Inspection on 23/06/09 for Chadderton Total Care Unit Limited

This inspection was carried out on 23rd June 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chadderton Total Care Unit... 26/06/07

Chadderton Total Care Unit... 27/02/07

Chadderton Total Care Unit... 27/09/05

Chadderton Total Care Unit... 03/05/05

Chadderton Total Care Unit... 20/10/04

Chadderton Total Care Unit... 21/04/04

Chadderton Total Care Unit... 19/11/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Chadderton Total Care Unit Limited Middlewood Court, Middleton Road Chadderton Oldham Lancashire OL9 9SR Lead Inspector Fiona Bryan Key Unannounced Inspection 23rd June 2009 09:00 DS0000025429.V376398.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chadderton Total Care Unit Limited Address Middlewood Court, Middleton Road Chadderton Oldham Lancashire OL9 9SR 0161 627 0027 0161 628 7769 mary@total-care.org.uk 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) Chadderton Total Care Unit Limited Mrs Mary Alison Green Care Home 151 Category(ies) of Dementia (151), Old age, not falling within any registration, with number other category (151), Physical disability (151) of places Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical disability - Code PD The maximum number of services users who can be accommodated is: 151 26th June 2007 2. Date of last inspection Brief Description of the Service: Chadderton Total Care provides care and accommodation for 151 residents with a variety of needs. It is divided into four distinct suites, including care for older people with dementia (Saddleworth Suite and Dale Suite), general nursing (Lakeland and Middlewood Suites) and a suite for younger adults with disabilities (Pennine Suite). The suites are staffed separately with qualified staff who have the knowledge and skills to provide the appropriate care for each service user category. The home has its own physiotherapy unit and is able to offer exercise and therapy to those who require it. The home is owned by Chadderton Total Care Unit Limited, which is a private company, and is managed on a day-to-day basis by a registered manager who is also a nurse. Accommodation is provided on the ground floor throughout the home. Fiftyfive rooms are single en-suite, whilst a further 87 rooms are single and are furnished with a washbasin. Five double rooms are also available for couples or those who wish to share. The home has several courtyard areas accessible for wheelchair users and a pleasant garden with seating at the back of the building. The lounge/dining spaces are open plan and provide ample space for movement by wheelchair Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 5 users. Disabled facilities are also provided. Fees for accommodation and care at the home range from £400 to £730 per week, depending on the degree of nursing care needed. Additional charges are also made for hairdressing, newspapers and personal toiletries. A service user guide is on display in the reception area of the home. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This key unannounced inspection, which included a site visit, took place on Tuesday 23rd and Wednesday 24th June 2009. Staff at the home did not know this visit was going to take place. All key inspection standards were assessed and information was taken from various sources which included observing care practices and talking with people who live at the home, the manager and other members of the staff team. Six people were looked at in detail, looking at their experience of the home from their admission to the present day. A partial tour of the building was conducted and a selection of staff and care records was examined, including care plans, staff duty rotas and medicines records. An expert by experience assisted the inspector for part of the inspection. The phrase “expert by experience” is used to describe people whose knowledge about social care services comes directly from using social care services. This person talked to a group of younger adults on the Pennine unit about their quality of life. She completed a report after the inspection; some of her written comments are included in this report. Before the inspection, we asked for surveys to be sent out to people living at the home and 19 people responded. We also sent surveys to staff and received 13 responses. Before the inspection, we asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. The manager completed the form well and demonstrated that she was able to identify areas that could still be developed and plan for future improvements to the service. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 7 What the service does well: Record keeping was generally good with each person having a full assessment before they were admitted to the home and detailed care plans drawn up to provide staff with information about the care they needed to deliver. The majority of people that we spoke to and that returned surveys felt they were very well cared for and were treated with kindness and respect by staff. Comments included “Pleasant staff who work well within their immediate resources”, “Look after me quite well”, “Treats me well, is always clean and tidy and the staff are always helpful”, “Carers are first class and really care for the residents”, “Our family are all happy that X is here. We feel confident that she is getting the care she needs”, “Gives good care. The staff are friendly to residents and family”, “They are always there to help. Nothing is too much trouble”, “The care is wonderful and I know mum is safe and happy there” and “The staff are kind and caring at all times. I have nothing but praise for CTC it’s a credit to all concerned”. Systems for the management of medicines in the home were satisfactory and protected people from mistakes being made. A number of social therapists were employed and there was a strong commitment to providing opportunities for social interaction and stimulation. The