Inspection on 10/03/09 for Chalk Leys

This inspection was carried out on 10th March 2009.

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

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

Chalk Leys 08/03/10

Chalk Leys 24/05/07

Chalk Leys 07/02/06

Chalk Leys 20/01/05

Chalk Leys 05/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chalk Leys London Road Great Missenden Bucks HP16 0BB     The quality rating for this care home is:   three star excellent 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: Lesley Garrett     Date: 1 0 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for 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 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Chalk Leys London Road Great Missenden Bucks HP16 0BB 01494863051 01494890224 manager.chalkleys@fremantletrust.org admin@fremantletrust.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): The Fremantle Trust The registered provider is responsible for running the service care home 40 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age- not falling within any other category (OP) Date of last inspection Brief description of the care home Chalk Leys is one of a number of homes run by the Fremantle Trust in Buckinghamshire. The home is located in Great Missenden, within walking distance of the village centre. The home provides care for up to thirty-seven older people in single Care Homes for Older People Page 4 of 25 Over 65 40 0 Brief description of the care home rooms. No rooms have ensuite facilities. The home is divided into four groups, each with a lounge and kitchen diner and a shared garden. General Practitioners (GPs) from two local surgeries visit on a regular basis. Other health care services such as, district nurse support, podiatry, dentistry, opticians, physiotherapy and occupational therapy are available through the home and the GPs surgery. Care Homes for Older People Page 5 of 25 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: three star excellent 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 inspection of the care home was an unannounced Key Inspection. Mrs Lesley Garrett, Regulation Inspector, carried out the inspection and the registered manager and the operational manager represented the service. We arrived at the service at 10:00 and were in the home for four hours and thirty minutes. It was a thorough look at how well the home is doing. It took into account information provided by the home and any information that CSCI has received about the service since the last inspection in May 2007. The registered manager for the service supplied CSCI with an AQAA (Annual Quality Assurance Assessment) and this document was used to assist with the inspection. The inspector also spent time talking with some of the people using the service and staff members. Care Homes for Older People Page 6 of 25 We looked at how well the service was meeting the key national minimum standards and complying with the regulations and have in this report made judgements about the standard of the service. Documents sampled during the inspection included the homes care plans, daily records and risk assessments, staff files, training records, and the homes safeguarding and complaints policies and procedures. From the evidence seen by the inspector and comments received, the inspector considers that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service benefit from an assessment prior to admission that ensures the home can meet their needs. Evidence: All people who wish to use the service benefit from a pre-admission assessment. This assessment is carried out by the registered manager. It is through and takes into account the activities of daily living. There was evidence in the care plan of a recently admitted individual that they had been given the opportunity to contribute to the assessment process and that their opinions are valued by the home. Three care plans were sampled and this included a recently admitted person. The family had access to information provided by the home which included the statement of purpose, the service user guide and a copy of the most recent inspection report. Prospective people wishing to use the service are also given the opportunity to spend time in the home if they wish. Care Homes for Older People Page 10 of 25 Evidence: The home does not offer intermediate care. Care Homes for Older People Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people using the service receive is based on their individual needs which is documented in care plans that are regularly reviewed. Evidence: Three care plans were sampled and all contained detailed information about each person using the service and they had been written in a person centred way. The way personal care was to be delivered was described and it was apparent that consultation had taken place with each person using the service. Risk assessments were detailed with clear instructions for staff should a risk assessment identify a problem. For example; where a nutritional risk assessment that was completed showed the person was at risk from poor nutrition, there was also a care plan in place with the assessment detailing the actions to be taken. This was repeated for the skin integrity (Waterlow scores ) and the falls assessment. It was clearly documented, by the carers, that reviews had taken place and that the care plans had been agreed by the people using the service following a consultation. All care plans also contained a detailed personal lifestyle summary and a night care Care Homes for Older People Page 12 of 25 Evidence: plan. Staff spoken to on the day were knowledgeable about the care needs of the people using the service. Aids and equipment are provided to encourage maximum independence for people using the service and these are reviewed and replaced to accommodate peoples changing needs. The manager said that there are four GP surgeries in the village and people using the service are registered with one of them. She stated the practises are a good support to the home and the GP will visit the home when required or the people using the service can visit the surgery with the assistance of a member of staff. The district nurses that visit the home are also attached to the surgeries. The manager said they provided good support to the home. On the day of inspection the district nurse was visiting one person at the home. A