Inspection on 07/10/08 for Chalfont

This inspection was carried out on 7th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chalfont 08/10/07

Chalfont 14/09/06

Chalfont 30/12/05

Chalfont 11/07/05

Chalfont 06/01/05

Chalfont 02/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chalfont 6 Southern Road Southbourne Bournemouth Dorset BH6 3SR     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: John Clarke     Date: 0 7 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Older People 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 © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Chalfont 6 Southern Road Southbourne Bournemouth Dorset BH6 3SR 01202420957 SAMEASTEL: Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Terence Charles Aston,Mr Michael Robert Adams Type of registration: Number of places registered: care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: One named service user (as known to CSCI) under the age of 65 may be accommodated. Date of last inspection Brief description of the care home Chalfont is a detached property situated in a quiet residential area of Southbourne. It is situated between the seafront and a shopping centre 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 Care Homes for Older People Page 4 of 27 Over 65 11 0 Brief description of the care home 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. Current fee levels are 342 pounds to 420 pounds. Care Homes for Older People 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit to the home as part of an inspection. As part of the inspection we looked at a number of records including pre-admission assessments, care plans, medication records. We also examined the policies and procedures of the home. There was also an opportunity to talk with individuals who live and work in the home about the quality of care provided in the home. As part of this inspection the manager completed a Annual Quality Assurance Assessment (AQAA) which set out the areas of practice based around the National Minimum Standards summarising what the home does well, the evidence for this, what they could do better and how they have improved in the last 12 months. The information form the AQAA and questionnaires have been used to help make a Care Homes for Older People Page 6 of 27 judgement about the quality of care provided in the home. What the care home does well: What has improved since the last inspection? What they could do better: There remain a number of areas that need to be addressed in terms of improvement. These include making sure risk assessments are completed in all areas associated with risk where care tasks are undertaken and in relation to the environment. This is a matter of concern in that a requirement was made at the previous inspection regarding this area of care practice and the provider has failed to address this issue and evidence clearly the level of care needed by individuals in the home. It is also important that records specifically care plans accurately reflect the current needs of individuals to ensure that the care provided is consistent and reflects current needs. It is acknowledged that improvements have been made in the training of staff however there remains areas to be addressed and requirments have been made in this regard. It is recognised that individuals who live in the home all felt able to express their views Care Homes for Older People Page 8 of 27 about the service they recieve and make suggestions and indeed these have been acted upon. However it is also important that there is a formal system of all interested individuals having a say in the running of the home and the quality of the service. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. The home undertakes pre-admission assessments and is improving this process so that they are able to make an informed decision based on the detailed information about the health and social care needs of the perspective resident. Evidence: We looked at a pre-admission assessment for one individual this was limited in information however the inspector looked at an up dated version which is being introduced and this provides good information about perspective residents. A copy of the local authority assessment had been obtained by the home being admission of the individual. Care Homes for Older People Page 11 of 27 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. The home is making good effort to improve care planning practice and once all have been completed they will provide full and informed information so staff are fully aware of individual health and social care needs. However there remains significant shortfalls in care planning specifically that of completed risk assessments so that the health and welfare of individuals is protected and evidence of good practice. The arrangements for the managing and administering of medication makes sure that the health needs of individuals is protected. The practices of staff help to make sure that the privacy of individuals is protected and all who live in the home are treated with dignity. Evidence: We looked at one completed care plan which the home is in the process of introducing. This provided detailed information about the care needs of the individual under Needs, Abilities, Objectives, How Needs to be Met. Included was dressing/Undressing tasks, bowel care (Catheter care plan), Mobility. We spoke to this individual about the care they receive and they was happy and felt staff do all they can for me.Risk Care Homes for Older People Page 12 of 27 Evidence: assessment completed for falls but not for catheter care. No evidence of involvement of individual. A further care plan was looked at relating to an individual who was receiving bed care only. The care plan did not reflect her current needs. No risk assessments (pressure care, nutritional) had been completed. No nuitritional record.Fluid chart completed. Discussed this individual with carer and she was able to give good details about daily care routine including mouth and skin care. Individuals who live in the home have access to community services such as chiropody, optician. One individual we spoke with said that they could see the doctor at any time only have to ask. One individual is receiving the support of community nurse service and in talking to the manager they were very clear about the importance of their involvement in this individuals daily care. We examined medication administering records and they were accurate in their recording of medication given to individuals. Storage arrangements were satisfactory though at present there is no controlled drug cupboard and a new fridge for medication these are both on order. Record of controlled drugs given was signed by two individuals as required and stock was found to be as recorded in controlled drug register. We spoke with a number of individuals who live in the home and all were very positive about the approach of staff and they felt their privacy was respected. One individual who spends alot of time in her room said how she always felt its my choice they dont pressure me to do anything I dont wont to do. Another said how they felt staff always talk to me very politely. Care Homes for Older People Page 13 of 27 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. 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. