Inspection on 16/06/05 for Chaldon Mead

This inspection was carried out on 16th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Chaldon Mead 10/10/07

Chaldon Mead 06/03/07

Chaldon Mead 24/11/05

Chaldon Mead 07/12/04

Chaldon Mead 11/08/04

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Insight - Eastchurch

Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Chaldon Mead 50 Rook Lane Chaldon Surrey CR3 5AB Lead Inspector Lesley Garrett Unannounced 16 June 2005 10:00 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chaldon Mead Address Chaldon Mead, 50 Rook Lane, Chaldon, Surrey, CR3 5AB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01883 383820 Surrey Oaklands NHS Trust Oaklands House, Coulsdon Road, Caterham, Surrey, CR3 5YA Ms Mary Bergin Care Home (CRH) 16 Category(ies) of Learning disability (LD), 16 registration, with number Learning disability over 65 years of age (LD(E)), of places 7 Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Within the category: Learning Disabilities (LD), 7 (seven) of whom may be within the category Learning Disabilities for older persons LD(E). 2 The age/age range of the persons to be accommodated will be: 46-65 YEARS & OVER Date of last inspection 07 December 2004 Brief Description of the Service: Chaldon Mead is a detached property and located in the village of Chaldon. The home is managed by the Surrey and Borders Partnership NHS Trust. Accomodation and care is provided for up to sixteen service users with learning didabilities. Service users benefit from a day care centre which is situated next to the home. All bedrooms are single with the exception of one double room for two service users to share. There was adequate communal areas including a quiete room. There is a large enclosed garden to the rear of the property backing onto a golf course and there is also a paved area. The home has its own transport for service users. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection for 2005/2006 and was unannounced and the inspection took four and a half hours. The shift leader was in charge and assisted the inspector as the manager was in London with two service users. The manager arrived back in time for the feedback. The inspector spoke with staff and some service users. Not all the service users were at home some were attending appointments, some had gone to a day centre and some were at the homes day centre. The inspector would like to thank the staff on duty for their assistance during this inspection. What the service does well: What has improved since the last inspection? The two requirements from the last inspection in December 2004 have now been met. The inspector saw the new chairs in the day centre and the pavements uneven surface has now been repaired. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 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. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 2 The home has a statement of purpose and a service user guide however there needs to be some adjustments made to keep them up to date. EVIDENCE: The shift leader explained to the inspector that there have been no admissions to the home for four years and there are no plans to change that arrangement. The statement of purpose was available for the inspector to see but it was noted that it still referred to the trust as Surrey Oakland’s and this needs to be changed to Surrey and Borders. There is a service user guide in each bedroom but again this needs to be up dated, as the staff list was out of date and the complaints procedure referred to NCSC. The report available to the service users was dated 2003 and the most recent inspection report needs to be available. If the home was planning any admissions there is a pre admission policy and the service users would be assessed prior to admission and they also have the opportunity to visit the home prior to admission. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 & 9 The health needs of the service uses are well met with regular review meetings. Risk assessments are in place including assessments for social activities. EVIDENCE: Each service user has an individual folder with a good range of care plans, risk assessments and person centered plans. They all contain a photograph and profile sheet. These folders are reviewed every six months and once a year they are reviewed with the care manager. Relatives or representatives are invited to these care reviews and some will attend. Not all service users sign their care plans as they are unable but they are discussed with them and the key worker always sign. Their person centred plans are reviewed regularly but always at the six monthly meetings keeping them up to date. One service user has an electric profiling bed with integrated cot sides and this needs to have a risk assessment. All social activities are risk assessed by the home and documented in their individual files. Some of these assessments may be at other centres that organise certain activities. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 & 17 Service users take part in age and peer appropriate activities and maintain links with family and friends. Menus were available. EVIDENCE: The shift leader told the inspector that service users are assessed with their ability and age for appropriate day centres and activities. The home has a day centre on the premises, which the neighbouring home also has access to. On the day of inspection seven service users were using this facility with a senior support worker and a carer from the other home organising the activities. The centre has a programme of activities, which include music workshop, and the service users have the opportunity to play instruments and local outings to garden centres or shopping then having coffee. There are also evening activity programmes where service users have access to clubs and classes appropriate to their age. Saturdays and Sundays are when most families visit or service users can go out with them and at least one service user goes to church on Sunday. The staff all takes turns to do the cooking, as the home is no longer able to employ a permanent chef. There is a four-week menu rota and the fridge temperatures are checked daily. Their former chef who now also has to do some care assistant shifts due to a policy change mainly does the cooking. The Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 11 inspector noticed that there was a bowl of sauce for the meal that day and some chopped herbs. Both these bowls were unlabelled and not dated, this will be a requirement. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 20 & 21 Service users receive personal support but the ageing process and death and dying issues need to be addressed. EVIDENCE: The shift leader explained to the inspector the person centred plans, as these contain the information that carers may require about the service users. One of the purposes of this document is to have information about the service users that may explain some of their behaviour and why they may behave in a particular way. The inspector was told that the G.P. calls weekly to se any service user that is necessary but that medicals or special procedures will be carried out at the surgery. On the day of inspection the dietician called for a routine visit and also the district nurse. Their folders also contain the manual handling assessment forms. There is only one shared room but there is no dividing curtain. The shift leader told the inspector they had to use a portable screen if they required personal care in that room, (however there was no screen seen on the day of the inspection). The local pharmacy supplies the medications in a blister pack and is delivered on a twenty-eight day cycle. The inspector saw example signatures and no gaps seen on the MAR sheet. The controlled drugs were checked and correct. The shift leader said that no service user was able to self medicate. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 13 The inspector spoke with the shift leader about the ageing process and death and dying. There were policies and procedures in place but none had been individualised into care plans for the service users. Five of the service users are over the age of sixty-five and the others are late forties upwards and the inspector explained that there should be individual plans to cover the wishes of the service users in case of serious illness and their wishes at death. Some of the service users are unable to provide this information so the family or representatives will need to be contacted to provide some of the information. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22& 23 There are policies and procedures for complaints and vulnerable adults. EVIDENCE: The home has an adequate complaints procedure and this has also been made into a pictorial format so that the service user has a better understanding. The shift leader told the inspector there had been no complaints since the last inspection. This procedure is available in the service users guide in each bedroom. The inspector saw the current Surrey multi agency procedure for vulnerable adults and the shift leader told the inspector that all staff had training yearly. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Services users live in a homely, comfortable environment, which is clean and hygienic. EVIDENCE: All bedrooms are single except for one double room. The shift leader showed the inspector around the home and the rooms that were seen had all been personalised. One service user that was sitting in her room told the inspector that she liked her room. There were adequate bathrooms, which were all clean and tidy. The inspector met the cleaner who was an agency. The shift leader explained it was their regular cleaners day off. There were no offensive odours in the home. There is a large lounge with a large screen television. One service user was in there. She had not gone out that day, as she needed a blood test with the district nurse. The service user told the inspector that it was all right living at the home and that she was able to do lots of things including art and sugar craft lessons. AS the inspector walked around the home it was noted that all radiators had covers and there was window restrainers in place. The shift leader said all taps had thermostatic valves. Fire alarms are tested weekly. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 16 Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 There are adequate numbers of suitably trained staff to meet service users needs. EVIDENCE: On the day of inspection there was adequate staff to meet service users needs. All service users were up and dressed and were doing the various activities on offer for them. The shift leader told the inspector that there always had to be a shift leader on and someone else that can do the cooking as well as someone to organise and assist in the day centre. All staff with the exception of one has NVQ level 2 and one has level 3. The staff have training throughout the year which includes yearly fire training, manual handling, food hygiene, first aid every three years and medication training for experienced staff every two years and yearly for any new staff. There are also vulnerable adults training yearly Health and safety general awareness and COSHH. There is training programmes available to see. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The home reviews aspects of its performance through a programme of selfreview and consultations, which include seeking the views of the service users, staff and relatives. EVIDENCE: The shift leader told the inspector that there are monthly meetings with the service users and all the minutes are documented and outcomes are clear. It was at one of these meetings that the service users decided they would like to buy a rabbit. The home was in the process of sending out questionnaires to service users and relatives to measure their performance. They had previously done this exercise and were hoping for a good response. The service users also had choices about holidays and the key worker normally takes their service users in small groups. One service user was able to tell the inspector that she had just returned from Euro-Disney and seen Mickey Mouse, which she had enjoyed. Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 x x 2 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chaldon Mead Score 3 x 3 2 Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? 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. 2. 3. Standard 17 1 21 Regulation 12 (a) 4 & sch 1 12 (3) Requirement Any food prepared in advance should be labelled and dated. The statement of purpose should be current and updated when necessary There are plans in place to deal with ageing, terminal ilness and death agreed with the service user and relative or representative. Risk assessments to be in place when bed-rails are in use. All persons employed at the care home should have application form, photograph and two written refrences Shared bedrooms should have a curtain to divide the room allowing privacy when the service user would like it. The inspector was told a portable screen could be used but was not seen on day of inspection. Individual plans are signed by the service user and or a relative or representative Timescale for action 23/6/05 30/6/05 14/7/05 4. 5. 9 34 12 (a) 19 (4b) & sch 2 12 (1a) 23/6/05 14/7/05 6. 18 16/8/05 7. 6 15 14/7/05 Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Chaldon Mead v231768 h58-h09 s13590 chaldon mead v231768 160605 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. 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