good interaction and handover was witnessed between the manager and the nurse. The manager also said that particular nurse was providing diabetic training for the carers the following week. The manager also stated that the village has the services of a chiropodist, optician and dentist. It was clear in the care plans that people using the service can visit these healthcare professionals personally or they will visit the home if requested. There are medication policies and procedures in place. The manager said these systems are reviewed regularly and all staff who dispense medicines in the home receive training. The medication round at lunchtime was not observed as only a couple of people received medications at lunch time. Medications were not identified on the completed AQAA as an area of concern and concerns have not been raised with us during the last year. Therefore the systems were not tested on this occasion. During a tour of the building it was observed that staff were speaking appropriately to the people using the service by their preferred name which had been documented in their care plan. All people were dressed in clothes appropriate for the weather with hair well groomed and nails clean. Care Homes for Older People Page 13 of 25 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. People who use the service are able to take part in social, religious and recreational activities and are able to exercise choice in their daily lives. The standard and quality of the meals are high resulting in nutritional needs being met. Evidence: The manager said that they do not have an activity coordinator at the moment. There is an activity programme displayed and the staff are assisting with programme so that the people who use the service benefit from the continued activity programme. The programme was varied and is age appropriate. Outside entertainers visit the home and also some of the people benefit from visitng a local luncheon club. One person spoken to on the day was about to go out once her hair had been done. She said she was going to a lunch club. When the inspector arrived another person was seen leaving the home accompanied by a member of staff and they were visiting the village. The manger also said that trips out are also organised and religious services are also held. One person who uses the service was keen to tell us about her one hundredth birthday party the staff arranged for her. She explained that the staff also bought her a present and was wearing the gift on the day of inspection. The hairdresser was in Care Homes for Older People Page 14 of 25 Evidence: the home on the day of the visit and the manager explained this was another activity that was enjoyed. In one of the lounges people were watching a daytime television programme and in another a DVD was playing. One person was happily singing and moving along to the music. She told us that this was one of her favourites. Newspapers and books were also being read by some people. At lunchtime in one lounge it was observed that the television had been turned off during the meal and replaced by some background music. A area of good practice was discussed by the manage who told us that one particular resident need to do things with his hands to keep occupied due to his past employment. He likes to undo screws or remove hadles from doors. Arrangements had been made for him to work in the shed in the garden where he had access to a range of tools. When the weather is fine he is assisted to work in this area for as long as he would like. This is also documented in his care plan that this activity is available to him if he becomes agitated. The manager said that visitors are welcome in the home at any time.The community are also welcomed into the home. On special occasions local schools will visit to sing for the people using the service. A church volunteer visits the home to talk with any of the people and groups of singers visit regularly to provide entertainment. The manager said that people are also encouraged to go out. Pub lunches are enjoyed and shopping trips are also popular. Lunchtime was observed in one lounge. People were sitting at the tables chatting to one another whilst the staff assisted with the serving of the meals. The staff were observed to give each person a choice of main course and vegetables. One person did not want either choice and instead requested soup which the kitchen provided for her. The meal looked well presented and all people spoken to were complimentary about the quality of the food in the home. The manager said there is also choice of suppers and one choice is always a hot meal. The manager has recently introduced a cold drinks dispenser into each lounge. She said that the juice in the dispensers were also packed with vitamins. The dispensers had been for a trial period but there had been an increase in fluid intake for all of the people using the service and so they will keep them. People spoken to said they enjoyed the different flavours and the operational manager said this system may be introduced into other homes in the group. Care Homes for Older People Page 15 of 25 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. People who use the service can be confident that their complaints are listened to and that they are protected from abuse from a staff team that have received training in safeguarding adults. Evidence: The manager said that during the last year they had received two complaints that had now been resolved. The complaints log was seen and both concerns had been appropriately investigated with timescales met. The home welcomes feedback from the people who use the service and their relatives or representatives and a log is kept of compliments also. The home has a clear complaints policy and this is available to all people and is clearly displayed. The home has not had a safeguarding referral during the last year. Training takes place regularly for all staff and they are knowledgeable about the procedure. Safeguarding training also takes place during induction for all new staff so that they are clear about these procedures before they start work with the home. CSCI have not been made aware of any complaints about the home or any referrals under the safeguarding procedures. Care Homes for Older People Page 16 of 25 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 enables people who use the service to live