Inspection on 29/11/06 for Chalkmead Resource Centre

This inspection was carried out on 29th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Chalkmead Resource Centre 21/05/07

Chalkmead Resource Centre 30/11/05

Chalkmead Resource Centre 07/06/05

Chalkmead Resource Centre 27/10/04

Chalkmead Resource Centre 21/06/04

Chalkmead Resource Centre 19/12/03

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Chalkmead Resource Centre Deans Road Merstham Surrey RH1 3HE Lead Inspector Suzanne Magnier Key Unannounced Inspection 07.45a 29th November 2006 X10015.doc Version 1.40 Page 1 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 Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 2 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. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chalkmead Resource Centre Address Deans Road Merstham Surrey RH1 3HE Telephone number Fax number Email address Provider Web 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 644831 sharon.blackwell@anchor.org Anchor Trust Mrs Sue Linfield. Care Home 50 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (50), of places Physical disability over 65 years of age (12) Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may be admitted in the categories OP (Older people) of whom 20 may fall into the category DE(E) Up to 12 people with physical disability over the age of 65 years may be accommodated PD(E) 30th November 2005 Date of last inspection Brief Description of the Service: Chalkmead is situated in Merstham, Surrey in a quiet residential area and is home to fifty older people. It is conveniently located for the local shops and not far from Redhill town centre. The home has five living areas with eight to twelve single bedrooms in each one. Each area has a lounge and dining room with a kitchenette where service users can entertain guests, make their own tea and coffee and light snacks. Main meals are cooked in the central kitchen and served in the dining room using heated trolleys. Chalkmead is on two floors and the upper floor can be accessed by a lift. The home is set around a nicely established courtyard with shrubs, flowers and seating where you can sit and relax. The home runs a welfare shop and money raised is used to provide outings and entertainment for service users. There is private parking to the front of the building. The registered provider is the Anchor Trust. The current range of fees are £446.00-600.00 weekly. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit formed part of the key inspection process and took place over ten hours. Pauline Long and Suzanne Magnier Regulation Inspectors carried out this inspection and the registered manager represented the service and was joined by the area support manager for the feed back at the end of the inspection. As part of the site visit the inspectors sampled matters arising from a recent concern received by CSCI regarding the overall management of the care home. Where regulations have been identified as not met, requirements have been made regarding such matters. As part of this unannounced site visit the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service users guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. A tour of the premises took place and the inspectors saw the majority of the residents and spoke to some of them in more detail. Records were sampled as part of the inspection process including care plans, risk assessments, health and safety records, menus, accident records, policies, procedures and staff files. For the purpose of the report the inspectors were told that people who use the service prefer to be referred to as residents. What the service does well: One health care professional commented ‘I always feel welcome when I visit Chalkmead and they seem to run a very caring establishment. It is a pleasure paying a visit.’ Comment cards received from relatives and other visitors to the home were favourable with one stating Chalkmead was an ‘excellent home’ During the site visit it was noted that there was a calm, relaxed atmosphere and residents moved freely around the home. The inspectors spoke at length with the deputy chef during the site visit and she explained the catering arrangements of the home. She advised that she visits each unit every day, sometimes several times, to talk with the residents regarding the meals served in the home. Residents confirmed that they speak Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 6 with the cook and that she takes an active interest in their diet and what they like to eat. The deputy chef told the inspectors that all residents are offered choice at meal times, and food is plated in order that residents can see the choice offered. One resident told the inspector that they had been resident for many years and said ‘I like it here, they are all very good and my family visit’. Another resident said ‘they look after me well’. What has improved since the last inspection? What they could do better: Improvements need to be made regarding the information available to prospective residents including the terms and conditions of residency in the home. This will ensure that residents have adequate information to make a decision about the care home. Following the assessment of a resident’s needs a written plan must be prepared as to how the resident’s needs in respect of their health and welfare are to be met. This will ensure the home is able to identify and meet the residents needs. All resident’s risk assessments must reflect the individual’s hazards in their daily lives and must be