Care Home: Whitehaven

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What the care home does well Whitehaven provides a service which is centred on the individual as one individual we spoke with said "the care here is very personal and they really care for me as a person" and a health professionally stated, "they provide person centred care". There are good systems in place particularly around care planning which is detailed and informative with regular reviews involving the individual and relatives. There is a strong sense of staff working well as a team with the necessary skills and training to meet the at times complex needs of individuals who live in the home. There were a number of very positive comments received about the standard of care and staff one in particular highlighted the quality of care: "I was overwhelmed by the high standard of care given and this level of care began with the manager and deputy and was apparent at all levels of staffing and extended to all residents who were all treated as loved and valued individuals. I was extremely impressed and remain so."And a nurse stated, "this is a residential home I would not hesitate to place my loved ones in". One individual said under section what the home does well "communication, regular reviews, to be able to discuss progress and problems". Other comments received included: "I think the care home is doing an excellent job" "the level of care and support, both to the service user and relative is very high. Home and staff are very welcoming and friendly the staff always have time for a word with service users and visitors" "the home environment and care cannot be faulted" What has improved since the last inspection? No requirements were made at the last inspection. What the care home could do better: This inspection did not identify any areas which need to be addressed other then fire risk assessment which the manager is looking at and has arranged visit from the fire service. CARE HOMES FOR OLDER PEOPLE Whitehaven Fosseway Midsomer Norton Bath Bath & N E Somerset BA3 4AU Lead Inspector Jon Clarke Unannounced Inspection 27th March 2008 10:00 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 Whitehaven DS0000045883.V360370.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. Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitehaven Address Fosseway Midsomer Norton Bath Bath & N E Somerset BA3 4AU 01761 413143 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) Quality Care Homes Ltd Ms Lorraine Denise Davis Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 23 persons aged 65 years and over requiring personal care only. May accommodate a named person with a Mental Disorder (MD). Will revert when named person leaves. Sufficient communal space for 23 people be provided in the home by the 30th September 2004 to ensure compliance with Standard 20.4 of the current National Minimum Standards for care homes for older people. 1st August 2006 Date of last inspection Brief Description of the Service: Whitehaven is one of three care homes owned and managed by Quality Care Homes Ltd. It is registered for up to 23 older people and situated in the town of Midsomer Norton within walking distance of local shops and amenities. Accommodation is provided over two floors with lift access between floors. Ten of the rooms offer en-suite facilities and the rear of the building has 5 rooms with access to the attractive and accessible gardens. There is a separate dining room as well as dining area attached to a lounge area. The aim of Whitehaven is to ensure an excellent quality of life for residents by providing first class care in a friendly, relaxed yet stimulating environment and to ensure that living in a residential setting is a positive experience. (Taken from the homes Statement of Purpose) Whitehaven DS0000045883.V360370.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 visit to the home as part of an inspection. During the visit we looked at a number of records including care plans, pre-admission assessments, staff training. There was also an opportunity to talk with individuals and staff who live and work in the home. A number of Have Your Say questionnaires were sent to the home as part of this inspection and responses were received from 15 residents, 8 relatives and 4 health professionals. As part of this inspection the manager completed a Annual Quality Assurance Assessment (AQAA) which set out the areas of practice based around the National Minimum Standards summarising what the home does well, the evidence for this, what they could do better and how they have improved in the last 12 months. The information from the AQAA and questionnaires has been used to help make a judgement about the quality of care provided in the home. What the service does well: Whitehaven provides a service which is centred on the individual as one individual we spoke with said “the care here is very personal and they really care for me as a person” and a health professionally stated, “they provide person centred care”. There are good systems in place particularly around care planning which is detailed and informative with regular reviews involving the individual and relatives. There is a strong sense of staff working well as a team with the necessary skills and training to meet the at times complex needs of individuals who live in the home. There were a number of very positive comments received about the standard of care and staff one in particular highlighted the quality of care: “I was overwhelmed by the high standard of care given and this level of care began with the manager and deputy and was apparent at all levels of staffing and extended to all residents who were all treated as loved and valued individuals. I was extremely impressed and remain so.” Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 6 And a nurse stated, “this is a residential home I would not hesitate to place my loved ones in”. One individual said under section what the home does well “communication, regular reviews, to be able to discuss progress and problems”. Other comments received included: “I think the care home is doing an excellent job” “the level of care and support, both to the service user and relative is very high. Home and staff are very welcoming and friendly the staff always have time for a word with service users and visitors” “the home environment and care cannot be faulted” 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. Whitehaven DS0000045883.V360370.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 Whitehaven DS0000045883.V360370.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: A number of pre-admission assessments were looked at and showed good information about the care needs of the individual. The home completed an initial assessment which includes the routines, likes and dislikes of the individual. Copies of local authority assessments are obtained if the individual is known to social services. In one instance where the assessment had indicated specific needs around diet this had been followed through by the care home. Whitehaven DS0000045883.V360370.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. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents are met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were looked at and showed that care needs are clearly identified particularly physical needs about personal hygiene, bathing and dressing ability. Also included were life profiles which provide information about the family, social interests and life history of the resident. Reviews are undertaken regularly as were risk assessments and moving and handling assessments. Resident’s signatures are obtained providing evidence of the involvement of the individual. Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 10 The home provides opportunity for resident to receive chiropody, dental and other community health services. The home has good links with the district nursing service who will visit the home when individuals require care of a medical or nursing nature. We spoke to a district nurse who was visiting the home she spoke of the “caring attitude of staff” how the home was pro-active in seeking advice and support and how staff will always follow any instructions given. A comment received from a GP stated, “ I think the standard of care is very good and consistently so”. Another health professional said “ a very caring atmosphere is created providing residents with a home from home. It is an excellent home and I am proud to visit”. One GP stated: “The service has an ethos of making the residents part of the “family”. The kindness and good humour of the staff is remarkable and the staff are usually able to provide a much better account of resident’s state of health then is often the case in nursing homes simply because although not qualified nurses, the staff know and care for the residents so well”. Responses to the questionnaire from individuals who live in the home said that they “always” 13 and 2 “usually” get the medical support they need. An individual said that ‘ a doctor is always available and if we ask one is called”. There are good relationships with the mental health service and this has been used where they have concerns about the ability of staff to meet mental health needs of residents. Medication administering records were looked at and evidenced accurate and appropriate recording of medication given to residents. The home has no residents at present who are taking responsibility for their own medication though this is an option if the individual can do so in a safe way. The storage arrangements are good with a separate secure storage for any controlled drugs required by residents. Any returns of medication are recorded and signed by the pharmacist or their representative as being received. All staff that have responsibilities around medication have received the necessary training. In talking with individuals they all spoke positively of the approach of staff “always friendly and caring” “treat me with respect as I would want”. Staff were observed talking with individuals in a sensitive and supportive way particularly when assisting with care tasks. Whitehaven DS0000045883.V360370.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. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: In talking with individuals who live in the home one spoke of “frequent entertainment, would like more hands on activities such as quizzes and exercise” another individual said that the activities were “very good and lots”. Respondents to the questionnaire said that there was “always” 9 “usually” 3 “sometimes”1 Activities in the home they can take part in. The home has identified one specific carer who is responsible for activities and it is hoped this will improve the activities available in the home. Outside entertainers are invited into the home and “outings” are also organised including pub lunches. Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 12 The home has an open visiting policy and one relative we spoke with on the day of our visit spoke of the home as being “friendly and welcoming” and that they were always “kept informed about how their relative was”. In the homes questionnaire of March 2007 94 of respondents (19) said when they visit the home it is “warm and welcoming” and 100 said staff were friendly. Comments were received about the lack of space in the lounge area and this was recognised by the manager as a difficulty however there is a visitors room available though in the inspectors view this could be improved (provide settee and chairs). The manager correctly pointed out that visitors could use their relative’s room when visiting. The home provides meals of a good quality and in looking at the menus there was a varied and interesting choice available. Residents were very positive about the food provided; “Brian is an excellent cook” “good home cooked food”. Individuals I spoke with said there was always a choice available if they didn’t like the meal being offered. There is a weekly resident’s choice and the chef is very conscious of the importance of meals and the food provided in the home as being appetising and enjoyable by all. He makes a real effort to find out what residents think of meals provided and individuals I spoke with on the day of the visit commented on this. Residents have made suggestion about the meals provided in the home and these have resulted in changes in the variety of meals provided. The inspector joined residents for lunch and the meal was well presented and appealing. Whitehaven DS0000045883.V360370.