Inspection on 18/09/07 for Chaltonholme

This inspection was carried out on 18th September 2007.

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

Chaltonholme 01/03/06

Chaltonholme 12/10/05

Chaltonholme 17/03/05

Chaltonholme 07/10/04

Chaltonholme 29/03/04

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 Chaltonholme 1-3 First Avenue Westcliff On Sea Essex SS0 8HS Lead Inspector A Thompson Key Unannounced Inspection 18th September 2007 10:30 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 Chaltonholme DS0000015424.V351086.R03.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. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chaltonholme Address 1-3 First Avenue Westcliff On Sea Essex SS0 8HS 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) 01702 346534 lisamariegray@hotmail.co.uk The Southend on Sea Darby & Joan Organisation Mrs Lisa Marie Gray Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (33) of places Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home may accommodate four residents under the age of sixtyfive years whose names are known to the Commission for Social Care Inspection. 19th September 2006 Date of last inspection Brief Description of the Service: Chaltonholme is an established home providing 24-hour care and accommodation for up to 33 older people, including those who have dementia. The Southend Darby and Joan Organisation own Chaltonholme. The home is situated in Westcliff-on-Sea close to the seafront. Bus services pass the building (there is a bus stop directly in front of the home), and Westcliff railway station is within half a mile. Local shops are close by with town centre shopping in Southend-on-Sea. The care home premises was created by adapting, converting and joining together three domestic style houses. There were 31 single and one shared bedrooms situated over the three floors of the home. Two passenger lifts provide access between levels. Communal space comprises two main lounges and one large dining area for service users. There was also a small room available for use as a quite area and a further separate smoking room. At the rear there was a well maintained garden, with sitting areas. Car parking for visitors was available on the home’s drive at the front. Information provided by the home confirmed current fees as £54.71 to £70.00 per day. CSCI inspection reports are available from the home and the CSCI internet website. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on Tuesday 18th & Wednesday 19th September 2007. The content of this report reflects the inspector’s findings on the day/s of the inspection along with information provided by the service and feedback by service users, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions took place with service users, visitors, the registered manager, the organisations responsible person, care team managers’, care staff and other staff on duty. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. Many service users were unable to express any views on the service owing to their diagnosed dementia. Those spoken to who did have a view confirmed they were satisfied with the care they received and with the quality of the food and accommodation offered. Visitors spoken with were complimentary of the care and support provided to service users by the staff and manager. Questionnaires were also left at the home so that relatives had the opportunity to make their views on the service known to the Commission. The home’s own quality assurance process includes gathering the views of service users and relatives. Evidence of this process being implemented was seen. Staff confirmed they received good support from the management team. They also confirmed that they had been provided good training opportunities, including NVQ training. Twenty eight standards were inspected and the outcomes for service users against twenty five of these was good. As a result this report includes one statutory requirement and three good practice recommendations as areas for improvement. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Chaltonholme DS0000015424.V351086.R03.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 Chaltonholme DS0000015424.V351086.R03.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): 3,5 Quality in this outcome area is good. Admission processes ensure that service users can be confident that the home considers they can meet their needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service user files inspected for people admitted since the last inspection evidenced that pre-admission assessments are carried out by the manager or deputy manager. Assessment headings included personal and healthcare needs. Completed assessments seen had been signed and dated by the member of staff involved. Files seen also included assessments from the placing authority. Service users and their families/representatives are encouraged to visit the home before agreeing to admission, which is initially on a month’s trial. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Care plans had been regularly reviewed and provided up to date information on the health, personal and social care needs of service users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Two care plans were inspected. Each included background information, personal details and next of kin contacts. There were detailed daily needs recorded and instructions for staff under headings of safety, environment, mobility, eating & drinking, elimination, personal cleansing, dressing, work and play, sleep, breathing and orientation. These main headings were broken down into detailed sub headings which included personal care, medication, likes and dislikes. Care plan files also included risk assessments on dependency, manual handling, pressure care, fractures, nutrition and of general risks. There was also a record of weight gain/loss. Plans seen had been regularly reviewed. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 10 The manager advised that the home had a good working relationship with local district nursing services who visit regularly to support service needs and will provide pressure relieving aids. A chiropodist visits the home every six weeks and an optician visits regularly. If service users require a dentist they visit community based facilities. Service users have the choice of several local GP practices to register with, although most use one practice close by. Evidence was seen to confirm that staff receive certificated training in medication procedures. Since the last inspection several staff have commenced a distance learning safe handling of medicines course entitled Certificate in Administration of Medication in Care Settings. Staff had also worked on the Skills for Care knowledge set for medication used in care homes. The homes medication policy and procedure provided detailed guidance and instructions for staff on ordering, storage, administration and returns of unused stocks. A separate returns book/pad is maintained and was seen. Medication administration records were inspected and were acceptable. The manager carries out a competency assessment on all staff new to medication administration. A record had been kept of this process and was also seen. Since the last inspection a new treatment room had been provided which has improved storage facilities for medication. Discussions with individual service users indicated that they were treated with respect by staff, as did observation of staff going about their duties and interactions with service users. Staff on duty were seen to be courteous and caring in their dealings with service users, and service users spoken with said staff were helpful and kind. Visitors spoken with were also complimentary regarding staff attitudes and the care provided. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 11 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 good. The home provides flexible routines and a lifestyle that enables service users to make choices. However activities should be provided by staff employed and trained for that role. Service users health and welfare is promoted by the provision of a varied and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user meetings take place, minutes of issues discussed and decisions made were seen and included issues such as food and routines. The home has a post of activities coordinator to work to provide daily activities in the home. Unfortunately at the time of this inspection the post was vacant. The manager was in the process of recruiting for this position and in the meantime care staff have filled the role, however until this post is filled there is a recommendation on this point in this report. Some records had been maintained of types of activities offered, these included: indoor games, visiting entertainers, board games, discussions and music. The manager advised that a mobile library visits the home and staff sometimes take service users for a walk to the seafront. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 12 Service users spoken with confirmed they were satisfied with the choices and options made available to them regarding daily routines and leisure interests on offer. They were also complimentary about the care support provided by the staff team. Visitors are welcome at all times, the home’s statement of purpose confirms the visiting policy. Advocacy support is available and a notice was displayed regarding access to this service. Records seen and inspection of private rooms confirmed that service users had been permitted to bring their own personal items with them on admission. Catering is provided by a contract service who supply the chef and arrange all deliveries of provisions. The manager advised that menus are decided between the caterers and the home taking account of service users likes and preferences. Nutrition records had been maintained, these were seen and evidenced choice and variety. The main daily meal is lunch, with two choices (a salad is available as a third choice). Service users decide their preference that morning. Teas are usually also two choices, with one choice often a hot meal. All service users spoken with were complimentary about the food. Four said it was good and that there was always a choice. Foods stocks were seen and were considered good. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 13 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. Practices in the home safeguard service users, and ensure that concerns are listened to and addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints procedure contains guidance on how to make a complaint and who to complain to. Also included were timescales for responses from the home. Evidence was available to confirm that records are maintained in the home, of complaints received and of any investigation and resulting outcomes. Service users spoken with said they knew who to speak to in the home if they had any concerns. The homes own in-house policy on adult protection was inspected, this included guidance for staff on recognising and reporting abuse and action to be taken by staff and the person in charge if abuse is suspected. The home had a copy of the adult protection guidelines issued by Southend Council, Social Care. Staff had been trained on adult protection issues and staff spoken with displayed a good understanding of procedures for reporting any concerns. There was also a ‘whistle blowing’ policy which provided guidance to staff on their responsibilities to report any concerns to management. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 14 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): 19,20,21,23,24,25,26 Quality in this outcome area is adequate. Furnishings in the home looked comfortable and the home appeared internally safe, but some carpets need cleaning or replacing and some doors and frames need repair and redecoration. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A programme of redecoration had taken place since the last inspection. This had included new carpets to some stairs and corridors, a refurbished bathroom, a relocated small ‘quiet’ lounge, redecoration to some bedrooms, one of the lounges and most corridor areas and redecoration to three further bathrooms. This had improved the environment for service users, however carpets in the two main lounges were stained and some doors and doorways had been damaged by wheelchairs. