Inspection on 04/10/06 for Chalkney House

This inspection was carried out on 4th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chalkney House 12/01/06

Chalkney House 09/09/05

Chalkney House 16/12/04

Chalkney House 28/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Chalkney House 47 Colchester Road White Colne Colchester Essex CO6 2PW Lead Inspector Neal Cranmer Key Unannounced Inspection 4th October 2006 09:30 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 Chalkney House DS0000047576.V302286.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. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chalkney House Address 47 Colchester Road White Colne Colchester Essex CO6 2PW 01787 222377 01787 222377 chalkneyhouse@aol.com 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) Mr Krishan Parkash Vacant Care Home 33 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (24) of places Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 24 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 9 persons) 12th January 2006 Date of last inspection Brief Description of the Service: Chalkney House is a large detached property set in its own grounds in the village of White Colne. The home provides care for 33 older people; the home is also registered to provide care for up to nine service users who may have a diagnosis of dementia. Accommodation is provided on the ground and first floors, for which access is provided by a lift. There are three shared rooms, with the remainder being single occupancy. A new wing was added to the home in November 2005. There is a large sitting room with a TV, two smaller sitting areas and two dining areas. In the garden there is a shed with heating and a call system for the use of any service users who smoke. The gardens are well maintained and provide lots of space for walking and sitting out in the summer. The home is served by a main bus route to both Colchester and Halstead. Fee’s for the home are from £426.09 to £450.00 per week, and additional charges are made for the following items: Hairdressing, chiropody and newspapers. This information was supplied by the acting manager to the inspector during a telephone conversation on the 31st October 2006. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection to the home, the first for the inspection year 2006/2007, which took place over one day in October 2006, lasting 5.75 hours. The inspection process included: discussions with three service users, four members of the care team, the acting manager and the area manager, a brief discussion also took place with the registered provider. During a tour of the premises service users bedrooms, bathrooms, communal areas and gardens were seen. A range of documentary evidence was sampled. Twenty-one of the thirty-eight standards were inspected, of which thirteen were met, five were considered to be minor shortfall, one being a major shortfall. What the service does well: What has improved since the last inspection? The previous requirement for the home to ensure that it had a current electrical installation certificate for the home has now been complied with. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 6 What they could do better: • Need to ensure that when care staff are supporting service users with personal care needs, they do so in a way that preserves the service users privacy and dignity. The home needs to give further consideration has to how to improve and facilitate opportunities for activities within the home. The homes recruitment process requires further development to ensure that it adequately safeguards service users. The registered person must ensure that all staff receive induction into the home. The homes quality assurance process requires further development to ensure that it includes the views of all interested stakeholders. • • • • 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. The summary of this inspection report can be made available in other formats on request. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Service users can expect their needs to be assessed prior to admission to the home being granted. Standard 6 is not applicable to the home, and was therefore not inspected. EVIDENCE: Three service users care plans were sampled; each contained a pre-admission assessment, which covered the following areas: • Personal care needs DS0000047576.V302286.R01.S.doc Version 5.2 Page 9 Chalkney House • Oral health needs • History of falls • Mental health state • Social interests • Medication • Communication needs. The pre-admission assessment undertaken was used to inform the content of the service users plan of care. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Service users can expect their needs to be set out in their individual plans of care. Service users can expect that their healthcare needs will be well met. Service users can be assured that they will be protected by the homes policies and procedures for administering their medicines. Service users cannot expect that their privacy and dignity will be protected and respected at all times. EVIDENCE: Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 11 Three service users plans of care were sampled, each set out clearly the actions which staff needed to follow to ensure that service users needs were meet, the plans seen showed that they were kept under review. Discussion with a visiting district nurse evidenced that the home works proactively with visiting professionals referring service users whenever necessary. All service users are registered with a general practitioner. There have been a significant number of deaths at the home in recent months and the district nurse spoke of the staff team supporting service users very well to remain living in the home during the latter stages of their lives, the district nurse spoke of staff being knowledgeable about the needs of service users. The nurse reported that all medical examinations are carried out in private. Staff who administer medication to service users do so only upon completion of accredited training or distance learning packs. Medication is dispensed directly from named containers. The home does not maintain any controlled medicines. The manager liaises closely with pharmacists about medicines dispensed to service users. Medication records sampled on the day of the inspection were found to be in order, no omissions noted. One service user spoken with was generally positive about the care provided at the home, stating that carers were usually polite, referring to service users by their chosen form of address. However the service user went onto say that staff have a tendency when carrying out care related tasks to talk over the service users to each other. The service user spoken with confirmed that all medical examinations or treatment was carried out in the privacy of their own rooms. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 & 15. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Service users cannot expect the home to always match their expectations in relation to their social and recreational activities. Service users can expect the home to support them to maintain links with their families and friends. Service users can expect the home to support them to exercise choice and control over their lives. Service users can expect that the home will provide them with meals that are wholesome and appealing. EVIDENCE: Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 13 The routines of daily living within the home are flexible and varied, and service users are supported to the best of their abilities to exercise some degree of choice, mostly related to meals and mealtimes. Little organised meaningful activity was seen to be being provided, and service users for the most part were seen occupying themselves, reading or watching the television, one service user when asked spoke of their concerns about the staffing levels stating that staff were always rushed off their feet and never had any time to stop and have a chat. The acting manager and the area manager spoke of consideration being given to the employment of an activities co-ordinator. Service users spoke of the home having an open door policy on the receiving of visitors, and of being free to chose to receive their visitors in private. Evidence was seen of the home involving service users relatives in the home. On the day of the inspection one relative was spoken with who was quite complementary about the care provided, they explained that they had a few minor concerns which had been shared with the deputy manager. Written evidence provided by the manager following the inspection indicated that the relatives concerns had since been addressed. The relative spoken with said that they were always made welcome whenever they visited. None of the service users residing at the home are able to manage their own financial affairs, the only money handled by the home on behalf of service users is their personal allowances, and records sampled were found to be in order. Service users spoke of being supported and able to bring personal possessions with them into the home. Service users are provided with three meals daily, at least one of which is hot, and snacks were seen to be available throughout the day. One service user spoken with said that food at the home was generally good. The menus sampled were varied and nutritious. The gap between the last snack offered and the next meal was no greater than twelve hours. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives can expect that their concerns and complaints will be listened to, taken seriously and acted upon. Service users can expect that the home policies and procedures will be sufficiently robust to protect them from abuse. EVIDENCE: Since the previous inspection two anonymous complaints have been made regarding the home’s staffing levels. These were discussed with the acting manager. One service user spoken with indicated that they were aware of how and to who to direct a complaint to, should they be unhappy with any aspect of the care provided. The home’s complaints procedure was displayed on the home’s notice board, alongside other information. The home maintains a log for recording of any complaints received. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 15 As noted in the previous section of this report one-service users relative spoke of having raised some minor concerns with the acting manager, and of their confidence that the matter would be listened to and acted upon. The home’s Adult Protection policies and procedures are sufficiently robust to ensure that service users are protected from the risk of harm and or abuse. The acting manager confirmed that all staff have received training in adult protection. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, & 26. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported in an environment that is safe, accessible and well maintained. Service users can expect the home to be equipped with suitable lavatory and bathing facilities. EVIDENCE: The home is suitable for its stated purpose, being accessible, safe and well maintained. The grounds were found to be tidy and safe and were accessible to service users. Since the previous inspection the acting manager pointed out Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 17 that the following refurbishment work had been undertaken, including replacement of a number of bedroom carpets, a new en-suite fitted in bedroom number 4, and new curtains have been fitted in rooms numbers 4 and 10. In addition a new computer has also been purchased for the office. It was noted during the tour of the premises that a number of service users wheelchairs were stored at the bottom of the main staircase, this may pose a trip hazard for both service users and staff, and a more appropriate place for the storage for these items should be found. The home was equipped with adequate toilet and bathing facilities in sufficient numbers to meet the needs of service users, these were clearly marked and were positioned close to lounges and dinning areas The laundry is situated away from food preparation areas, and is equipped with hand washing facilities and sluicing, floors and walls are readily cleanable, and on the day of the inspection the home was clean and hygienic and free from any offensive or unpleasant odours. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Service users can expect that their needs will be met by the home’s staffing levels and skill mix. Service users can expect to be supported by a team of staff who are competent. The home’s recruitment practice is not sufficiently robust to adequately protect service users. Service users can expect to be supported by a team of staff who are generally well trained and competent to carry out their roles. EVIDENCE: The duty rota sampled for the period 9th-15th September indicated the following staffing levels on the morning shift there are in addition to the acting manager, five care staff, a cook, kitchen assistant and laundry assistant. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 19 The afternoon shifts are covered by the acting manager up until 5.00pm, and four care staff up until 10.00pm.The Night shifts are covered by three waking night staff. The acting manager and area manager informed the inspector that they are in the process of considering reinstating a 4-8pm shift. The home is also in the process of appointing domestic staff. All staff providing personal care are all aged over eighteen, and no member of staff in a position of being left in charge of the home is under the age of twenty-one. Discussion with the acting manager evidenced that seven of the care team are qualified to N.V.Q level two, with one in the process of doing their level three award, and a further three are waiting to commence. One member of staff is qualified at N.V.Q level four. Four staff files were sampled relating to the home’s recruitment practice, the records evidenced the following gaps: Two files did not have copies of the staff members application form. Two did not have any references on file. Two did not have any evidence of a current Criminal Records Bureau Check (CRB). Two did not contain any evidence of induction having been undertaken Staff files sampled indicated that access to induction training for staff was variable. Access to other relevant training was better and included: • Fire prevention training • Protection of Vulnerable Adults • Medication administration • Moving and handling. Staff spoken with during the inspection indicated that access to staff training was reasonable. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home is currently not managed by a person who has been registered to do so. Service users can expect to be consulted with on all aspects of the running of the home. Service users can expect that the home’s practice will safeguard their financial interests. Service users and staff can expect that the home’s policies and procedures will ensure that their welfare is protected and promoted. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 21 EVIDENCE: Since the previous inspection the registered manager of the home has been promoted, leaving the post currently vacant, the role in the interim is being carried out by the acting manager. The acting manager has a number of year’s experience of working in the care sector, and hold an N.V.Q level four award. The area manager leads on quality, and has met with seventeen service users; whose responses are recorded on comments cards. The area manager will provide feedback to the manager and Social Services, the manager of the home will then hold a service users meeting to provide feedback on the outcome of the report. The area manager indicated that the process is under further development to include a range of other stakeholders The only money managed on behalf of service users is personal monies, records relating to this were sampled and found to be in order, and money held was seen to be stored securely The previous requirement from the last inspection relating to the homes safe working practices has been addressed; the following safety certificates were sampled and found to be in order: • Electrical installation certificate • Emergency aids • Hoist service certificate • Lift safety certificate • Fire extinguisher safety certificate • Gas boiler service report. Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 22 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 x X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP10 Regulation 12 (4a) Requirement The registered person must ensure the home is conducted in a manner, which respects the privacy and dignity of service users. The registered person must make provision for providing recreational activities within the home. The registered person must not employ persons in the care home without first having obtained all of the documentary evidence required under Regulation 19, Schedule 2 of the Care Homes Regulations. The registered person must ensure that staff are provided with the necessary training appropriate to the work they are to perform. This relates specifically to the need for all staff to be inducted into the home. The registered provider must make provision for the appointment of an individual to DS0000047576.V302286.R01.S.doc Timescale for action 31/12/06 2. OP12 16 (n) 31/12/06 3. OP29 19, Schedule 2. 31/12/06 4. OP30 18 (i) 31/12/06 5. OP31 8 31/12/06 Chalkney House Version 5.2 Page 24 6. OP33 24 manage the care home. The registered person must develop a process for reviewing and keeping under review the quality of the homes service provision, which is based upon the views of service users and other stakeholders. 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 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 © 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 Chalkney House DS0000047576.V302286.R01.S.doc Version 5.2 Page 26 - 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!