in a safe, well maintained, comfortable environment. Evidence: The operational manager told us that the company is building a new care home due for completion in approximately eighteen months. The plan for Chalk Leys is to move to that home along with another home when work is completed. Consultation has already begun with the people who use to service to ensure they are prepared for the move. Even though the home will eventually close refurbishment programmes continue and the operational manager and registered manager both said that work will continue in the home to keep it in a good standard. During the past year the entrance hall has been decorated and new occasional tables purchased and a new table for reception. The upstairs quiet lounge has been decorated and new carpet laid. All four lounges have been deep cleaned along with the chairs and curtains. Thirteen bedrooms have been decorated and five of these have been re-carpeted. Bathroom cabinets have been put up in the majority of rooms and the manager said this was done in consultation with the people using the service. Bedlinen, curtains and covers have also been replaced. Care Homes for Older People Page 17 of 25 Evidence: The bedrooms that were observed during a tour of the building were noted to be homely with personal possessions around them. People that were spoken to on the day were happy with their rooms and the environment that they live in. The garden is accessible to all and in December are large area was decked and the manager said she is now waiting for a delivery of bamboo furniture for the people to enjoy in better weather. The home was noted to be clean with no obvious offensive odours. The cupboards when linen is stored and the laundry area was very tidy and spotlessly clean. Liquid soap, paper hand towels and alcohol hand rub were all available for staff. Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers at the home on the day of inspection were sufficient to meet the assessed needs of the people using the service. NVQ training for the care staff continues to ensure a good skill mix of staff on duty. Evidence: The home benefits from an experienced staff team and when sampling the staff rota it was observed that staffing levels were consistent. There is one staff member per unit during the morning and afternoon period and a floater. In the afternoon the floater comes on duty at five pm to help with suppers and stays until nine pm. The home also has a senior on duty and the registered manager is always supernumerary. The night staff levels was reviewed following the last inspection and due to the special circumstances on that occasion the numbers were increased. The numbers have returned to two carers at night but both the operational manager and registered manager said numbers could increase if the dependency levels changed. Night staff are still expected to do some cleaning and laundry during the night but the manager stressed this was not an expectation if the home was busy. The manager said that well over 50 of the care staff have NVQ certificate and some at level three. The training at the home is on going and six carers are undertaking the course at present. The manager said that she was an NVQ assessor and that the home Care Homes for Older People Page 19 of 25 Evidence: was a centre for NVQ training. Records confirmed that this training takes place. Two employment folders of newly recruited staff were sampled and both were found to have all the necessary paper work to enable the home to employ those people safely. This ensures that the people who use the service are protected by the homes recruitment procedures. The operational manager stated that the company has a training department and each home is supplied with a training programme. This training programme identifies the training that needs to take place for individual members of staff. Mandatory training takes place every year and this includes moving and handling, fire awareness, safeguarding adults, infection control and food hygiene. Records confirmed that the training takes place and staff spoken to confirmed that the home supplied a variety of training to help them meet the needs of the people using the service. Care Homes for Older People Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements at the home ensures the staff team is adequately supported and there are clear lines of managerial accountability. Quality assurance systems are in place which improve the quality of care offered to the people who use the service. Evidence: Since the last inspection in May 2007 the home has recruited a new manager. She has experience of being a registered manager as she had previously worked for the Freemantle Trust as a manager in a home that closed during the companys refurbishment programme. She has experience therefore in running a care home and told us that she is currently doing her level 4 NVQ training. She has completed her registered managers award. She is supported in the home with senior care staff and the operational manager meets regularly with her. Every year auditors visit the home to assess the quality of the service provided by the home. At this time they will also speak to the people using the service to gauge their Care Homes for Older People Page 21 of 25 Evidence: view of living at the home. At this time the manager said that surveys are sent to relatives, healthcare professionals and staff to seek their views about the home. This information is collated and an action plan written should short falls be identified. Regulation 26 visits take place and these reports are filed at the home and available to be seen by us. The manager said that meetings are held regularly for the people who use the service and the minutes are kept. The home has systems in place to manage the personal allowance for people who use the service if they wish and records and receipts are kept of all transactions. Health and safety in the home is promoted and the AQAA advises that there are generic risk assessments in place to promote safe working practises.The AQAA also showed us that the maintenance of equipment and services is up to date Care Homes for Older People Page 22 of 25 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 25 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 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 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!