Inspection on 02/06/09 for Chaffinch Residential Care Home

This inspection was carried out on 2nd June 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chaffinch Residential Care Home 04/06/08

Chaffinch Residential Care Home 13/08/07

Chaffinch Residential Care Home 06/07/06

Chaffinch Residential Care Home 06/03/06

Chaffinch Residential Care Home 06/10/05

Chaffinch Residential Care Home 08/02/05

Chaffinch Residential Care Home 30/06/04

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Chaffinch Residential Care Home 36 Chaffinch Drive Bury Lancs BL9 6JU     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Bodell     Date: 0 2 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Chaffinch Residential Care Home 36 Chaffinch Drive Bury Lancs BL9 6JU 01617634579 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Swadesh Munbodhowa care home 5 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: 1 5 The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Within the maximum number registered there can be up to 5 MD and up to 1 LD. Date of last inspection Brief description of the care home Chaffinch House is a small privately owned home providing long term care and support to four people with mental health needs and one person with a learning disability. The home is situated in a residential area off Rochdale Old Road in Bury, approximately a mile and a half from the town centre. Buses and shops are within walking distance of the home. The house is a large, extended semi-detached property, with gardens at the front and back. There is room for car parking on the road. All bedrooms are single. Standard weekly fees are currently 365 pounds per week. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The home did not know this inspection visit was to take place. A total of six hours was spent in the home. We (the commission) talked to the registered provider, the registered manager and two people that lived at the home. We looked round the home and at some key records. We received information requested (AQAA) before this visit from the service provider. We also received a feedback survey from four people and three staff members. Surveys were generally positive in there responses about the home. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The care staff team would benefit from more training in person centred planning to help them improve the present care plans and risk assessments and develop good practice. People who come to live at the home need to be able to access community activities independently because staffing levels limit opportunities for staff to support them outside the home. The staff team need to undertake safeguarding training to ensure that they know what action to take if a person makes an allegation of abuse. There is a need for continuing improvements to be made to the home to ensure that acceptable standards are maintained. Members of the staff team need to receive regular supervision sessions from the registered manager. The registered manager must continue to make progress towards completing a recognised management qualification and NVQ Level 4 in care. Care Homes for Adults (18-65 years) Page 7 of 27 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 set out 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. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 thinking about going to live at Chaffinch Drive are assessed to ensure that their individual needs can be effectively and safely met. Evidence: For people considering moving into the home a community psychiatric assessment would be undertaken by a qualified person to ensure that it was a suitable placement for them. The registered provider told us that either he or the manager would visit people at home or in hospital to undertake an assessment to ensure that individual needs could be met. The needs of the existing group of people living at the home would also be taken into account before agreeing to offer a place. People were able to visit the home, including overnight stays before making the decision to move in. No new people had come to live at the home for sometime. Before people come to live at the home they are given a copy of the service user guide, a copy of the complaints procedure and information about an advocacy service. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices and decisions about their daily lifestyles but a person centred approach to support by the home, could be developed further. Evidence: Where appropriate people had an up to date CPA review in place. Care plans and risk assessments relating to one person were looked at and were seen to be still basic. The care plan covered areas such as monitoring mental health needs, personal care, emotional needs and daily living skills. At our last visit we talked about ways to improve the care plans through adopting a person centred approach and finding relevant training for the staff team to attend. A reviewing officer had advised the home about where they could access training to help the staff team to develop and keep up to date with current practice. We were told by the manager that the staff team had watched a DVD about person centred approaches and planning but they had yet to put this into active practice or update care plans and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: risk assessments. Discussions with the registered manager confirmed that she had a good understanding of the needs of people living at the home. Records showed that care plans and risk assessments were reviewed regularly by the home. People spoken with said that they could choose how and where they spent their time. They said they got up and went to bed at the times they chose. Most people had their own bank accounts and looked after their own personal money. They had residents meetings. The last meeting took place on 13.05.09 and people discussed doing more for themselves. People also talked about the home becoming a smoke free zone from 3rd August with the offer of help if people wanted to stop smoking. We talked to people about this. They were not happy about the decision but one person said that they were happy to give it ago. People also talked about meal planning, arranging day trips out and their care plans. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 have access to community activities and most people have regular contact with their families and friends. Evidence: People who live at the home were all able to travel independently using public transport. On the day of our visit three people were out visiting relatives, which they did most days and two people were at home. People we spoke with said that they could choose how they spent their time. Some people took responsibility for some household tasks. One person had an activity timetable that involved attending music classes at a local drop in centre and going to the gym. One person was going to college and another was planning to go back to college in September to attend maths and English courses. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: The registered manager said that they continued to help and encourage people to find suitable activities and would accompany people on activities outside the home whenever possible. There is only usually one staff member on duty at any one time but the registered manager said that she was confident that the registered provider would make staff time available to support people where necessary. A number of trips out were planned for the summer months to a garden centre, the Science Museum, Heaton Park, the cinema, York, Salford Quays and a shopping trip to Stockport. People were satisfied that their privacy was respected. They had a key to their bedroom and they said that no one entered their rooms without permission. Most people had their own television and sound system in their bedrooms and one person was watching a DVD. People said that staff treated them with courtesy and respect. This was observed during our visit. People said that they generally got on well with each other as a group. People said that the meals were good and that there was enough to eat. Planned menus showed that a varied diet was provided. There was no specific alternative listed on the menu but people knew that they could ask for something different if they wanted to and a record of the alternative was recorded. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples mental health, including medication, are kept under review and monitored to ensure that they do not relapse into ill health. Attention was needed to ensure people had regular healthcare checks with dentists and opticians. Evidence: People living at the home were very independent in respect of their physical needs. Staff involvement in meeting personal needs is mostly in the form of prompt and encouragement. At a recent meeting it had been discussed with people about the importance of washing their hands and cleaning their teeth. The people we spoke with said that they had choices about their daily routines, for example what time they got up or went to bed. They said that they were happy with the way that staff members treated them and the way they spoke to them. The registered manager knew the needs of people well and they described how they would quickly pick up on any mental health concerns and contact the appropriate person for help and advice if necessary. No major issues of concern about behavioural management were raised at this visit. There was evidence on care files of contact with Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: healthcare professionals such as GPs, psychiatrists, psychologists, chiropodists, opticians and dentists. It was noted that one person had not seen an optician or dentist for a number of years. This matter had been noted at a previous visit involving another person living at the home. The registered manager said that she would take action to follow this up. People had signed a consent form agreeing that members of the staff team could administer their medication. The homes medication procedures included guidelines covering non-prescribed medication. The Boots monitored dosage system was being used. Medication was appropriately stored and medication administration records (MAR) were completed and up to date. Hand written entries were signed and countersigned. Sample staff signatures were kept with the MAR sheets. Depot injections were administered and monitored by community psychiatric nurses. Staff training certificates showed that all staff including the registered provider had undertaken training in the safe handling of medicines. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All the staff team would benefit from undertaking updated safeguarding vulnerable adults awareness and procedure training to ensure they are able to respond appropriately to any suspicion or allegation of abuse. Evidence: People said they would speak with the registered manager if they had any concerns. They felt that they would be listened to. A complaints book is kept on the kitchen table for people to write in any concerns they have. The home had a copy of the new local authority safeguarding vulnerable adults procedures. No allegations had been made since the last visit. The registered manager when asked was not clear about the role of the safeguarding coordinator but would contact the local authority or CQC if she had any concerns. All the staff team had undertaken vulnerable adults procedure training in the past and had recently watched a DVD on the subject. But this had not given them the information they needed to ensure they are able to respond appropriately to any suspicion or allegation of abuse. It is therefore required that all the staff team undertake training on the safeguarding procedure through the local authority training initiative. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a homely and clean environment but there is a need for continuing improvements to ensure that standards are maintained. Evidence: The home had a lounge, two small dining areas, a domestic style kitchen and a small laundry room. There was a bathroom with an overhead shower on the first floor and a shower room on the ground floor. Each contained a toilet. Bathrooms were lockable to ensure privacy. All bedrooms were single and lockable. Bedrooms were personalised with peoples own possessions. Since our last visit one persons bedroom had been redecorated and had new furniture and a new carpet. People we spoke with said that they were satisfied with their rooms and with the home in general. Because the home was to become no smoking from 3rd August plans were in place to decorate another persons bedroom to help remove the smell of smoke as an added incentive to give up smoking. The registered provider also planned to build a smoking shelter outside the back door. There were also plans to decorate another persons bedroom and replace the kitchen. The registered provider must produce a maintenance and renewal programme to show what improvements were planned for the coming year. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: The home was clean and tidy. A cleaner works at the home for 9 hours a week. Liquid soap and paper towels were provided for hand washing in communal areas for hand drying in the interests of good hygiene. People had been reminded at the resident and staff meeting about the importance of washing their hands. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 receive care and support from staff who know them well and have the skills to support them correctly. Evidence: People were happy with the support they received from the registered manager and staff members. Staff rotas were seen. There was normally only one staff member on duty at any one time. As a result, the staff team were rarely able to spend time with people on meaningful activities outside the home. The registered manager said that she was confident that if anyone needed extra staff support that the registered provider and the staff team would ensure that time was made available. Two of the current staff members are retired psychiatric nurses. Two support workers are of retirement age. The registered provider said that he was satisfied that they were fit and able to carry out their role. One new support worker had commenced employment since our last visit. Their recruitment details were checked. An application form had been completed that had a full employment history, with dates and reasons for leaving previous care jobs. Two references had been taken up and a criminal record check had been undertaken. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: The support worker had received induction training on the day they started and training in administering medication before they started. They had since undertaken training in Managing Challenging Behaviour, basic mental health training, first aid, food safety, watched DVDs about adult abuse and fire safety. They were waiting to receive health and safety training. They were in the process of completing NVQ Level 2 and had had a staff appraisal. At our last visit we advised the manager again about seeking information about induction standards on the Skills for Care website and contact the local Adult Care Training Partnership for further information on induction and mandatory training. The registered provider said that he would look into this himself. The manager said that with the exception of the health and safety training identified above the staff team had received all the mandatory health and safety training required such as first aid, food hygiene, medication, and health and safety. Some staff had undertaken equality and diversity training and Mental Capacity Act training was planned. Staff supervision sessions had not been undertaken for sometime. The registered manager said that she would resume the sessions as soon as possible. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager must complete a relevant training course at management level to ensure that she is suitably qualified to manage the home. Evidence: The registered manager holds a NVQ Level 2 and was undertaking the management and leadership course. Progress had been slow because of a number of changes in assessors. NVQ Level 4 in care and management had not been completed. To ensure her continued professional development she has undertaken updated medication training, equality and diversity and watched a person centred planning training DVD and completed a questionnaire. It was clear from observations and discussions, that the manager encouraged an open and inclusive atmosphere within the home. Rotas showed that the owner of the home, an experienced psychiatric nurse, worked there at weekends, therefore Regulation 26 visits are not required. The home is Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: intending to put out questionnaires in the near future and carry out a review of the service. Before our inspection visit we asked the home to complete our Annual Quality Assurance Assessment (AQAA). The registered manager completed the form but the information provided to us was limited. The home now has a laptop and we showed the registered manager and the provider how to access the CQC website and explained the inspection process and how quality ratings were reached. We downloaded an AQAA so that the home could complete it online the next time we requested it. Safety records were checked. These included portable electric appliance tests, electrical installation, gas safety, servicing of fire alarms, emergency lighting and fire extinguishers. Examination of the fire book showed that alarms, means of escape, fire fighting equipment and emergency lights had been tested weekly. The fire officer had visited the home recently and identified a number of areas where action was required. The manager said that all the areas identified had been addressed. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 37 18 The registered person shall ensure that the manager complete NVQ Level 4 training in management and care. 30/09/2008 Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 12 Arrangements must be 24/07/2009 made to ensure people have regular access to a dentist and an optician. This must be done to ensure people receive any necessary treatment they might need. 2 23 13 The staff team must undertake training in safeguarding procedures. This must be done to ensure that they are able to respond appropriately to any suspicion or allegation of abuse. 31/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 It is recommended that the staff team undertake further training in person centred planning which will enable them to improve the present care plans and risk assessments Page 25 of 27 Care Homes for Adults (18-65 years) and develop good practice. 2 11 The registered person needs to keep staff rotas under review. This needs to be done to ensure that enough staff time is available to enable people to become involved in activities outside the home that will help their personal development. It was recommended that the manager resumes staff supervision sessions so that staff receive the support they need. It is recommended that more detail is put in the AQAA (Annual Quality Assurance Assessment) to evidence that the home is run in that best interests of the people living there. 3 36 4 39 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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