaints to date. The manager said in his AQAA “we deal with any concern very quickly before it becomes an issue” and “we have regular meetings with professionals and family as and when necessary”. One person living in the home said they were aware of how to complain and would not hesitate to do so if they needed to, they also said in their survey “if I am not happy my support worker will help me to pass on any concerns to the home manager”. There have been no safeguarding issues raised at Whitehall House since it opened. Staff spoken with was aware of the home’s safeguarding policy, which was reviewed in August 2008 to reflect the new Southend, Essex and Thurrock guidelines; there was a copy of the CD-rom setting out the new guidelines available for staff in the office. All staff have had training in the safeguarding of vulnerable adults. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable safe environment. EVIDENCE: The home was in a good state of repair, is modern and has been newly decorated. Each person’s room showed their individuality and contained many of their own personal items. There are no washing or toilet facilities in either of the bedrooms; both people living there together with the home’s staff share the only bathroom and toilet. One person spoken with said, “I am happy with my room but the only problem I have is that the bathroom is shared and it is not nice when the other person forgets to lock the door and I walk in on them”. This issue was discussed with the manager who said that he is aware of the issues and is looking at the possibility of moving bathing facilities upstairs into the area currently used as an office. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 17 There are handrails on the stairs but the stairs are very steep, when asked about this, the person living in the home said they did not have a problem with them. Staff also said that they did not find the stairs to be a problem. There is loft space in the house, which is accessed again by very steep stairs; the manager said this is used for storage only. The galley style kitchen provides ample facilities for people to prepare and cook their meals; all of the cooking knives are kept in a locked drawer for safety reasons. The small courtyard garden is secure and has a shed that stores a table and chairs that are set up for people to use in the summer months; there is also a rotary washing line on which people can dry their clothing. The downstairs flooring is laminate with carpeting to the rest of the house; the home was clean and hygienic and both the staff and one of the people living in the home said it is always kept this way. Cleaning materials were safely stored away in a locked cupboard. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are cared for by a competent, well-trained and supervised staff team, who are safely recruited. EVIDENCE: The rota showed that there is always a member of staff on duty both day and night and that the manager regularly works one of the day shifts. There are two staff that are employed to work night shifts; one staff is employed to work four nights each week and the other, one night each week, the other nights are covered by day staff. One staff meeting has been held since the home became operational and the focus of this was on each individual’s care plans. Staff spoken with said that a further meeting was due to take place soon. Three staff returned a completed survey and all were positive about their experience of working at the home and felt that there was enough staff to meet people’s needs. Four staff files were checked and they all contained the required documents including two written references, CRB (Criminal Record Bureau) check and evidence of their training that included safeguarding, medication, food hygiene, Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 19 fire awareness, dementia, care planning, first aid and epilepsy. Each of the staff files contained some induction paperwork and staff spoken with confirmed that induction had taken place. The manager said that he would be looking at improving the home’s induction process to ensure that it meets with the Skills for Care standards. There was some evidence that supervision has taken place on two of the four staff files examined; one of these was on 4th September 2008. Another staff member started work on 29th October 2008 and supervision had not yet taken place. The manager said that he is aware that he needs to improve the level of supervision for all staff working at the home. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People will live in a well run home that is run in their best interests. EVIDENCE: The manager is a qualified nurse and has worked in the care industry since 1988 and completed his training as a Registered Nurse for Learning Disabled in 1991; he regularly updates his practice and has recently undertaken training in fire, moving and handling, supervision and the Mental capacity Act. The manager has a Diploma in Nursing and a Degree in Healthcare Management. One health and social care professional said in their survey “I have only known the service for three months so cannot comment on what they do well, however the manager has good experience and skills in learning disabilities and mental health and the service is helpful and client centred”. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 21 The home has been operating since the end of July 2008 and although no formal meetings have taken place, daily discussions with people living in the home were recorded in their daily notes. The manager has said that he intends to hold more formal meetings for people living in the home but as the two people are so very different it may be that individual meetings will be held for them. The manager has recently sent people using the service, their relatives and other relevant people his own questionnaire to establish people’s views on how the home is doing. All safety checks have been carried out and certificates were available to evidence that they were all up to date. There were written COSHH (Control of Substances Hazardous to Health) assessments for the use of all chemical substances and staff spoken with were aware of the assessments and how to use them. The fire risk assessment was dated 10th August 2007 and the manager said that he would be reviewing this to reflect the needs of the current people living in the home. Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 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 3 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 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 23 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 YA32 Good Practice Recommendations It is recommended that a full induction that meets Skills for Care standards be carried out, to ensure that staff have sufficient knowledge to work with the people living in the care home. It is recommended that all staff have supervision at least six times each year as required in the National Minimum Standards. This will ensure that all staff are fully supported to do their work. 2. YA36 Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Whitehall House DS0000070516.V373637.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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