Inspection on 13/09/05 for Chaldon Rise

This inspection was carried out on 13th September 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 Rise 06/11/07

Chaldon Rise 14/03/07

Chaldon Rise 20/06/06

Chaldon Rise 09/01/06

Chaldon Rise 15/11/04

Chaldon Rise 15/06/04

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

CARE HOMES FOR OLDER PEOPLE Chaldon Rise Rockshaw Road, Merstham, Surrey, RH1 3DE Lead Inspector Fiona Cole Unannounced 13 September 2005 th 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chaldon Rise Address Rockshaw Road, Merstham, Surrey, RH1 3DE 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) 01737 642281 01883 340498 Care Unlimited To be confirmed CRH Care Home 34 Category(ies) of DE(E) Dementia - over 65, 34 registration, with number LD Learning disability, 10 of places MD Mental Disorder, 5 Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The age/age range of the persons to be accommodated within the category DE(E) is over 65 years. 2 The gender of those accommodated will be: MALE AND FEMALE. 3 Up to 10 beds may be used for people with a Learning Disability above the age of 40 years. 4 Up to 5 beds may be used for the care of mentally ill residents between ages of 21 and 60 years. 5 Up to 2 beds may be used for Respite Care. Date of last inspection 15-November-2004 Brief Description of the Service: Chaldon Rise is one of three homes owned by Care Unlimited, and is a country house which stands in its own five acre grounds that surround the home. The house is conveniently situated on the outskirts of Merstham village. The home offers nursing care to 33 older people with learning disability or mental disorder. Accomodation is arranged over three floors accessible by a lift. Bedrooms are mainly singles with en-suite toilets and some have bathrooms. A large patio area embraces the home and provides ample space for the less able to go for short walks. On warm summer days meals and afternoon tea are taken outside. Car parking space is plentiful and this is of particular importance as the home is situated on a main road which is narrow in places. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was the first of the inspection year 2005/6 and was an unannounced inspection, which means staff and residents were not aware the visit was to take place. The inspection was carried out with the manager and the quality controller for the group. The home was being run in an organised manner when the inspector arrived in the morning. Several residents were up, and others receiving personal care to get ready for the day. Seven staff members and five residents were spoken with. A tour of the building was undertaken at the beginning of the inspection and care records, staff files, training schedules rotas and menus were all looked at On this inspection. What the service does well: The home has a committed and experienced staff group that have a sound knowledge of the residents needs. They are keen to improve and promote the quality of resident’s lives offering staff more time to spend with personal care and general conversation. Activities are varied and geared to the needs of the residents who have some degree of learning disability and/ or mental health needs, and this has taken staff time to organise and find out individual needs and preferences. Menu choices were attractive and the meal served at lunchtime looked appetising well presented and a good-sized portion available. The home presented as a friendly homely place to live and staff were observed to be kind caring and committed to their work. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3.4.5 The home has policies and procedures to welcome residents in an organised manner to the home. Residents receive a full assessment of their needs before they are offered a place. All their relatives and friends are involved in the assessment process. EVIDENCE: The home had an updated statement of purpose, which accurately depicted the services provided by the home. The resident care plans were comprehensive and had been updated and reviewed since the last inspection. The inspector looked at care records for residents who were newly admitted. There were plenty of care notes relating to all the assessments of need from hospital staff, to community health care staff. The notes explained the resident’s mobility likes and dislikes, special diets medication, and in one case a detailed discharge plan. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 9 A care plan is then written on the basis of all of this information. Brochures and service user guides are offered to the new residents when the manager is visiting them in hospital or in their own homes. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 8 9 10. The systems are in place for consultation with residents and their families and access to support from health care agencies is clearly evidenced. The systems for administration of medication are good with clear arrangements in place to ensure that resident’s medication needs are being met. Care plans also contain robust risk assessments. EVIDENCE: Care plans for 5 residents were inspected. Detailed plans of care included realistic goals risk assessments on pressure sores, falls, moving and handling. All care plans were signed mostly by family members and clearly they were very involved in the putting together of the information. Resident’s health needs were well met and medication administration was accomplished satisfactorily. The plans were very comprehensive and are reviewed on a monthly basis to ensure they are accurate and reflect the resident’s needs. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 11 Daily notes were informative and included details about the activities the resident participated in and their mental status. Staff stated that where possible residents are involved with their care plans and reviews. There is evidence that resident’s optical dental dietary and chiropody needs are met and confirmed in the diary and other records. Where appropriate, occupational therapists, dieticians and speech therapists would be involved in residents care. The records showed that assessed medical needs were followed up properly and notes taken of the care given. None of the residents self-administer their own medication, and suitably trained staff dispense all medication. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, 14 15 Links with the community and with relatives and friends are good and strongly encouraged by staff members. Appetising and nutritious food is provided at all times. EVIDENCE: The home assists residents with transport in order to access the local community. Residents are able to have visitors at any reasonable time in private. Communal areas were utilised by residents to entertain their visitors. Alternatively, residents can entertain in their own bedrooms in private, in the quiet conservatory or in the garden (weather permitting). Residents are unable to manage their own financial affairs; as a consequence these are usually managed by relatives and advocates which was seen to be the most appropriate process. Mealtimes were observed to be satisfactory and unhurried occasions. During the inspection residents were seen to be enjoying their midday meal, It was seen to be of high quality and presentation. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 13 There is always a choice of menu at lunchtime and suppertime, and both meals are sufficient in quantity and appearance. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18. Residents are well protected by the companies training policies and procedures with regard to the protection of vulnerable adults. EVIDENCE: There have been no complaints since the last inspection. The home has a robust complaints procedure in place. The residents are encouraged to talk to the staff and relatives also can talk to the nurse in charge or the manager. Copies of the complaints procedure are readily available and easy to follow with clear instructions about who will investigate the complaint right up to the owners of the home. The manager holds regular staff meetings and makes herself available for staff and residents to speak with her sometimes at short notice. The staff have all received training in the protection of vulnerable adults and the Local Authority Multi-Agency Procedures for protecting vulnerable adults were in place at the home. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26. The environment is well maintained and benefits from having a full time handyman. The home is well kept decoratively and was clean and hygienic On the day of inspection. Residents are provided with a high standard of living accommodation. The gardens are extensive and are well looked after offering pleasant views across Surrey Hills countryside. EVIDENCE: The location of the home is suitable for its stated purpose; it is accessible, safe and well-maintained, meeting resident’s individual and collective needs in a comfortable and homely way. Standards of cleanliness and hygiene were high throughout the home and no malodours were evident. Dedicated staff are employed to clean the home. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 16 The homes communal areas are spacious and are decorated and furnished to a high standard. No safety hazards were evident within the communal and private space areas. Toilet and bathing facilities were of a good standard and afforded adequate privacy for the residents. Resident’s bedrooms were decorated tastefully and showed they had been personalised by the residents themselves. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 29 30 The home employs adequate staff to run the rota in a manner that allows sufficient staff to be on duty on each shift. Staff are given training in many areas and the home is over its 50 quota of qualified NVQ trained staff. EVIDENCE: The administrator works almost full time hours on a term time only basis and was observed to be efficient and professional in her dealings with the staff. She treated one resident who continuously came into the office and required attention with kindness and respect. The manager has been relieved of a number of administrative tasks now with the administrator in post and it was clear that she was updating files. The home offers a wide range of training, which the staff spoken with appreciated and welcomed. Examples of training covered (as evidenced in the personal training logs and talking to staff on the day) included: Moving and handling, basic food hygiene, fire safety training, Fortisip nutrition, protection of vulnerable adults, Diabetes care, care of the skin, mental illness, and rehabilitation to name but a few. There are currently sufficient staff employed to meet the needs of the residents who are all of high dependency. Staff are able to work on alone to one basis with residents when required. Recruitment is managed by each home within the group, and the manager is involved in all aspects of staff recruitment, and of equal importance staff Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 18 induction programmes Staff files were comprehensive, all contain two references and CRB checks. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 34 36 37 38. There is good leadership and consistent direction to staff in this home to ensure the residents receive consistent quality care. The manager is fully aware of the needs of the residents in the home and as such is able to communicate this to staff through regular staff meetings and group supervision sessions. The manager has a good staff team and works well with meeting her responsibilities. The home has relevant health and safety procedures and staff are given training in all aspects of health and safety to protect the residents as well as themselves. EVIDENCE: Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 20 The manager is a qualified nurse and has nearly completed her registered Managers Award. She is a very competent experienced and caring manager for who all of the staff has a great deal of respect. The following records were examined during the inspection: Residents care plans, Medication records, the staff rota and menus; these records were all in good order. Staff were noted to receive training in matters of health and safety and ample information was available to advise staff on safe practices. Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x 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 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 x 3 3 3 Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 22 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. Standard YA35 Regulation 18.2 Requirement The manager must ensure that all staff in the home are appropriately supervised on a regular basis through individua support as well as group support.l Timescale for action 3 months from date of inspection. 2. 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 Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Chaldon Rise H09-H58 s13307 Chaldon Rise v217338 130905 stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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