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 15 The manager was attempting to recruit staff who could use the home’s carpet cleaner and she advised that redecoration was on-going with the dining room also scheduled for attention and a new carpet due to be laid in the main corridor to the dining room. However attention was needed to the lounge carpets and this report includes a requirement on this issue, and a recommendation regarding the damaged paintwork on doors and frames. The garden rear appeared safe and fully assessable, and was seen being used by service users and their visitors during the inspection. The manager advised that the main pathway had been re-laid since the last inspection. Those bedrooms seen were comfortable and made homely with people’s personal possessions. The home has sufficient toilet facilities. There were five bathrooms, two of which had fully assisted baths fitted, and three had showers one of these was a new ‘walk in wet room’ type facility. The laundry had appropriate equipment for the home’s laundry needs. Communal space is sufficient with two lounges, a dining room and a small ‘quiet’ room and a separate smoking room. Evidence was seen that the fire service regularly visit the home as do the local environmental health dept. The last fire report asked for changes to some doors, this work was in progress at the time of the inspection. The manager confirmed that radiators were guarded and that hot water supply is regulated with monthly manual checks (records seen) taking place. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 16 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 good. Staffing levels appeared to meet the needs of service users and staff had been trained to equip them with the skills for their role. Staff recruitment procedures aimed at the protection of service users had been followed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s staffing rota was inspected and confirmed that daytime staffing levels are being maintained at a minimum of six care staff on duty, (this figure does not include the home manager or shift care team manager, who are additional). Night staffing is three on waking duties with an on-call manager. Separate and additional staff were deployed to undertake cooking, kitchen assistant, administrative (post vacant at time of inspection), activities (also vacant), domestic and maintenance duties. Discussion with staff and records confirmed that regular staff meetings are held. Agenda items included training, service users and general issues. These had taken place every two months. Staff records and discussion with staff evidenced that application forms had been completed, interviews held, written references obtained, written terms & Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 17 conditions issued and criminal records checks undertaken. Copies of proof of ID and photographs were also on file. Training opportunities offered had been good. Evidence of this included inspecting records and discussion with staff. The registered manager is a nurse has completed the NVQ level 4, and advised that since the last inspection most staff had commenced NVQ training, with one undertaking the level 3 and fifteen staff on an NVQ level 2 course. New staff undergo the home’s induction programme. This is based on the Skills for Care induction standards and includes headings of: principles of care, role of the worker, the needs of service users and safety. Staff spoken with confirmed that they had undergone induction training when commencing employment. Staff training records had been maintained and evidenced that opportunities have been provided to staff in: health & safety, nutrition, fire safety, first aid, infection control, food hygiene, medication, moving & handling, bereavement, dementia, continence promotion, abuse, care planning, supervision and diabetes. Courses are provided by using external trainers. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 18 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): 31,33,35,36,37,38 Quality in this outcome area is good. The home had been run and managed efficiently. Procedures for gaining the views of service users and relatives were in place, but there should be a summary of the results of the findings and outcomes from the 2006 surveys. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a nurse has been in post for over 3 years and has obtained the NVQ level 4 award. Other qualifications include the Institute for Leadership Management course with Essex County Council. Previous experience includes managing an acute unit at a hospital. The homes management team includes a deputy manager and three care team managers. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 19 Some service users personal allowance monies were held by the home for safe keeping. Records of transactions had been kept and all monies held were kept together in one locked box. An annual quality assurance process takes place with questionnaires issued to service users and relatives. Topics covered included staff attitudes, care provided, the food and complaints. The last full survey was carried out in 2006, the summary of responses and of any resulting actions had not yet been formulated. This report includes a recommendation on this point. Staff had received regular recorded 1-1 supervision from the management team. Records of this process were seen and included discussion on service users, training, personal development and actions to be taken. Random samples of records required by regulation were checked and found to be in order, with the exception of the point made above concerning service users monies. Certificates and service records were available for inspection to confirm that the home’s fire equipment, passenger lift, hoists, emergency lights, gas supply, portable electrical appliances and electrical installation supply had all been tested/serviced within acceptable timescales Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling training, fire safety, food hygiene, first aid and basic training in infection control. Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 20 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 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 2 3 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 3 3 Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 21 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 OP19 Regulation 23 Requirement Stained and/or worn carpets in the home must be cleaned/replaced to ensure that all rooms used by service users provide a clean and well maintained environment to live in. Timescale for action 31/12/07 Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP19 Good Practice Recommendations Activities offered to service users should be provided by staff employed and trained for that role. Cracked/chipped paintwork on doors and doorframes should be repaired to ensure all areas of the home are well maintained. The results of the home’s 2006 quality assurance surveys should be collated, with the results of any actions identified and/or taken made available to service users and the Commission. 3. OP33 Chaltonholme DS0000015424.V351086.R03.S.doc Version 5.2 Page 23 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. 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