vast majority of people that returned surveys and that we spoke to were aware of how to make a complaint and were confident that any concerns would be listened to and acted on. The manager looks at all complaints raised and kept good records to show that they were taken seriously and issues were rectified where necessary. Everyone we spoke to knew who the manager was and said they regularly saw her around and about the home. People said the manager and the deputy managers were approachable and they could talk to them at any time. The manager and deputies worked shifts between them to make sure one of them was always on duty throughout the day and evening and it was impressive that in such a large home they all clearly knew everyone living there and were up to date with their current condition and care needs. Due to the size of the home recruitment was a planned activity to ensure that staff were recruited in advance of known vacancies. This gave enough time for the necessary checks to be made and also meant new staff could receive a proper induction and health and safety training. A training programme was in place to ensure that staff received refresher training when needed and staff also undertook specific training where necessary to help them look after people with particular conditions. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 8 The arrangements for handling peoples’ money were good, allowing them to manage their own money if they wished to do so and were able to and therefore promoting their independence. A team of maintenance people ensure all parts of the building and equipment are regularly checked and serviced to meet health and safety requirements. What has improved since the last inspection? What they could do better: Although care plans were detailed, discussion with people living at the home indicated that they did not always have much input into them and did not have regular access to them so they could check for themselves if they were still relevant or ask for changes where they felt they were needed. People told us they were not able to go out of the home as often as they used to because the cost of transport had gone up. Consideration should be given to the provision of a minibus due to the size of the home and the numbers of people who want to go out. Work should be done on looking at how peoples’ independence can be further maximised particularly on the unit for younger people. Although there is a small adapted kitchen this did not seem to be used to its full potential. Consultation should be held with people about the best ways in which routines and systems can be made more flexible to suit individuals. The Pennine unit could be made much more comfortable and homely with the provision of more soft furnishings, ornaments and pictures etc. The overall ambience at the moment is quite clinical and institutional. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 9 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 10 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 Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before moving into the home to ensure their needs can be met. EVIDENCE: Six people were case tracked. Each person had been admitted to the home on the basis of a full assessment, which included risk assessments for pressure areas, falls, moving and handling and nutrition. Since the last inspection one of the units, The Dales unit, has been refurbished and opened to provide accommodation for up to 12 people with dementia who have low to medium dependency and care needs. The service user guide was updated in March 2009 to reflect this change. We received surveys from 19 people living at the home and all but one said they had received enough information about the home before moving in to enable them to make a decision about living there. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The healthcare needs of people living at Chadderton Total Care are generally well managed to ensure that they receive the care and attention they need. EVIDENCE: The care for 6 people living at the home was looked at in detail. Each person had a care plan that addressed the needs that had been identified during the assessment process. Care plans were in general quite detailed and offered specific information about peoples’ abilities and preferences. Care plans and risk assessments were reviewed monthly but staff did not always exactly follow the actions stated as being needed in peoples’ care plans. For example, the care plan for one person said they should be weighed monthly but they had only been weighed in August, September and December 2008 and March and May 2009. This Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 13 person’s weight in May 2009 appeared to be in question as it appeared they had put on significant weight but the person had not been reweighed since to check the accuracy. Another person should have been weighed weekly according to their care plan but was only weighed monthly. Although care plans were reviewed monthly this was often only evident from staff having signed and dated the care plan to record they had reviewed it. Several people had care plans for mental health needs and behavioural problems where it would have been helpful if staff had used the review process to expand on the care plan and provide additional information about possible triggers that caused challenging behaviour and techniques that had been identified that could lessen the behaviour or de-escalate situations. The expert by experience spent time chatting with younger people living on the Pennine unit, talking to them about the care they received and how they were consulted about their preferences and needs. Most people she spoke to were not really aware that they had a care plan and could not remember it being discussed with them. No one had a copy for their own information. It is recommended that a better system for reviewing care plans is developed to enable people to be more involved where possible. Records showed that people had seen GPs, dieticians, physiotherapists, Speech and Language therapists (SALT) and opticians and had been supported to attend hospital out patient appointments etc. We looked at how medicines were managed for a small number of people and were satisfied that systems were in place that reduced the risk of errors and ensured the safety of people living at the home. People we spoke to said that staff were “very good” and treated them well. People felt that staff understood what help they needed and generally met their needs well. 93 of people returning surveys said they always or usually got the care and support they needed and 100 said they received the medical attention they needed. 