Care Home: Whitworth House

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What the care home does well Relatives and visitors to the home said `they attend to everybody`s needs`, are `considerate to people`s needs`, `give individual attention`, `care for people well`, `make people feel at home and `accept different religions and faiths and allow representatives to visit`. Staff say they `look after people well`, `offer good activities and outings`, `respect peoples privacy and dignity`, `promote independence` and `support people to make choices`. The service provides a homely environment with individualised care due to the small number of people who live there and the number of staff employed. What has improved since the last inspection? Health and safety and administrative posters have been removed from the dining area, keeping the environment homely for the people who live there. Training and development profiles have been developed for staff, showing the training they have completed and any training they need to complete, to ensure they are able to meet people`s needs.The owner and manager said they have an annual development plan for the service and will be updating this document in the near future. Staff receive regular supervision with records available confirming this takes place. These were all issues raised at the last inspection in November 2007. The owner told us that they got a grant which enabled them to repaint the bedrooms, lounge/diner, bathrooms and the front of the home. They have also bought new dining room chairs and some new armchairs for the lounge. This has improved the environment for the people who live there. What the care home could do better: Make information about the home and services provided more accessible to people who use the service and consider including photographs and information about the local area. Care plans must be reviewed monthly, to ensure any changes in need are recorded and can be acted upon. The curtains in bedrooms must hang properly to ensure peoples privacy and dignity is maintained. The staff rota must be available at the home to show which staff are on duty at any time and to comply with the Care Homes Regulations 2002. CARE HOMES FOR OLDER PEOPLE Whitworth House 11 Whitworth Road South Norwood London SE25 6XN Lead Inspector Emma Dove Unannounced Inspection 4th November 2008 11:00 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 Whitworth House DS0000025868.V373138.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. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitworth House Address 11 Whitworth Road South Norwood London SE25 6XN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8771 7675 020 7924 5293 tbsawyerr@hotmail.com Mr Thomas Sawyer Mrs Christiana Sawyer Post vacant Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (9) of places Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category 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. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 9 12th November 2007 Date of last inspection Brief Description of the Service: Whitworth House is situated in a residential road in South Norwood. The home can accommodate up to nine older people. Six people are currently living there. Accommodation is provided over three floors. A lounge/dining room, three bedrooms and a bathroom are available on the ground floor. One bedroom is on the first floor with the remaining three bedrooms and a bathroom on the second floor. The loft has been developed into a staff office and staff room and is not accessed by people who use the service. People use a passenger lift to access the ground, first and second floor. The dining area is accessed by a short staircase. Local transport facilities are good. Shops, leisure facilities and churches are accessible in the local area. The weekly fees are from £383.80. Whitworth House DS0000025868.V373138.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 two star. This means people who use this service experience good quality outcomes. This unannounced inspection took place over four and three quarter hours on the 4th November 2008. One regulation inspector visited, looked at records, spoke with people who use the service, the owner and staff. Questionnaires were sent to people who use the service, their relatives or friends and staff. We have received twelve completed questionnaires, comments from these are included throughout this report. The owners completed an Annual Quality Assurance Assessment (AQAA), which provided some brief information which has been included in this report. The assessment could have included more areas for the service to develop and did acknowledge staff training as an important area to focus on to improve the services provided. What the service does well: What has improved since the last inspection? Health and safety and administrative posters have been removed from the dining area, keeping the environment homely for the people who live there. Training and development profiles have been developed for staff, showing the training they have completed and any training they need to complete, to ensure they are able to meet people’s needs. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 6 The owner and manager said they have an annual development plan for the service and will be updating this document in the near future. Staff receive regular supervision with records available confirming this takes place. These were all issues raised at the last inspection in November 2007. The owner told us that they got a grant which enabled them to repaint the bedrooms, lounge/diner, bathrooms and the front of the home. They have also bought new dining room chairs and some new armchairs for the lounge. This has improved the environment for the people who live there. 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. Whitworth House DS0000025868.V373138.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 Whitworth House DS0000025868.V373138.