Inspection on 08/11/05 for Chamarel

This inspection was carried out on 8th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chamarel 23/04/07

Chamarel 16/06/05

Chamarel 08/12/04

Chamarel 14/04/04

Chamarel 30/10/03

Chamarel 10/04/03

Chamarel 03/09/02

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

CARE HOME ADULTS 18-65 Chamarel 8 High Street Longstanton Cambridgeshire CB4 5BP Lead Inspector Shirley Christopher Unannounced Inspection 8th November 2005 4:00 Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 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 Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 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 Adults 18-65. 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. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chamarel Address 8 High Street Longstanton Cambridgeshire CB4 5BP 01954 789856 01954 200101 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) Mrs Lesley Joy Mowlabocus Mr Gorabye Mowlabocus, Mr Roger Paul Shelley, Mrs Melanie Shelley Mr Roger Paul Shelley Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (1) of places Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th June 2005 Brief Description of the Service: Chamarel is a small family run home for up to seven adults with a learning disability, one service user is over the age of 65. The home is owned and run by joint proprietors, Mr and Mrs Mowlabocus and Mr and Mrs Shelley who are long time friends and associates with considerable experience between them. Mr Shelley is the registered manager. The home is situated in the village of Longstanton, which is close to the City of Cambridge and has good bus links to Cambridge and Bar Hill. The home is centrally located and provides spacious accommodation. Originally there were five single bedrooms and one double bedroom, but the house has been recently extended to create all single bedrooms for the benefit of the existing service users. En suite facilities have been added to one bedroom and an additional bathroom is being built as well as an additional residents lounge upstairs. The home has a small rear, and front enclosed gardens and parking spaces. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was undertaken on the 8 November 2005 and was conducted from 4.00 pm until 7.00 pm. This was at a time when all the service users were at home. Two care staff were on duty and the manager was also present. A number of documents were inspected and included; medication records, one service user plan, staff induction records, menus, complaints book, service user personal allowance and polices and procedures. The main method of inspection was direct observation and discussion with all the service users, care staff and the manager. The manager was asked to complete a pre inspection questionnaire and send out relative/service user comment cards and return them to the CSCI. No timescale for this was proposed. What the service does well: What has improved since the last inspection? Improvements have been made to the home, to give two service users who were sharing a bedroom a bedroom of their own, one with en suite. An additional en suite is to be built for another service user. The kitchen has been refurbished and most of the kitchenware renewed. Carpets have been replaced. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 6 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. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected EVIDENCE: These standards were not assessed, partly as there have been no new admissions to the home for many years and these standards have been previously met. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Service users are consulted and involved fully in every aspect of their lives. Potential is recognised and encouraged. EVIDENCE: One service user file was inspected .The information had been updated and transferred from one file to another. The information provided was fairly comprehensive and included a photograph, basic details, a list of social activities attended and circles of support. Every area of health and personal care is covered by the plan and looks at service users like, dislikes and support needs. There was clear evidence of annual reviews, but not of six monthly reviews, although the manager pointed out the staff signatures on the care plans, which indicated they had been reviewed. It was suggested a separate review sheet may be more appropriate. This has apparently already been devised. Assessments and risk assessments were in place. The manager demonstrated an in-depth knowledge of service users. It was suggested that documentation could be put in place to capture their experiences and past events in the form of a life storybook. This could be used to help staff in developing a better understanding of their experiences and may Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 10 be beneficial as service users get older and perhaps less able to recall past events. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,17 Service users are encouraged to pursue their own interests and hobbies. They are supported by a wide network of staff, family and friends. EVIDENCE: Service users were spoken to at length and discussed what they did during the day and weekend. Service users showed the inspector photographs of their holidays, one recently taken in Minorca and of family members. The home actively encourages service users to maintain contact with friends, family and advocates. Service users pursue a range of day and social activities. One person goes out to work. He said that he also attends Hester Adrian, a day centre and has attended college but decided to leave. Evening classes have finished. Unfortunately there are no suitable classes available at present and the providers are actively pushing for such provision. One service user has a keen interest in photography and is encouraged to pursue his hobby. Another service user is in a football team for people with learning disabilities and plays for Cambridge. He has just got engaged. Another service user over 65 chooses not to retire and has a busy day. The manager stated it is sometimes difficult Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 12 to motivate service users to go out in the evening, but all have an early start. The home also celebrates special events and occasions. They enjoy individual and group holidays. Both of which families are encouraged to participate in. A meal was being prepared by staff, who confirmed that service users are involved in food preparation as appropriate. All of the service users were consulted about the day’s menu. Menus are completed. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 20 The home has systems in place for the safe storage and administration of medication through adequate polices and staff training. The health care needs and wishes of service users are recorded. EVIDENCE: One service user file was inspected and provided evidence to how the health care needs of service users are met, through regular check ups and take up of screening and other preventatives measures, such as flu vaccinations. Some service users take medication but this is regularly reviewed. Homely remedies are also used and approved for use by the doctor and pharmacist. The home also uses an alternative therapist. There is a consultation sheet in place for this. Medication records were inspected and were satisfactory. The home has polices and procedures in place including one for homely remedies. The manager was asked how frequently they are updated and he stated that he was going to purchase a date stamp, which would indicate when they were last reviewed. Care staff are instructed in the safe administration of medication through in house induction and support from the local pharmacist, who also does medication audits. The frequency of these pharmacy audits was not determined on this occasion. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 14 Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home has policies and procedures in place for dealing with complaints and the protection of vulnerable adults. Care staff receive training in the latter. EVIDENCE: The manager stated that no complaints have been received since the last inspection and produced the complaints log, which showed a number of minor complaints recorded, which had all been dealt with in a timely manner. The manager confirmed that all staff attend training in the protection of vulnerable adults and this is covered both in induction and as part of the NVQ. The home has policies and procedures on both complaints and adult protection. The home also has the new Cambridgeshire adult protection policy/ procedures. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Accommodation is of a high standard and is suitable for purpose. EVIDENCE: The home has recently been refurbished and extended. A new kitchen is in situ and the extension means that all service users now have their own bedroom one with its own en suite. There are further plans to create a second en suite bedroom. The home was clean and maintained to a high standard, with new carpets purchased and equipment replaced where required. The manager stated that the radiators in the communal areas are to be covered although they present little risk to service users. The manager confirmed that there were no outstanding maintenance issues. The home has had a recent inspection from the insurance company who made a few practical recommendations/ suggestions. Very few areas of the home were seen as part of this inspection. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35,36 The home benefits from a low turn over of staff and ensures consistency and familiarity for service users. EVIDENCE: The home has a very low staff turnover and do not use agency staff. On the day of inspection there were two care staff on duty and this is normally the case. The manager was also at the home. At the last inspection staff records were made available but were not being kept at the home. A requirement was made stating that records must be kept in the home. This is now the case and they are kept securely. No staffing records were inspected on this occasion, other than an induction record for newly employed staff. The manager confirmed that staff’s mandatory training was up to date. He confirmed that all staff do a basic induction and three staff are currently doing the induction units of (LDAF.) One member of staff has completed the induction units of this award (LDAF) and was amongst the first in the county to do so and has been invited to a National Conference, where she has been invited to speak at the conference. One member of staff is doing NVQ 2. Another member of staff has passed. One of the registered providers is an assessor for the LDAF award and will be able to assess in-house. Care staff had received fire training on the day of inspection. The manager confirmed that moving and handling refresher training was planned for Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 18 November. Staff completed first aid training last year. The medication is delivered by Tesco’s and the pharmacist provides basic training for staff, which compliments the in house induction staff receive. Further medication training is also being sourced. Staff have training in the protection of vulnerable adults. Staff supervision has always taken place informally but not always recorded. The manager stated that he had devised a new form and will now take every opportunity to record meetings with staff as a recorded supervision. This may be a staff meeting or whilst being assessed for LDAF or NVQ. No evidence of supervision was requested. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40,41 Service users records were adequate, but insufficient information was available with regards to their finances. This information must be kept in the home. EVIDENCE: Service user records in relation to their finance were not available other than in relation to their personal allowance, for which clear records and receipts are kept. Service users also get mobility allowance, which is used to offset some of the petrol costs. A charge of 35p a mile is set and this is all recorded individually. Care staff have business insurance and copies are kept of their MOT and car insurance. No other evidence/records of finances were seen and must be kept in the home. Mrs Shelly manages the finances and was in the home briefly on the day of inspection. She confirmed that all service users have their own bank accounts and monies/benefits are paid directly. Five service users sign for their own money. She is a signature for two service users. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 20 The manager confirmed that the home has an annual quality assurance review in which a report is completed. A copy of which must be forwarded to the CSCI. The manager was asked to distribute service user/ relative comment cards on behalf of the CSCI as part of this review. Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 4 X X X X X x LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 4 16 X 17 Standard No 31 32 33 34 35 36 Score x 3 X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chamarel Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 3 2 X x DS0000015275.V259853.R01.S.doc Version 5.0 Page 22 Yes 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 YA39 Regulation 26 (2) Requirement The registered person must make a report available to the Commission in respect of their internal quality review at appropriate intervals The registered person must keep all the records specified in Schedule 4, Specifically (9) that relates to service users finances/valuables. Timescale for action 30/12/05 2 YA41 17 (2) 30/12/05 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 YA36 Good Practice Recommendations Evidence of regular supervision should be provided Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Chamarel DS0000015275.V259853.R01.S.doc Version 5.0 Page 24 - 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. 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