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. Evidence: We spoke with a number of individuals about the activities arranged in the home they spoke of enough for me I enjoy having chat with staff they are so friendly. Staff said that they do try arranging activities such as games but find this difficult and find that we just try and spend time with people. We spoke with a relative who regularly visits the home. They spoke of staff being very freindly and always tell me how my relative is. They spoke of the home as being homely and just like a family. Care Homes for Older People Page 14 of 27 Evidence: Individuals we spoke with all said how they always enjoyed the meals food is always good. One individual said that staff knew what she liked and didnt like and there was always something esle given if I dont like what is on that day. The meal on the day of our visit was well presented and looked appetising. Staff were available to give assistance if this was necessary. Care Homes for Older People Page 15 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. The home has procedures in place enabling individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. Evidence: The home has a complaints procedure and is available in individuals rooms. We spoke with a number of individuals who live in the home and they spoke of being able to say if they were unhappy about any thing I would talk to one of the staff and they would do something have never had to make a complaint. the relative we spoke with said they would certainly say something if I had worries about anything or the care provvided here. The provider confirmed that no complaints had been received since the last inspection. The home has a Adult Protection policy. We spoke to staff about training in Adult Protection and they informed us they were due to undertake this training in November. We spoke to them about their understanding of what may be seen as abuse and they were able to give examples being forced to do something they didnt want to do not giving choice to people. They were also very clear that if they had concerns about any Care Homes for Older People Page 16 of 27 Evidence: care of individuals in the home they would talk to the owners and definitely say something we are here for the residents if they were upset we would say something. Care Homes for Older People 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, 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. 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. The home provides a safe and hygienic environment for the individuals who live and work in the home. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. Evidence: Chalfont has a warm and homely environment which is well decorated and maintained to a satisfactory standard. Indvidiuals we spoke with all commented on the cleanliness of the home and on the day of our visit was clean and hygenic. A new boiler has been installed since the last inspection and this has impoved the heating arrangements and removed the need for stand alone heaters which were previously needed to maintain adquate heating in the home. Since the last inspection two rooms have been decorated and new carpeting has been laid in all communal areas. Staff use the required protective clothing and hand washing facilities are available in the home and there are policies and procedures inplace in relation to infection control. Care Homes for Older People Page 18 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. However there are areas of staff training that need to be addressed to make sure that the health and welfare of individuals in the home is protected as far as possible. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. Evidence: The home employs two members of staff one of whom has worked in the home for nearly 14 years. Individuals we spoke with all said how they found staff always there if we need them I only have to ask and they will help me if I need it. Recruitment records showed that the necessary checks had been undertaken including Criminal Record Bureau checks. Training records showed that staff had undertaken moving and handling, food hygiene and medication training. Both staff members have commenced NVQ level 2 professional qualification. There was no evidence of First Aid training. The providers have not undertaken Adult Protection training. Care Homes for Older People Page 19 of 27 Care Homes for Older People Page 20 of 27 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. The practices of the home help to make sure that the health, safety and welfare of residents and staff are protected. Individuals live in an environment where they are able to express their views however there is no formall quality assurance system. Evidence: The providers have been operating Chalfont for a number of years they do not have professional qualification and feel that because of the lenght of time they have beeen running the home their focus is on making sure that they provide a good quality of care. Individuals we spoke with said how they always feel able to voice their views about the service they receive. Staff said they always found them approachable and have the best interests of residents. There is no formal quality assurance system in place however it was evident that changes are made where suggested by individuals who live in the home. An example being the change of evening meal time at the request of individuals. Care Homes for Older People Page 21 of 27 Evidence: The providers have no responsibility regarding the finances of individuals who live in the home. Records showed that the required fire system checks take place such as weekly fire alarm tests. A Fire Safety Audit was undertaken by the Dorset Fire and Rescue Service (03/06/08)a number of recommendations were made one of which was the fitting of self-closing door mechanisms. This is being acted upon. Fire system is serviced regularly the last being 03/03/08. Staff undertake regularly fire drills and have undertaken the Certificate in Basic Fire Safety Management. It was noted that radiators were uncovered. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 23 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 7 13 The provider to make sure that unnecessary risks to the health or safety of the individuals who live in the home are identified and so far as possible eliminated. This refers to the need to undertake risk assessments relating to all aspects of care where there may be risks with care tasks i.e. catheter care, pressure care. 01/12/2008 2 7 15 The provider to make sure 01/12/2008 that consultation takes place with individual or their representative about what is included in their care plan. This refers to individuals and/or their representative being involved in the completion of their care plan. Care Homes for Older People Page 24 of 27 3 30 13 The registered provider to make sure that there are suitable arrangements for the training of staff in first aid. This refers to the need to make sure staff who are on duty in the home are trained in first aid in that there must always be a member of staff on duty who has undertaken first aid training. Guidence is available on the CSCI professional website. 30/01/2009 4 30 13 The register provider to make sure there are arrangements through training to prevent individuals who live in the home beingn harmed or suffering abuse or placed at risk of harm or abuse. This refers to all staff including providers undertaking the required Adult Protection training. 30/01/2009 5 33 24 The registered providers shall establish and maintain a system for the reviewing and improving of the quality of care provided in the home. This shall provide for the consultationof individuals who live in the home and their representatives. This refers to a formal quality assurance system that seeks the views of individuals who live in the 01/03/2009 Care Homes for Older People Page 25 of 27 home and others such as relatives and professional. this information should form part of the yearly AQAA provided to the CSCI. 6 38 13 The registered provider shall 01/03/2009 make sure that unnessary risks to the health and welfare or safety of individuals who live in the home are identified and so far as possible eliminated. This refers to the undertaking of risk assessments with regard to uncovered radiators and where identified action taken such as covering to eliminate risks to individuals. 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 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) 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. Care Homes for Older People Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!