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): 1, 3 and 6 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service understands the importance of having sufficient information when choosing a care home. Admissions are not made until a full needs assessment has been completed. Intermediate care is not provided at the service. EVIDENCE: The Statement of Purpose and Service Users Guide dated December 2003 include the aims and description of the service, who the service is for, information about medical care, peoples rights, activities and how to make a complaint. These documents are currently in written format and could be made more accessible to people who use the service by using pictures and photographs of the home, owners, staff and local area. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 9 People told us that they had received enough information to help them make the decision to move in. People said that they had a contract of residence. We saw assessments completed before people move in. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Staff support people to be independent and take responsibility for their own personal hygiene. Care plans are in place, they could be more detailed and need to be reviewed every month. People have access to health care services in the home. Medication is well managed. EVIDENCE: We saw care plans, developed from assessments. These documents include information for staff about what care and support people need. The manager said they review care plans every six months. Care plans must be reviewed every month and updated as required. One person’s case file contained brief details of their life before moving into the home. This is an area staff could develop further by spending time with individuals, talking about their previous employment, family, hobbies and leisure pursuits and record details to help people remember important things. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 11 Four people told us they ‘always’ get the care and support they need. Two relatives or friends said the home ‘always’ meets people’s needs and three said the home ‘always’ meets people different needs. Relatives or friends are also kept up to date with changes. Staff say they have enough information to meet people’s needs. Case files contain details of people’s religion including if they are practising and any help or support they may need to attend services. We saw daily records note the activities people do, any visitors they have, health appointments they attend and any time spent with staff. We saw risk assessments which have been reviewed and updated when required. One risk assessment noted the person was ‘unbalanced’, we saw staff offer appropriate support when they walked. Four people said they ‘always’ get the medical support they need. Medication is appropriately stored with records up to date and signed by staff. The manager told us that the new Medication Administration Record Sheets had been written up incorrectly by the pharmacist and were due to be changed the day we visited. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service take part in activities of their choice to meet their needs. People are supported to maintain contact with friends and family. The menu is varied and takes into account peoples needs. EVIDENCE: We saw people sat in the lounge watching the television, talking with the owner and manager and spending time in their room watching films and listening to the radio during our visit. One person said ‘there’s not much to do’. In surveys three people said the home ‘always’ has enough activities available and one person said they ‘sometimes’ have enough to do. Three people told us that the home helps them to live the lives they choose. The manager told us that the local church are very supportive, visit regularly and invite people to parties and celebrations. The church had recently arranged a party to celebrate someone’s Birthday and ‘made the day special’. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 13 People who use the service told us they can have visitors. Surveys from friends and relatives confirmed that they are made welcome when they visit and that they are offered drinks and biscuits. People have the choice of meals to meet their medical and any cultural and religious needs. Peoples comments about the food included: ‘lovely lunch’, ‘the food is good’ and ‘I don’t know what I had for lunch so I can’t tell you if it was good’. Four people told us they ‘always’ like the meals. One person said the menu is a bit ‘repetitive’, but is ‘based on what people ask for’. Another comment received indicated that once people have shown a preference for something, they always get this. Staff should continue to offer individuals a choice, even when they have previously shown a preference for something. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is accessible to people who use the service and their representatives. People who use the service and their representatives say that they are happy with the service provided. Appropriate policies and procedures are in place for safeguarding adults. EVIDENCE: The manager told us that the home has a clear policy for complaints and they regularly ask people who use the service if they have any concerns. Four people told us in surveys that they are aware of who to speak with and how to make a complaint. Three relatives and or friends told us they are aware how to make a complaint and feel that the home responds appropriately or they haven’t made a complaint. The manager told us that the home has a policy regarding the protection of vulnerable adults which is followed by staff. They also told us that they could improve the service by organising a training course for staff to cover safeguarding issues. Staff told us in surveys that they are aware of the procedures to follow if someone makes a complaint or an allegation of abuse. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23 and 26 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides an environment that has been adapted to meet people’s needs. There are some shared rooms, which are not being shared at the moment. People have access to sufficient bathrooms and toilets. All areas of the home were clean and fresh. EVIDENCE: Accommodation is provided over three floors with the lounge/dining room and three bedrooms on the ground floor, one bedroom on the first floor and three bedrooms on the second floor. There are bathrooms and toilets close to the lounge and all bedrooms. We saw people have generally personalised their rooms to their taste with pictures, photographs and belongings. People told us they have all they need Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 16 in their rooms. We saw the curtains in one bedroom to be hanging off the rail. The owner said that this had happened that morning and the curtains would be hung properly during the afternoon. The lounge/dining room, bedrooms and bathrooms have all been redecorated since the last inspection in November 2007. This keeps the environment clean and bright for people who live there Four people who use the service told us in surveys that the home is ‘always’ clean and fresh. We saw all areas to be clean and good standards of hygiene. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 17 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 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People have confidence in the staff who care for them. Appropriate recruitment policies and procedures are in place with checks completed before staff start work. Staff have access to relevant training to help them carry out their job but could do more training. EVIDENCE: Four people told us that staff ‘always’ listen and act on what they say. Four people told us that staff are ‘always’ available. People also told us that staff ‘help’ when needed. Three relatives or friends said they think staff are skilled and experienced to meet people’s needs. The service is a small family run business with the owner and manager assisted by some of their family and five members of staff. The staff rota was not available during our visit, the owner said it was at the office so staff could be paid. The rota must always be available at the home for inspection with a copy sent to the office to allow the pay to be calculated. We saw the owner, manager and one of their relatives at the home during our visit. These staffing levels were seen to be sufficient to meet the needs of the Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 18 people currently living at the home. Should the number of people using the service increase, these staffing levels may need to be reviewed. We saw recruitment records for two members of staff, they contained the application form, a photograph, a full employment history, two written references and a clear enhanced Criminal Records Bureau (CRB) check. The application form we saw needs updating, the owner told us this has been completed and will be used for any new staff. No new staff have been appointed since the last inspection in November 2007. Five staff told us in surveys that they had the appropriate checks before they started work. They also told us their induction covered everything they needed to know. Staff said they feel supported and do training to help them meet peoples’ needs. Four staff said they see the manager ‘regularly’ and one member of staff said they see the manager ‘often’. Five staff said the way the staff team communicate works well. Staff training records indicated that staff have completed training in food hygiene, first aid, fire safety, medication administration and safeguarding. The manager said they are planning to get a new accredited consultant to take charge of staff training in the next year. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 19 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 and 38 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager is qualified and has the experience necessary to run the home. People who use the service are asked about how it is for them. Good health and safety systems are in place. EVIDENCE: The owner and manager have been at the home since it first registered seventeen years ago. The manager has many years experience as a nurse and has completed NVQ to Level 4, which covers management. The owner and manager have completed an annual development plan for the service, which they said they will be updating following this visit. This will Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 20 show how the home plans to maintain and improve services provided. The owner said this will be done using comments from people who use the service and their representatives. The manager told us that people who use the service have opportunities to comment about the service they receive at residents meetings and during care reviews. Systems to check health and safety are in place, with checks completed on the fire alarm system, lift, portable electrical appliances and gas safety as required. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 3 X 3 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 Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP27 Regulation Sch Requirement The staff rota must be available for inspection at the home at all times to comply with the Care Homes Regulations 2002. Timescale for action 19/12/08 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. 2. Refer to Standard OP1 OP7 Good Practice Recommendations The Service Users Guide could be updated to include photographs of the home, owner, manager, staff and the local area, to help people make the decision to move in. Care plans should be reviewed every month and updated as required to ensure peoples changing needs are recorded and can be met. Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Whitworth House DS0000025868.V373138.R01.S.doc Version 5.2 Page 24 - 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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