appropriately reviewed and updated to ensure the safety and welfare of the residents. Care records must be accurately recorded and signed in full by staff members in order to demonstrate that the resident’s health and welfare is promoted and personal care needs met. The residents are not protected by the homes complaints and safeguarding adults procedures. This is because the complaints procedure was not accurate and evidence of staff training regarding safeguarding adults was not readily available. All areas of the home need to be kept clean and reasonably decorated in order to provide a comfortable and well presented environment for residents. The home must ensure that adequate pre employment checks are undertaken for all staff prior to commencement of employment or voluntary work in the home in order to ensure that safety, protection and welfare of the residents. All persons employed in the home must receive training appropriate to the work they are to perform including structured induction, moving and handling, health and safety (including risk assessments); fire training and first aid. A Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 7 staff development programme must be developed and implemented to ensure that competent staff are able to meet the care needs of the residents. The registered manager needs to undertake from time to time such training as is appropriate to ensure that she has the experience and skills necessary for managing the care home. During the feedback to the area support manager the inspectors were advised that Anchor Trust had assessed a number of issues in relation to the management and environment at the home and a project Manager had been assigned to provide support, development and an improvement plan for the home. A full care standard audit by an internal care specialist team had also been undertaken a few days prior to the inspection and an action plan was implemented following the findings. It was immediately required that the home must give notice to the CSCI without delay regarding any event which affects the safety and welfare of residents. 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. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 1,2,3,5,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements need to be made regarding the information available to prospective residents including the terms and conditions of residency in the home. The homes admission and assessment procedures did not ensure that resident’s needs were appropriately identified and met. Prospective residents are able to visit the home prior to residency in order to make an informed choice about where they wish to live. EVIDENCE: In discussion with the registered manager she advised and showed the inspectors that Anchor Trust have developed a new information pack for prospective residents, which includes a corporate statement of purpose, a local service user guide and compact disk. One file sampled of a resident newly admitted to the home included a statement of purpose which was out of date and did not include the current manager details, staffing details, for example qualifications and training and Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 10 included an out of date complaints procedure. It is required that all residents are provided with adequate up to date information regarding the provision of services in the home. The inspector sampled three care records of people recently admitted to the home. All resident’s records evidenced that care needs assessments had been undertaken by the local authority and included the resident’s diagnosis, mobility issues, personal care needs, sensory, mental state, physical deterioration, history of falls, and spiritual needs. The home had undertaken their own care needs assessment of residents care needs which included physiotherapy, continence management, support regarding specific medical conditions, support regarding medication, sensory impairments, the residents mental state, physical disability, hobbies and spiritual needs. All records were signed and dated. Of the three files sampled one contained a signed contract stating the terms and conditions of residency in the home. One resident told the inspector that they couldn’t remember receiving any information prior to coming to the home but their family came to visit the home before they were admitted and they may have the contract. Another of the three residents told the inspector that they had visited the home and had made a choice about living at Chalkmead other than another Anchor home. This resident told the inspector that they could not remember if they had signed a contract regarding staying at the home. The manager informed the inspectors that the home did not provide intermediate care. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 7,8,9,10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The resident’s individual plans of care were not satisfactory to demonstrate that their health, and personal care needs had been fully met. Significant improvements must be made regarding the risk management of resident’s daily lives. There was clear demonstration that medication was administered to all residents in a safe and appropriate way. EVIDENCE: The inspectors sampled four of the five units during the course of the site visit. Whilst sampling the resident’s records on Dove unit it was noted that one resident who had been accommodated in the home for nine days did not have a written care plan and another resident, the manager advised, had destroyed their care plan and a replacement copy had not been documented. A requirement was made that following the assessment of a resident’s needs a written plan is prepared as to how the resident’s needs in respect of their health and welfare are to be met. