CARE HOME ADULTS 18-65
Chantry Close, 1 1 Chantry Close Tenbury Wells Worcestershire WR15 8QE Lead Inspector
Christina Lavelle Unannounced Inspection 15 March 2006 04:15
th Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 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 Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 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. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Chantry Close, 1 Address 1 Chantry Close Tenbury Wells Worcestershire WR15 8QE 01905 611147 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) SCOPE Mr Andrew Joseph Deakin Care Home 4 Category(ies) of Physical disability (4), Physical disability over 65 registration, with number years of age (1) of places Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is primarily for people under 65 years of age with a physical disability and may also accommodate people with an additional learning disability. 9th August 2005 Date of last inspection Brief Description of the Service: Chantry Close was first opened in 1994 and is part of a community project set up by SCOPE called 1st key Worcestershire. SCOPE is a national organisation, providing a range of services for people with cerebral palsy and other physical disabilities. The property is actually owned by a housing association, which has responsibility for it’s ongoing maintenance, and leases it to SCOPE. The home provides accommodation with personal care for four adults who have physical disabilities and may also have a learning disability. The stated aim of SCOPE is for disabled people to achieve equality, and one of the home’s main aims is to empower service users to lead their lives in a way they choose. The house is situated in a quiet cul-de-sac close to the centre of Tenbury Wells, which is busy market town. It has a very pleasant outlook towards the parish church and the river beyond. The property has a few parking spaces out the front and a small private garden with a patio area to the rear. Each service user has a single bedroom, none of which have en-suite facilities. One bedroom is on the ground floor and the other three can be accessed by a stair lift. There is a dining area, sitting room, ground floor shower facilities and a bathroom upstairs for everyone to use. The kitchen is not adapted to make it’s use easier for people in wheelchairs, and overall the accommodation would not be suitable for service users with more severe physical disabilities. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a routine, statutory inspection that was carried out unannounced in two hours on a late Tuesday afternoon in winter. The main aim of the visit was to obtain a snapshot of life at the home. Also to confirm it still offers a good quality service, which is valued by service users and meets its stated purpose. For more detailed information about the care, service and facilities provided at Chantry Close you should also read the report of the last, fuller inspection, which was undertaken on the 9th of August 2005. Most of the inspection was spent talking to two service users and the staff member on duty about their experience of living or working at Chantry Close. There are three people living at the home as the other long standing resident had sadly passed away recently. Staff and service users were coming to terms with their bereavement together and it was good that they wanted and felt able to talk openly about him and the funeral. What the service does well:
Chantry Close has offered an ordinary living opportunity for service users, which has helped their integration within the local community. The home is in a lovely and convenient location and Tenbury Well’s shops and amenities are within easy reach by foot or wheelchair. A suitable vehicle is also provided for transport further afield. The house is very homely and comfortable and there are appropriate aids and equipment to meet service users’ special needs. There was a relaxed and welcoming atmosphere and the staff member and service users obviously get on very well together. It is also clear service users consider Chantry Close to be their real home and they are very settled there. They were positive about their lives and support; the home in general and staff Service users continued to lead full, active and interesting lives. They are enabled to be independent to the extent they are able and so the primary aim of the service is being achieved. Staff provide any support service users need and they also have advocates and social workers to help them make sure their goals and wishes are known and are being fully met. They are each allocated a keyworker from the staff team, who spend some individual time with them and make sure their wishes inform the planning and review of their care. The home is appropriately and flexibly staffed to meet service users’ personal care and social needs. The staff team is also stable and they are all expected by SCOPE to undertake relevant training to help them to do their job properly and to keep the home and service users as safe as possible. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 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. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 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 Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards are not assessed, as there have not been any new service users admitted to the home for years. However, it was previously confirmed the home provides the required information documents, including a statement of purpose, service users’ guide and a Service Level Agreement (contract) for current and prospective service users. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards are not fully assessed. However it was confirmed in the last inspection that all service users have a care plan, which details their needs and the support needed from staff to meet them. Plans also include personal goals and the care records their background history and preferred daily routines. One of the service users said a review meeting about their care was being held at the home tomorrow, which would involve their funding authority. They were appropriately to fully participate in this review. The home operates a keyworker system whereby staff are allocated to each service user, which can help make the support given them be more personal. One service user understood and valued their keyworker’s input and individual time spent with them. The keyworkers also have a role in drawing up and reviewing care plans and ensuring service users’ goals and wishes are known. It is clear that service users make decisions and choices in their daily lives and routines, and that this is encouraged and facilitated by staff. However, even though they appear to be self-determining it is good they all have external advocates whom they see regularly and can contact whenever they wish.
Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 14 Service users are enabled to lead full, active and interesting lives and are well integrated within the local community. EVIDENCE: Service users continued to lead busy lives, in accordance with their individual choices and interests. They discussed attending a workshop, doing voluntary work with older people and a life skills development course at college. One of the staff team is a nominated activities co-ordinator and facilitates service users’ social and leisure activities. Those able to also go out without staff support and they clearly feel they are part of the local community. The close proximity to town is a real advantage as there is a cinema, theatre and lots of pubs and other facilities. One service user discussed how she meets up with friends in cafes, does both her personal shopping and some for the home, uses the library and attends local events. The home also has a suitable vehicle, which can accommodate one wheel chair user and the rest of the group, for outings further afield and holidays etc.
Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 11 Although food provision is not fully assessed it is apparent service users are fully involved in choosing and preparing their own drinks, snacks and meals. One of the service users also takes responsibility for writing out the home’s daily menu for the main meal which is a record of food provided as is required. Meals and mealtimes are flexible and service users choose when and what to have for breakfast and snacks, depending on their activities or when they get up etc. Staff provide the main cooked meal and mealtimes are clearly part of the social life of the home when staff and service users sit and eat together. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards are not assessed. However it was confirmed in the previous inspection that appropriate arrangements were in place to ensure the personal, emotional and health care needs of service users are being met. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards are not assessed. However SCOPE provides a suitable complaints procedure and the organisation has a Complaint Resolution Officer to investigate complaints when necessary. The home has polices and procedures for abuse and service users’ protection, including whistle blowing. There was also a copy of the Worcestershire interagency procedures for Protection of Vulnerable Adults. SCOPE employ an Adult Protection advisor and the staff member said all the staff team had received instruction on how to identify indicators of abuse or neglect and about their responsibility to report any suspicion or evidence, in respect of service users. There have not been any complaints or vulnerable adults concerns raised with the home or the Commission about the home or service users, since the last inspection. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The accommodation at Chantry Close suitably meets service users’ needs and provides them with a homely and comfortable environment. EVIDENCE: The home is in a very convenient and lovely location, close to the centre of Tenbury Wells whilst also having a view of a Church, the river and countryside. The town is within walking distance and has a good variety of shops, many pubs and cafes, a leisure centre, cinema, library and other amenities. The property is an ordinary house in a row of other houses, which is therefore in keeping with the local community. The impression of the environment is homely and comfortable and those areas seen today were clean and tidy. There are appropriate adaptations and equipment for service users’ physical needs. They include a call bell system throughout, a stair lift and grab rails in bathrooms. Other aids were provided for individuals according to their needs. A Housing Association own the property and are responsible for its ongoing maintenance and upgrading. The staff member said when repairs are needed they are recorded and reported to them to be actioned.
Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Suitable staffing levels are being maintained to meet served users’ needs. EVIDENCE: The staffing arrangements for the home had not changed and it was previously confirmed that staffing levels and deployment are appropriate to meet service users’ needs, which had not changed either. The staff member on duty and one service user felt there are sufficient staff to provide the personal care and support service users’ need. Also to carry out the household tasks and cooking, which service users are encouraged to take as active a role as they are able to. There were no staff vacancies at the home and the staff team continued to be stable. This is good for consistency of care and helps to make sure that staff and service users know each other well. The staff member on duty had achieved an NVQ qualification in care and had also undertaken all the required health & safety training topics. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards are not fully assessed; however management arrangements for the home have not changed. The registered manager is the Community Services Manager for 1st Key Worcestershire (Mr Andrew Deakin), who has many years experience with SCOPE and has been in post since 2003. He visits the home at least weekly and so the day-to-day management of the service and staff team is delegated to a senior team leader. It was previously confirmed a formal Quality Assurance and Monitoring (QA) system was being introduced by SCOPE. This would appropriately include getting feedback from service users to inform the home’s development. QA systems are required, and will play an increasingly important role, to ensure the quality of care services is continually reviewed and they develop as service users and other involved people (e.g. families and funding authorities) wish. This process must result in a development plan and periodic reports; copies to be sent to the Commission and made available to other interested parties. The Commission has not yet received a report of any quality reviews of the home.
Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 17 The Commission has to be kept informed about care homes through reports made following required monthly visits to the home from a representative of the service provider. However in the last year only six reports had been received from SCOPE, the latest one for November 2005. These visits are important, as they are one of the ways the provider monitors the standard of care by inspecting the premises, checking events and complaints and obtaining feedback about the home from service users and staff. The staff member on duty had completed all the mandatory health & safety training areas, including first aid, moving & handling, fire safety and food hygiene. He had also attended a general health & safety training session. There were no safety hazards noted during this inspection and the fire log showed that all the required tests and checks on the fire safety system and equipment were recorded as having been carried out at the specified intervals. In addition that the home had arranged regular fire drills. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 18 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X X X X X X Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 19 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 Regulation YA43 26 Requirement Copies of the reports made by a representative of the provider following their required monthly visits must be supplied to the Commission. Timescale for action 30/04/06 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 YA6 Good Practice Recommendations Consideration should be given to recording all information about service users individually. This would ensure that all personal information is accessible to them and it would also become part of an ongoing record of their progress and life. Not reviewed in this inspection and so carried forward. Chantry Close, 1 DS0000018483.V283999.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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