84 of people said that staff always or usually listened and acted on what they said. Comments from people returning surveys included “Pleasant staff who work well within their immediate resources”, “Carers are first class and really care for the residents”, “Our family are all happy that X is here. We feel confident that she is getting the care she needs”, “The staff are friendly to residents and family”, “The home does very well in every way for my mum in keeping her clean and always well dressed nice, she is very well looked after”, “They are always there to help. Nothing is too much trouble”, “The care is wonderful and I know mum is safe and happy there”, “The staff are kind and caring at all times. I have nothing but praise for CTC it’s a credit to all concerned”, “Good standards of care”, “Total care home staff are loving and caring” and “The home got me walking with a walking stick when I had been here 4 months and gave me back my independence”. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a strong commitment towards meeting peoples’ social interests but some people could be further supported to maximise their independence and choice. EVIDENCE: Three social therapists are employed at the home; one works on Saddleworth unit, one works on Pennine unit and one works on Lakeland unit. A part time holistic therapist is also employed on a free lance basis who works 12 hours per week on Pennine and 3 hours per week on Saddleworth, providing therapies such as Indian head massage and reiki healing. A therapy room is situated on the Pennine unit and people living in other parts of the home are welcome and encouraged to attend the sessions organised as part of a weekly programme. Some people told us they enjoyed going to these sessions because it gave them an opportunity to meet people living in other parts of the home. Other people chose not to take part in group activities, as Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 15 they had regular visits from family and friends or preferred to spend time watching TV or pursuing their own interests. There were varying amounts of information in peoples’ care plans about their social care needs and expectations. The manager told us that staff were trying to move away from planning care based predominantly around peoples’ health needs towards looking at people as individuals and building on their abilities, thus enabling their independence as much as possible. In the AQAA it was recognised that ensuring equal access to social resources and facilities for everyone living at the home was difficult and staff aspired to involve everyone in some form of therapeutic activity but did find that some people participated in many of the activities, whilst some took part in very little. People told the expert by experience that bingo was held on a Friday and Tuesday afternoon and they had party nights such as at Halloween when there was a bar and disco. Other activities included quizzes and baking. People said they could come and go as they pleased although if they needed support from staff this could limit the frequency of trips out. People also told us that since the last inspection they had been on fewer trips out in the evenings due to the increased costs of transport. This was discussed with the manager and we asked her to speak to the home owner to see if he would consider buying a mini bus because due to the size of the home and the number of people living there this would be of major benefit. Comments about the food provided at the home were variable. Everyone told us there was a choice and some people said they always or usually liked the meals. However others said the quality was “so so” and one person said “the quality of food is poor, although Sunday lunch is excellent”. The expert by experience had lunch with people on the Pennine unit and reported that the experience reminded her of being in hospital, with the meal already plated and drinks served from a ‘drinks trolley’. The expert by experience was told that the mealtimes were set and people chose from a menu issued the day before. People said they had an allocated table in the dining room where they sat for all their meals and they only ate at the designated times. All of the people she spoke to informed her that they were not allowed in the kitchens and were not allowed to prepare their own meals or have access to facilities to make their own drinks during the day. If they did want a snack or drink there was a vending machine in the reception area and some people had small fridges in their rooms. We discussed this with the manager who told us there was a small kitchen area adapted for use by people in wheelchairs but this could be promoted and used more. When people have to ask for everything such as drinks or food it impacts on someone’s independence. Encouraging and helping people to make more use of the kitchen area where possible could increase life skills and give people more choice and control in their lives. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 16 On the day of our visit the weather was very hot and although a chilled drinks machine was provided in the reception area of the home, where staff, visitors or people living at the home could buy extra drinks, we were told that in hot weather the supply sometimes ran out. The provision of chilled water dispensers around the home would enable staff to easily offer people cold drinks and would be of benefit to people living there. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel their concerns are listened to and staff follow procedures to protect people living at the home from abuse. EVIDENCE: A detailed complaints procedure is provided in the home’s service user guide. The majority of people that returned surveys said they knew who to complain to if they were unhappy and were aware of the complaints procedure. One person wrote “If there was a problem it would be sorted out right away. Not only do they look after my mum so well, they are always there to listen to relatives”. The manager told us in the AQAA that they were in the process of developing large print and picture formats for the complaints procedure so it will be more accessible for people who have difficulty understanding the standard format. A record of complaints made to the manager was maintained and the manager analysed the types of complaints being made to detect trends or persistent areas of dissatisfaction. The records showed how each complaint had been investigated and responded to and also whether the complainant had been happy with the response. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 18 The manager and staff at the home are very proactive in reporting any incidents that occur in the home to the relevant agencies and accessing advice and support from other healthcare professionals where necessary, for example in managing challenging behaviour. The manager said that the new framework for implementing the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (MCA DOLS) had been discussed with staff and at the time of our visit no one living at the home was subject to an application being made under these requirements. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and safe environment but some areas could be improved to provide a more homely setting. EVIDENCE: A partial tour of the home was conducted. Peoples’ individual rooms and the communal areas were generally tidy and the home smelled clean and fresh in most areas. The home provides a spacious and reasonably well-maintained environment. The home is single storey and allows for free movement by people around the home to all areas, with the exception being people living on the Saddleworth Unit. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 20 People living at the home are encouraged to personalise their own rooms and many were very individualised and showed the personalities, preferences and interests of the occupants. The manager told us that staff enjoyed helping people to furnish and fit out their rooms to their tastes. Several garden and outdoor areas were available for people to use and these provided plenty of benches, chairs and parasols. The main garden in particular was well landscaped with mature bushes, plants and trees. A number of people told us they enjoyed spending time in the garden and liked to sit there when their families visited. On Middlewood unit we noticed that a number of people were sat in their wheelchairs and they told us they usually sat in them all day. In one small lounge area there were not enough comfortable armchairs to accommodate all the people that were in the room at the time. We later saw one person asleep in their wheelchair and she looked uncomfortable as there was no proper back or neck support for her. Staff should be encouraged to transfer people from wheelchairs into proper armchairs where possible, where these would be more suitable for sitting for longer periods of time. On Saddleworth we noticed that several people were eating lunch (sandwiches) and were having to balance cups and plates on their knees as there were no small tables nearby for them to use. The expert by experience noticed that one person living on the Pennine unit, who used an electric wheelchair found it very difficult to get into their room due to the width of the door and required assistance from a member of staff. The main communal area on the Pennine unit did present as being rather tired and institutional. A vast expanse of floor was only broken up with some rather basic looking chairs and settees. The use of cushions, lamps, wall units, books, magazines, pictures, ornaments and photographs could make the unit look much more homely and welcoming and more contemporary for the people living there who are all younger adults and the environment could better reflect their age and tastes. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements, recruitment and training ensure that people are cared for and supported safely. EVIDENCE: Because the home is so large and the numbers of staff employed are consequently high, recruitment within the home is a planned activity which is reviewed monthly. The manager aims to be proactive and plan ahead to meet staffing needs. Staffing is flexible to meet the demands of the day, for example mealtime supervisors are employed on some units to provide additional staff when it is especially busy and people need extra help to eat. The majority of people that returned surveys said there were always or usually enough staff on duty to meet their needs. Most people that we spoke to on the day of our visit felt that staffing levels were usually satisfactory. We looked at the personnel files for 2 new staff members. Both had been recruited following a robust vetting procedure. Records showed that induction training had been given. We spoke to one person who had been working at the Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 22 home for about a year. This person said she felt she had received enough training, supervision and support to enable her to settle into her job. In the AQAA it was reported that 51 of care staff had successfully completed NVQ training. There is a big commitment within the home to ensuring staff receive appropriate training. All staff receive regular health and safety refresher training and people are encouraged to undertake additional training in specific topics such as palliative care and a range of medical conditions. Thirteen staff returned surveys and all said they felt they received enough training to be able to carry out their jobs well and they all said they were well supported by the management team in the home. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 25 and 38 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Chadderton Total Care is managed with systems, policies and procedures in place to ensure the health and safety of staff and people living there are promoted and protected. EVIDENCE: There have been no changes to the management of the home. The manager is an experienced nurse who has managed this home in excess of ten years. Evidence was available to show that the manager had attended training over the past year to ensure she updated her own knowledge and skills. There are Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 24 two deputy managers, who work shifts to ensure that at least one of the management team is on duty during the day. In the AQAA the manager told us she had an open door approach so anybody could see her at any time to speak to her about any issue. Everyone we spoke to on the day of our visit said they regularly saw the manager around and about and she would stop and chat with them. Regular meetings were held for people living at the home and records of these meetings showed that people had been asked for suggestions to improve their experience of living in the home. It wasn’t always clear whether any of the suggestions were acted on, although in discussion with the manager it was reported that some ideas and suggestions were taken up. It was recommended that an additional record was kept for quality monitoring purposes showing how peoples’ commments and feedback were used to develop the service. Other methods of obtaining feedback from people living at the home and other interested parties were also used, for example a suggestion box was provided in the reception area and surveys were distributed and the responses analysed in order to check if there were any recurring areas that people felt needed improvement. A summary of the most recent surveys received was written in February 2009 and it was noted that the majority of comments received were positive. It was also reported in the AQAA that the catering manager does regular surveys to guage peoples’ satisfaction with the food provided at the home and the social therapist has researched with people what activities they would like, and made arrangements accordingly. The home has been accredited with the Investors In People award since 1997 and this is subject to 3 yearly reviews. Procedures for handling residents’ money were satisfactory and promoted residents’ rights to manage their own money if they wished. Residents can deposit money in their account or withdraw up to £20 per day via staff on the reception desk. Amounts larger than £20 need to be ordered the day before. All transactions are recorded in triplicate and the accounts are held electronically and audited regularly. Health and safety records were available, which showed that the maintenance of the building and equipment was up to date. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 25 The manager returned the AQAA to us within the time we requested. Information in the AQAA showed a high level of understanding about the importance of equality and diversity, (although this still needs to be translated into action in some areas) and there was a wide range of evidence showing how they have listened to residents. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 26 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 3 x 3 x x N/A 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 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 2 X 2 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 4 X 3 X 3 X X 4 Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP12 Good Practice Recommendations A system should be developed to ensure people have better access and input into their care plans where they wish. Due to the high number of people living at Chadderton Total Care and their expectations to be supported to go out of the home consideration should be given to providing a minibus to facilitate this more easily. Further consideration should be given as to how peoples’ capacity to exercise autonomy and choice is maximised, for example by promoting the use of kitchen facilities based on risk assessment. Consideration should be given to providing chilled water dispensers around the home. The décor and furnishings on Pennine unit should be reviewed and updated in consultation with people living on the unit to provide a more homely and contemporary environment that is better suited to younger people. DS0000025429.V376398.R01.S.doc Version 5.2 Page 28 3. OP14 4. 5. OP15 OP20 Chadderton Total Care Unit Limited 6 OP22 7 OP33 On other units the provision of suitable armchairs should be reviewed and staff should ensure that where possible people are transferred out of wheelchairs to sit in more comfortable chairs for the majority of the day. People who use electric wheelchairs should be accommodated in rooms where the door width is sufficiently wide to enable them to drive through them independently. To develop quality assurance systems further records should be kept to show where improvements have been made following feedback from people living at the home and to demonstrate how peoples’ views have been acted on. Chadderton Total Care Unit Limited DS0000025429.V376398.R01.S.doc Version 5.2 Page 29 Care Quality Commission Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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