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 12 On Magpie unit the inspector sampled care plan records which included daily notes, a bathing, hair washing and bed linen change list. It was noted that residents care plans were also stored in their bedrooms. Some daily notes stated that residents had received a general bath and this was not documented on the bathing lists. A staff member told the inspector that a resident had received a general bath the previous day but this was not recorded in the resident’s daily notes or the bathing lists. In discussion with the manager during the feedback following the inspection the manager stated she was unaware that bathing lists were being used on the unit. One staff member told the inspector that the lists were not used on all units within the home. It has been required that resident’s care records are accurately recorded and signed in full by staff members in order to demonstrate that the resident’s health and welfare is promoted and personal care needs met. Comment cards from health care professionals were varied and stated that there was ‘Often poor communication between senior staff about treatment plans/ reasons for a visit request/patient symptoms etc’. ‘Management do not always take appropriate decisions when they can no longer manage the care needs of the service user.’ ‘The home have increased its service to older adults with Dementia and have accepted and dealt with effectively a number of new clients with difficult behaviours’. ‘More than satisfied with the care provided’ ‘Care staff mostly demonstrate a clear understanding of the care needs of service users’. ‘ I’m not always informed that a doctor has visited and prescribed. Usually find out when I query something’. One resident told the inspector that the district nurse comes to visit and helps to do some ‘special dressings’. During the site visit the manager told the inspectors that the home were introducing new care plans and these will be phased in following full staff training in the coming months. Several care plans sampled contained independent living agreement (ILA) the resident’s life histories, communication skills, abilities, physical disabilities, allergies and religious beliefs. Risk assessments sampled by the inspectors lacked sufficient detail and were based on generic hazards as opposed to individual identified hazards in the resident’s life. One risk assessment dated 14.9.06 for a resident with a history of falls had not been reviewed following several falls in the home and did not indicate fully what preventative actions had been arranged to safeguard the resident. Another risk assessment noted that a resident wandered into other people’s rooms and refused to leave the room and that they suffered from confusion and could be distressed. The risk assessment did not indicate if staff used any Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 13 methods for example diffusion techniques, or aids and support for the resident to be orientated to their own bedroom. The risk assessment had not been reviewed or updated since 20.9.06. It has been immediately required that resident’s risk assessments reflect the individual’s hazards in their daily lives and are appropriately reviewed and updated to ensure the safety and welfare of the residents Records also indicated that residents had un witnessed falls, which had not been reported to CSCI and this is more fully documented under Standard 38 within the report. The daily records were found in a file in the dining area and the inspectors have required that the current storage of resident’s records is reviewed in order to promote resident’s rights to privacy and confidentiality. Medication procedures and practices were sampled and found to be satisfactory. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident activities are undertaken and visitors are welcomed to the home to maintain contact with their family members. The food served during the site visit was of a satisfactory standard and consultation regarding menu planning demonstrated residents rights to exercise control and choice over their lives. EVIDENCE: One health care professional commented ‘I always feel welcome when I visit Chalkmead and they seem to run a very caring establishment. It is a pleasure paying a visit.’ Comment cards received from relatives and other visitors to the home were favourable with one stating Chalkmead was an ‘excellent home’ During the site visit it was noted that there was a calm, relaxed atmosphere and residents moved freely around the home. The home had appointed an activities organiser since the previous inspection and the units contained notice boards indicating what activities were arranged. These activities included crafts, bingo, quizzes, one to one activities, manicures, puzzles and dominos. One comment card from a resident stated that the home ‘does not provide suitable activities’. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 15 The inspectors did not meet with the activities coordinator during the inspection and no activities were seen to take place during the morning. During the site visit feedback the manager told the inspectors that the activities organiser had been in the home and staff had also engaged residents in activities. The area support manager advised that all Anchor homes are currently involved in a project related to meaningful occupation in the home. One resident showed the inspector their new budgie and said that keeping a pet gives her something to do and she enjoys trying to tame the bird to come onto her finger. It was recommended that several notices, which referred to the warm weather precautions and a fete that had been held on the 18th November 2006 be removed from notice boards as they were out of date. Notices were also displayed regarding Sunday worship. The inspectors observed breakfasts and the main midday meal being prepared and offered in calm and pleasant surroundings. Dining areas in each of the separate units were well presented and offered a homely atmosphere. Tables had tablecloths and sufficient cutlery and crockery. Staff members were observed to be mindful of residents needs, ensuring that they were aware that it was breakfast time and assisting them to come to the dining room or have breakfast in their bedrooms if they preferred. The inspectors spoke at length with the deputy chef during the site visit and she explained the catering arrangements of the home. She advised that she visits each unit every day, sometimes several times, to talk with the residents regarding the meals served in the home. Residents confirmed that they speak with the cook and that she takes an active interest in their diet and what they like to eat. The deputy chef told the inspectors that all residents are offered choice at meal times, and food is plated in order that residents can see the choice offered. Special diets are available for example diabetic meals and soft diets, which are blended separately in order to ensure that the meal is well presented. Nutritional drinks are also prescribed and available to residents. During the site visit a juice machine was being installed on each unit for use by the resident’s. The deputy chef and manager explained that the menus displayed in the home were not current as a new menu was being printed and displayed in the home over the next day. The inspectors were told that within each dining area the residents would have a menu card on the dining room tables in order that they would have an informed choice regarding their meal preferences. Residents demonstrated that they were aware of the changes in the menu planning and in general the meals served were of a good quality. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 16 The homes kitchen practices were observed and the inspector noted that some food in the fridges in the main kitchen contained the day of the week, the packages were opened but did not reflect the date, some dried herbs and spices were out of date, and on one unit several packages of cheese were out of date. The home rectified the shortfalls immediately at the time of site visit by discarding the food. A cleaning schedule was in place and the kitchen cleaned satisfactorily. Kitchen storage areas were tidy and orderly. The inspectors noted that the chef and assistants did not wear appropriate clothing for example one assistant was observed to have a coffee break in a tee shirt and track suit bottoms. The tee shirt was stained with flour, which indicated that the assistant was not wearing protective clothing. The assistants advised that the providers have ordered new protective clothing and all staff including care staff will be provided with new uniforms by the end of the month. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 16,18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents are not protected by the homes complaints and safeguarding adults procedures. EVIDENCE: All residents spoken with during the inspection told the inspectors that they were aware of the complaints procedures. The home has a complaint procedure, which was noted to be displayed in several areas around the home, which included the dining areas and front foyer. The site visit also focussed on matters arising from an anonymous concern received by CSCI, which had also been forwarded to Anchor Trust to investigate. The inspectors evidenced that a complaints procedure in a resident care plan, who had been newly admitted to the home, was not a current document and referred to the National Care Standards Commission and stated that the procedure related to another Anchor Home. These shortfalls were discussed with the registered manager who advised that the documents would be changed. The pre inspection questionnaire stated that the home had received nine complaints since the last inspection and all complaints had been investigated Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 18 by the home. The inspectors did not sample the complaints log or the methods the home had used to investigate the complaints. The staff training file was sampled by the inspectors and no records to evidence that staff had undertaken safeguarding vulnerable adults training were located. The registered manager advised that some staff had received training. The inspector requested that confirmation be provided to CSCI following the site visit regarding staff attendance to safeguarding adults training. At the time of writing the report no detail has been sent to CSCI regarding verification that staff have attended the training in order to safeguard residents from harm and abuse and it is required that all staff attend safeguarding vulnerable adults training within the required timescales. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 19 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 the following standard(s): 19,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes cleanliness and hygiene was of a variable standard and some improvements must be made regarding the decoration of specific areas in the home. EVIDENCE: Several areas in the home have been redecorated which included the upstairs corridors, reception area and lounges. During the site visit the inspectors observed that the level of cleanliness in the home varied from unit to unit. In various rooms the state of the cleanliness was poor which included dust on pipe work, skirting boards, dusty tables, several bedrooms had a malodour and suitcases had been left on the top of wardrobes covered in dust. It was evident that in some bedrooms furniture had not been moved in order that the carpets could be vacuumed thoroughly. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 20 A bedroom carpet in Kingfisher unit was noted as very soiled and debris was noted behind the armchair next to the bed. The manager told the inspector that arrangements had been made to replace a lounge and 2 bedroom carpets on Kingfisher and Dove unit. The inspector noted that in one sluice room there were no paper towels or hand wash available and the house keeper was asked to replenish the stocks, which were attended to immediately. Several areas of the home were noted to be in need of decoration for example chipped paint and stained walls. One inspector noted that the housekeeper had left safety signs to indicate that the bathroom and toilet floors had been cleaned although on further inspection the floors remained soiled. The staff toilet and waste paper bin, with special attention to the bin lid, was noted as unhygienic and needed a deep clean. It has been required that all areas of the home are to be kept clean and reasonably decorated. The home has a safe bathing policy and one inspector sampled the water temperatures, which were satisfactory. Bathrooms were noted to be clinical in presentation and an improvement for the home would be for the providers to consider ensuring the bathrooms reflect a more homely environment. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 21 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staffing levels in the home during the site visit were appropriate to the needs of the residents. There were significant shortfalls in the recruitment, selection of staff and a lack of structured induction and training to ensure the safety, protection and welfare of residents. EVIDENCE: During the course of the site visit the inspectors observed there were a significant number of staff on duty. One resident told the inspector that they had been resident for many years and said ‘I like it here, they are all very good and my family visit’. Another resident said ‘they look after me well’. The inspectors sampled a variety of staff files, which included day and night care staff, housekeeping and a volunteer file. The evidence gathered did not demonstrate that the home operates a robust recruitment and selection process. For example no application form or history of employment had been obtained for the volunteer, one care staff reference was not the reference from the application form and another care staff file contained a reference with no date stating ‘to whom it concerns’. There were no induction or training records for the housekeeping staff and no employment history and appropriate food handling training for the deputy chef. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 22 The home is displaying a certificate, which states that 58 of staff have achieved National Vocational Qualification (NVQ) level 2 training. It was noted that the certificate was not dated and it was difficult to ascertain if the figure was current. The inspectors sampled the training file, which contained a section for each staff member. Some training records for staff were out of date and the training file was not structured or manageable. This meant that the manager was not able to state whether staff training needs had been identified or met. The inspectors requested a documented training plan to be sent to CSCI, which would offer clarity regarding the staff training achievements. At the time of writing the report this has not been received by CSCI and a requirement has been made that the home ensures that all staff receive training appropriate to the work they are to perform in order to ensure that safety and welfare of residents in the home. The manager told the inspectors that the home had recently held dementia training and medication training and several staff are continuing their achievement of their NVQ. The inspectors spoke with the housekeeping staff and one stated she had been employed for 3 weeks and had not received Health and Safety training including control of substances hazardous to health or moving and handling training, one other housekeeper told the inspector that they had only received moving and handling training. Records sampled by the inspectors evidenced shortfalls in the housekeepers training and observations during the inspection which included cleaning trolleys left outside residents rooms in the corridors with chemicals unsupervised indicated a lack of awareness regarding the safety and welfare of residents. It is required that housekeeping staff receive training appropriate to the work they are to perform for example control of substances hazardous to health (COSHH) health and safety, moving and handling training. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 23 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Information gathered prior to and during the site visit highlighted shortfalls in the overall management of the home and the safety, protection and welfare of residents. EVIDENCE: The homes manager is now registered with CSCI. She advised the inspectors that she walks around the home each day. Several staff told the inspector that they found the manager to be approachable and if there are problems she will sort them out promptly. Staff advised that the general atmosphere in the home was good. Other information gathered from staff indicated concerns regarding some management issues in the home which included low staff morale, lack of a Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 24 structured induction, lack of day to day management in the home, inadequate risk assessments, lack of one to one input from senior staff to care staff, lack of staff supervisions, poor communication in the home, incomplete handovers, lack of consistent team/unit meetings, and lack of management of poor performance for example not turning up at work and use of mobile phones in the home. During the feedback to the area support manager the inspectors were advised that Anchor Trust had assessed a number of issues in relation to the management and environment at the home and a project Manager had been assigned to the home to provide support, development and an improvement plan for the home. The area support manager advised that a full care standard audit by an internal care specialist team had also been undertaken a few days prior to the inspection and an action plan was implemented following the findings. This was sampled following the site visit and reflected similar shortfalls. The inspector sampled the accident and incident records and daily notes of several residents within the home and noted that there were a significant number of un witnessed falls, which affected the welfare and safety of residents. These incidents had not been reported to the Commission for Social Care Inspection as required. It was immediately required that the home must give notice to the CSCI without delay regarding any event which affects the safety and welfare of residents. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 25 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 X 3 X X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X X X X X X 1 Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 26 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 OP1 Regulation Schedule 1 4.(1)(2) (3) Requirement The registered person must update the Statement of Purpose and Service User Guide to provide residents with adequate up to date information regarding the provision of services in the home. The registered person must ensure that following the assessment of a resident’s needs a written plan is prepared as to how the resident’s needs in respect of their health and welfare are to be met. The registered person must ensure that resident’s risk assessments identify and reflect the individual’s hazards in their daily lives and are appropriately reviewed and updated to ensure the safety and welfare of the residents The registered person must ensure that resident’s care records are accurately recorded and signed in full by staff members in order to demonstrate that the resident’s health and welfare is promoted DS0000013591.V305157.R01.S.doc Timescale for action 12/12/06 2 OP4 OP8 15 (1)(2)(ad) 06/12/06 3 OP7 13.4.(a-c) 29/11/06 4 OP7 17.(3) (a) 06/12/06 Chalkmead Resource Centre Version 5.2 Page 27 5 OP10 12.(4) (a) 6 OP16 22.(7) (a-b) 13.(6) 7 OP18 8 OP26 23.(2) (d) 7,9,19 Schedule 2 9 OP29 10 OP30 18.(1)(i) 17.(2)9 11 OP31 10.(3) 12 OP38 37.(1) (a-g) and personal care needs met. The registered person must ensure that the current storage of resident’s records in the dining area is reviewed in order to promote resident’s rights to privacy and confidentiality. The registered person must ensure the complaint procedure is updated to include accurate CSCI details. The registered person must ensure that each staff member receives safeguarding vulnerable adults training to ensure the safety and protection of residents. The registered person must ensure that all areas of the home are to be kept clean and reasonably decorated. The registered person must ensure that robust recruitment practices are in place and that records detailed in Schedule 2 are available for all staff employed by the home. The registered person must ensure that all persons employed in the home receive training appropriate to the work they are to perform including structured induction, moving and handling, health and safety (including risk assessments) fire training first aid. A staff development programme must be developed and implemented. The registered manager shall undertake from time to time such training as is appropriate to ensure that she has the experience and skills necessary for managing the care home. The registered person must give notice to the CSCI without delay regarding any event, which affects the safety and welfare of DS0000013591.V305157.R01.S.doc 06/12/06 06/12/06 29/02/07 29/12/06 29/12/06 29/02/07 29/02/07 29/11/06 Chalkmead Resource Centre Version 5.2 Page 28 residents. 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 OP12 Good Practice Recommendations It is recommended that all notices displayed in the home which are out of date are removed. Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Surrey Area Office 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 Chalkmead Resource Centre DS0000013591.V305157.R01.S.doc Version 5.2 Page 30 - 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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