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Inspection on 11/07/05 for Chalfont

Also see our care home review for Chalfont for more information

This inspection was carried out on 11th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Chalfont provides a supportive and caring environment were the needs of the residents are at the heart of what the home does well. Before any residents moves into the home an assessment is completed so the home can be assured that they are able to meet the person`s needs. Individual care plans state how the needs of the resident will be met. This information is straightforward and easy to understand. The residents are able to make decisions about their lives and when they become unwell or unable to make decision the staff will make decisions such as contact health care professionals on their behalf but with their best interests in mind. 1 resident said, " She felt she was in very capable hands". Food is prepared with what ever ingredients are in season, the dining room is small but elegantly presented and 1 resident said that the food was "always good" A record is kept of all the meals prepared in the home and they appear to provide a balanced diet. Chalfont provides very comfortable surroundings for the residents. All residents said they felt safe in the home. All the communal rooms in the home were clean and pleasant.

What has improved since the last inspection?

At the conclusion of the inspection in January 2005, there were 2 requirements and 9 recommendations. The home has addressed the requirement regarding residents who self medicated and the need to ensure that an accurate record is kept of all medicines coming into the home. The management of the home said they try to encourage their residents to sign the care plan but also said that sometimes it is not appropriate especially if someone is confused. The recommendations from the Occupational Therapist have been partially completed. The registered provider is concerned that the grab rails suggested in the report are not appropriate. However the other 2 recommendations have been implemented. There are bath thermometers in each bathroom and temperatures are now checked before each resident takes a bath.

What the care home could do better:

At the conclusion of this inspection there were 1requirements and 6 recommendations. 1 requirement has been repeated for the 3rd time. It is very important that the home undertake risk assessments of all working practices within the home to ensure the safety both of staff and residents. Safe working practices includes areas such as; moving and handling, infection control, first aid, food hygiene and fire safety. Failure to act on this requirement may result in enforcement action. At present the home does not keep a record of any repairs or re decoration work undertaken. The recommendations of the specialist report on the premises have not been fully implemented, which means that residents might not be able to maximise their independence. It is important that all staff are encouraged to undertake training which would ensure residents and their relatives that they are in safe hands at all times. It is important that all staff receive induction and foundation training to the appropriate standard, which would mean they were trained and competent to do their job. Very experienced providers manage the home. They have worked and ran care homes for over 30years, however they might like to consider undertaking the Registered Managers Award.

