CARE HOMES FOR OLDER PEOPLE
Chace, The Chase Road Upper Welland Malvern Worcestershire WR14 4JY Lead Inspector
R Buckland Unannounced Inspection 14th February 2006 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 Chace, The DS0000018683.V282412.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 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. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Chace, The Address Chase Road Upper Welland Malvern Worcestershire WR14 4JY 01684 561813 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) enquiries@thechase.com Chace Rest Home Limited Mr Anthony William Reeley Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34), of places Physical disability over 65 years of age (26) Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd July 2005 Brief Description of the Service: The home provides a residential care service for a total of 34 people over the age of 65 years. The home is able to provide care for older people who are physically disabled and older people who suffer with dementia. The number of residential places for those who have a physical disability is 26. Respite care is available as is a day care service. The premises are situated in a village location in Upper Welland, near Malvern. They consist of an original building, formerly a country manor house, and a large extension. Accommodation is provided on two levels in both parts of the building. There are fourteen bedrooms on the ground floor, twelve of which have ensuites. There are eighteen bedrooms on the first floor, seventeen of which are ensuites. There are four bathrooms, three of which are adapted for people with disabilities plus a shower room, also adapted for people with disabilities. Rails are provided in corridors. A garden area is available for use by service users. There is a rural bus service close to the home. The home has achieved Classic Homes Status and the Investors in People Award Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over a period of three hours on a weekday. During the inspection three residents and two members of staff were spoken to as well as the general manager. Some documents relating to care and health and safety were looked at, and a brief tour of the building was made including visiting some residents in their bedrooms. What the service does well: What has improved since the last inspection?
The afternoon/evening staffing levels have been re-assessed and changes made to ensure that residents’ needs are met. The registered manager and general manager have both commenced training courses that will fully qualify them for their roles. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 6 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. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 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 Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5 The assessment process ensures that residents’ needs are understood and planned for prior to admission. EVIDENCE: The inspector saw assessments that had been undertaken for two residents prior to them moving into the home to ensure their needs could be met. Information had been sought from any other agencies involved. Prospective residents were able to visit the home before moving in. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9, 10. Residents’ care plans cover most needs. The management of medication systems ensures the safety of residents. The care practices in the home promote residents’ privacy, dignity and independence. EVIDENCE: The inspector saw care plans relating to three residents most topics were included but there was insufficient detail about needs related to bathing and reviews. The inspector does not doubt that staff are aware of these needs. The full implementation of a quality assurance system will highlight this deficiency and prompt the inclusion of the necessary information. The inspector observed the administration of midday medications, no deficiencies were noticed. A high level of support is provided by the pharmacy that supplies the medications. Residents who were spoken to confirmed that staff were very respectful and helpful. Observations made during the inspection also indicated that residents were treated with respect.
Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 10 Residents said that staff were, “Kind” “Very good”, “Lovely”. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The activities provided in the home promote the health and welfare of the residents and are tailored to meet individual and collective needs. Visitors are welcomed to the home and residents are regularly offered opportunities to go out into the local community. The food provided by the home was varied and catered for residents with specialist needs. EVIDENCE: Routines in the home were flexible; one resident stated, “It was easygoing”. There is an emphasis put on the provision of meaningful activities that includes regular trips out into the community in the homes’ car. Whilst one member of staff undertook the organisation of activities, all staff have the opportunity to be involved with them. Group activities were undertaken as well as individual time spent with residents. The provision of activities in this home is commendable. Residents were able to maintain their contact with family and friends. Residents who were asked about the food stated that “the food is good”, “its like I used to have at home”
Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 12 Menus were displayed on the tables and choices and alternatives were offered. The dining room was attractively laid and the meal that took place whilst the inspector was in the home was unhurried. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The ethos of the home is such that residents feel able to voice any concerns. EVIDENCE: Residents spoken to by the inspector said they felt able to bring their concerns up with staff. They were also confident that any concerns would be addressed. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25, 26 The environment is maintained to a high standard, providing the residents with a very comfortable and homely place to live. EVIDENCE: The inspector visited all communal areas of the home. The home is well maintained and was very clean on the day of the inspection. The standard of décor is very high. There is a choice of communal rooms and a separate dining room. Residents spoken to by the inspector confirmed that they had been able to bring their own furniture in and were very content with their rooms. The bedrooms are decorated to a high standard. Staff spoken to said that they had received infection control training. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 Staffing levels were judged to be adequate for the needs of residents at the time of the inspection. Staff training was well in hand. EVIDENCE: Since the previous inspection the general manager had assessed afternoon and evening staffing levels and made some changes to the pattern of staffing. However no record had been kept of the assessments involved. The full implementation of a quality assurance system will highlight this deficiency and prompt the recording of the necessary information. Staff who were spoken to confirmed that they had received training in all key areas of health and safety although this had not been recorded in every case. They also enjoyed working at the home. Incidence of staff turnover and sickness is low. Residents who where asked about staffing levels had no concerns and said that help was there when they required it. There was no other evidence to suggest that residents’ needs were not being met. Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 38 Although neither of the managers at the home have completed the required training there is no evidence to indicate that this has had a negative impact on the care received by the residents. EVIDENCE: The registered manager has commenced the outstanding course of training that will fully qualify him for his role and the general manager has commenced the training required of registered managers. There was no evidence to indicate that management systems were not mostly efficient and effective. The inspector examine recent entries in the record of personal expenditures relating to two residents. The system used included the necessary safeguards and no discrepancies were found. With a few exceptions the procedures and records examined by the inspector were comprehensive and up to date. The exceptions included omission of some recent fire precaution checks, some records of staff training, residents’
Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 17 reviews and staff supervision not fully up to date, The general manager is in the process of introducing a quality assurance system, such a system will highlight these deficiencies and prompt the recording of the necessary information. Chace, The DS0000018683.V282412.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 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 Chace, The DS0000018683.V282412.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 OP33 Regulation 24 Requirement A quality assurance system must be put in place. Timescale for action 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 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 Chace, The DS0000018683.V282412.R01.S.doc Version 5.1 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