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. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: In talking with individuals who live in the home they all spoke of being able to speak to the manager if they had any concerns or complaints. One individual commented that they “wouldn’t hesitate to say something” if unhappy and that they believed “something would be done”. No complaints have been made since the last inspection. There is an Adults Protection policy and procedure in place in the home and staff have undertaken BANEs Protecting of Vulnerable Adults training. In discussion with a member of staff at the time of this visit they illustrated an understanding of abuse and what signs may indicate a resident has been abused. In talking with residents they all spoke positively of the attitude of staff and how they felt safe in the home. Whitehaven DS0000045883.V360370.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 home provides a safe and hygienic environment for the residents and staff. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. EVIDENCE: In walking around the home it was evident that there is a good standard of cleanliness residents spoke of the home as “always being clean”. There are procedures in place to inform staff of good practice around infection control and staff have also completed training in this area. At the time of this inspection the home was clean and free from offensive odours. Whitehaven DS0000045883.V360370.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. Staffing arrangements in the home are good and ensure that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: Staffing rotas were looked at and showed that with the current needs of residents there are adequate staffing available. Over the previous month staffing was 3 am, 2 pm (2-10) with 1 waking night staff and 1 sleep-in night staff. Individuals we spoke with said staff were “always there if you wanted help” and “staff always around for us we only have to ask and they are there to help”. Respondents to the questionnaire said staff “always” available when needed (9) and “usually” (6). Recruitment record was seen for a new member of staff. The necessary checks had been undertaken: two references obtained, Criminal Record Bureau check (CRB). There was a full application including medical declaration that the individual was fit to undertake the tasks associated with their position. Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 16 The individual had also completed a full induction that looked at the procedures and practices of the home including health & safety. The manager was advised that CRBs once seen by CSCI must be destroyed and not retained in the home. Training records were looked at for 5 members of staff and showed they had all completed the “mandatory” areas of training: moving and handling, health and safety, first aid. In addition some staff have completed Mental Capacity Act training and this would benefit all staff. All staff have completed or undertaking NVQ 2 or 3 professional qualification. One comment received from individual was that they felt “staff are excellent, well trained and caring” and another said, “staff are very well trained, supported and motivated”. Whitehaven DS0000045883.V360370.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): 31,33,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home is well qualified and competent to manage the home and makes a good effort to make sure that residents receive a good quality of care. There are opportunities for residents and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff is protected. Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 18 EVIDENCE: Ms Davis has been manager of the home for 21/2 years having previously been deputy of the home. She has extensive experience of working in a care home and has the NVQ 4 Registered Manager Award. Ms Davis is also the staff trainer for Quality Care Homes. Residents spoke of her as being “approachable” “someone you can go to” “ I would always speak to Raine” Residents and relatives are given the opportunity to voice their views and opinion about the service the home provides through the use of questionnaires. There are also regular residents meeting which again provide an opportunity for resident’s comments and also for the manager to inform residents of any changes in the home. Records showed that staff receive regular supervision and group supervision is also held for senior staff. Health & safety records evidenced the necessary checks take place with regard to fire and safety equipment in the home. Weekly fire alarms tests and monthly emergency lighting are undertaken as required as well as fire drills for all staff at the required intervals. Fire system is serviced twice yearly the last being 28/10/07. Lift last serviced 5/03/08 and previously 13/04/07. The homes fire risk assessment was looked at and did not in the inspector’s view provide sufficient detail. This was discussed with the manager who advised that she has requested a visit from the fire officer to discuss this with them and also review fire safety in the home. Whitehaven DS0000045883.V360370.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 X 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 3 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 X 3 X 3 Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 20 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. 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. Refer to Standard Good Practice Recommendations Whitehaven DS0000045883.V360370.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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