CARE HOMES FOR OLDER PEOPLE Chalfont 6 Southern Road Southbourne Bournemouth BH6 3SR Lead Inspector Tracey Cockburn Unannounced 11 July 2005 12:40 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. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chalfont Address 6 Southern Road, Southbourne, Bournemouth, Dorset, BH6 3SR 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) 01202 420957 SAME AS TEL Mr Michael Robert Adams Mr Terence Charles Aston CRH - Care Home 11 Category(ies) of OP - 11 registration, with number of places Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One named service user (as known to CSCI) under the age of 65 may be accommodated. Date of last inspection 06 January 2005 Brief Description of the Service: Chalfont is a detached property situated in a quiet residential area of Southbourne. It is situated between the seafront and a shopping cnetre and other local amenities that include a post office, cafes, restaurants, a library and places of worship. Public transport is available within easy walking distance and provides access to other areas of Bournemouth. The home is registered to provide care to up to 10 older people. The accommodation is arranged on two floors and there are 9 bedrooms 8 are single and there is 1 double. There is a chair lift to assist with access to the first floor. There is a separate lounge and dining room. There is an enclosed garden to the rear of the property with seating. The front of the home has a forecourt which is used for parking up to 3 cars. There are pets in the home belonging to residents and the registered providers. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place unannounced on the 11th July 2005 in the afternoon over 2 hours 45 minutes. The purpose of this inspection was to review the requirements and recommendations from the previous inspection in January 2005. Both the registered providers were present throughout the inspection. 3 care files, 2 staff files and other records were examined. 5 residents were spoken to. A tour of the premises was undertaken. What the service does well: What has improved since the last inspection? At the conclusion of the inspection in January 2005, there were 2 requirements and 9 recommendations. The home has addressed the requirement regarding residents who self medicated and the need to ensure that an accurate record is kept of all medicines coming into the home. The management of the home said they try to encourage their residents to sign the care plan but also said that sometimes it is not appropriate especially if someone is confused. The recommendations from the Occupational Therapist have been partially completed. The registered provider is concerned that the grab rails suggested in the report are not appropriate. However the other 2 recommendations have been implemented. There are bath thermometers in each bathroom and temperatures are now checked before each resident takes a bath. Chalfont D55 S3925 Chalfont V229039 110705 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. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 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 Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 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, standard 6 was not assessed as the home is not registered to provide intermediate care. Assessments detail the needs of prospective residents, which means the home knows whether or not they can meet their needs before they move in and can give them assurance of this. EVIDENCE: The assessments were seen for 3 residents, the information contained within the assessment covered information such as help with personal care, oral care, foot care, mobility and medical needs. All residents have an assessment completed prior to moving into the home. Each care plan is based on the original assessment with information added if the resident’s needs change. 1 resident has become very weak and lost a great deal of weight. This is clearly recorded in the care plan with the action to be taken such as ensuring that she has regular drinks to keep her hydrated and encouraging her to eat contacting the district nurse if concerned and ensuring that she is on the right pressure relieving equipment at all times. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 Individual plans of care detail succinctly the health, personal and social care needs of each resident, which means that staff have the information they need to provide the care needed. Residents receive support from health care professionals as soon as a problem is identified. This means that residents health care needs are met by people qualified to provide treatment and give guidance to staff. EVIDENCE: The records for one resident who was very unwell very clearly demonstrated the course of action the home had taken and the involvement of the district nursing service and general practitioner. The care records mapped the initial concerns and subsequent action taken such as build up drinks, air mattress, DN visiting to dress pressure sore. The records gave a very clear indication of the action taken over the past 2 months. Another resident attends a local day centre, which she finds very beneficial. Not all care plans are signed by the resident however there is evidence of reviews taking place and although many of the residents spoken to could not recall if they were involved in the process or not, the manager stated that those residents who can are and those that are able to sign the care plan do. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 10 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) 13,15 The home encourages residents to maintain contact with family and friends; this means they are able to be in contact with the people that matter to them in their lives. Resident’s receive an appealing diet, which is mindful of their nutritional needs and provided in familiar surroundings. EVIDENCE: Several residents said that they are able to see visitors as they choose; one resident said that friends take her out. There are no restrictions imposed on when people can visit. The registered provider said that residents could have as much or as little involvement with the local community as they want. The registered provide said that all meals are cook freshly each day and that meals are recorded. The records showed that the residents were receiving a balanced menu. Residents said that the food was good and there was always too much. There were drinks available throughout the day. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 11 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) Not assessed at this inspection. EVIDENCE: Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 12 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) 19,26 Residents live in a safe and well-maintained home, which means they are in an environment, which meets their needs and is pleasant to be in. However there is no written evidence of maintenance taking place. The home is clean and free from offensive odours giving a good impression to prospective residents and visitors. EVIDENCE: The home is comfortable and homely and elegantly furnished. The registered provider does not have a written record of the maintenance work, which is undertaken and no record is kept of any repairs and re decoration. The garden at the rear of the home, which is accessed through patio doors in the dining room, is secure and provides a quiet space for residents to sit in. One resident has access via a patio door in her room. Residents said they enjoy sitting outside when the weather is nice, There is seating and a table with a sun shade. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 13 The home was clean and most of the room were clean, one resident has a pet and the room occupied by the resident and the pet does have a malodour which the registered provider says he constantly tries to get rid off bu the resident si reluctant to let him do anything. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 14 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) 29,30 Recruitment practices within the home ensure the protection of residents. Staff are competent to do their jobs however the home does not fully implement its policies. EVIDENCE: During the inspection 3 staff files were looked at. All 3 files contained references, application forms and confirmation of the member of staffs ID. Criminal Records Bureau checks were also satisfactory. One member of staff is in this country to study and the registered providers have ensured that her work permit and other documentation is up to date and she is working the number of hours agreed under the work permit guidance. Two new members of staff have been taken on, on temporary contracts. The manager said that the new members of staff would be enrolled on the NVQ level 2 training but they were employed on a temporary contract so would be leaving possible before completion. Induction and foundation training was not fully discussed therefore the standard was repeated to be fully assessed at the next inspection. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 15 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) 33,38 There are systems in place to monitor the aims and objectives of the home and the service it provides however this information is not made public so that the people who use the service can see how well the home they live in is doing. There are systems in place, which promote the health, safety and welfare of people using the service, however risk assessments in some areas fall short and the home cannot demonstrate that residents are fully protected. EVIDENCE: This standard was not fully assessed and the recommendation is therefore carried forward to the next inspection. There was evidence that staff undertake training in the appropriate areas such as fire safety and food hygiene. However the manager explained that he has not yet undertaken risk assessments on safe working practice and was unsure as to how to do this. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 16 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x 2 x x 3 3 STAFFING Standard No Score 27 x 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x 3 x x 2 x 1 Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 17 YES 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 38 Regulation 12, 13 Requirement The registered person must complete risk assessments for safe working practices. The previous timescale of 30/04/05 was not met. Timescale for action 31/10/05 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. 2. 3. Refer to Standard 19 22 28 Good Practice Recommendations There should be a written record of all decoration and repair work done to the premises. The registered person should consider acting on all the recommendations within the Occupational Therapists assessment report. The registered persons should arrange for staff to undertake the NVQ level 2 in care to meet the Department of Health target of 50 of care staff working in the home qualified to NVQ level 2 by December 2005. The registered person should implement their written policy and procedures concerned with staff training and development. To ensure that all people working in the home receive or attend taining in line with NTO targets. The registered person should make a decision regarding their plans for meeting the qualificaiton target of this D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 18 4. 30 5. 31 Chalfont 6. 7. 36 standard. their designated candidate should be enrolled on the NVQ level 4 as soon as possible. The regsitered persons should ensure that supervision sessions between maangement and staff are recorded. Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 Chalfont D55 S3925 Chalfont V229039 110705 Stage 4.doc Version 1.30 Page 20 - 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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