Inspection on 15/01/07 for Chandos House

This inspection was carried out on 15th January 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

Chandos House 19/12/05

Chandos House 14/07/05

Chandos House 24/11/04

Chandos House 02/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Chandos House Gorse Road Grantham Lincs NG31 9LH Lead Inspector Moya Dennis Key Unannounced Inspection 15 January 2007 09:00 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 Chandos House DS0000002344.V311266.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. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chandos House Address Gorse Road Grantham Lincs NG31 9LH 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) 01476 562393 The Orders Of St John Care Trust Miss J Garrill Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category: Old age, not falling within any other category (OP) - 33. The maximum number of service users to be accommodated is 33. Date of last inspection 19th December 2005 Brief Description of the Service: Chandos House is a purpose-built home, providing personal care for older people. Formerly owned by the local Authority, the home is now owned by the Orders of St. John Care Trust, which manage a group of 16 homes across the county. The care home is situated in a quiet residential area to the north east of the town of Grantham. There are limited local amenities available in the area. The town centre is not within walking distance but there are various forms of transport available for easy access. The home was purpose built to meet the needs of older people and has large landscaped gardens and on-site car parking. Residential accommodation is provided on both the ground floor and first floor. The first floor is reached by stairs or the shaft lift. The home provides permanent, intermediate and respite care for up to 33 older people and at the time of the inspection, 30 people were being accommodated. Most people are referred by Social Services. The home advertises in hospitals, GP surgeries and on its website. Fees range from £335 to £549 per week. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place in January 2007. It consisted of a visit to the home, lasting 3 hours and a review of all the information known about the home. The manager was not present during the inspection. The inspector was assisted by a manager from an associate home who was acting on behalf of the manager, and spoke to six members of staff, six residents and inspected a sample of care records and other documents. No visitors were present during the inspection but relatives had provided feedback by way of ‘Have Your Say’ surveys. Others had written letters to the home, giving their views. The letters were made available to the inspector. This feedback, and pre inspection information provided by the home contributed to the inspection process. The main method of inspection was tracking the care received by particular residents, checking their records and discussing the care they received with them, with care staff and observations of care practices. The feedback received during the inspection was positive. Residents said they could find no fault with the home or staff and would have no hesitation in recommending the home to others. General feedback about the outcomes of the inspection was given at the end of the visit to the acting manager. What the service does well: Residents were supported to remain as independent as possible. The home employed an activities co-ordinators who worked 15 hours per week. The range of activities was decided by residents and changed as they requested. Staff were well trained and said that team spirit was very good within the home. Staff turnover was low. Many workers had been working there for several years. Residents were positive about the care they received, “It’s lovely here. There’s no reason not to like it, they look after me very well”. The home had a comprehensive quality assurance and self audit system and the Investors in People award. The home had a good reputation in the area. One resident said she was told by hospital staff that, “Chandos is not like a residential home; it’s like a real home”. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 6 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. Chandos House DS0000002344.V311266.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 Chandos House DS0000002344.V311266.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were confident that the home could meet their needs on admission. Contracts protected their rights. All had received a Statement of Purpose to help them make an informed choice of home. EVIDENCE: Relatives answered in the Have Your Say surveys, that they were given plenty of information and booklets whilst they were looking for a home for their relatives. A check of records confirmed that these included Statement of Purpose, service user guides and contracts. Residents’ files contained full assessments, their own and their relatives’ expectations of the proposed admission and their perspective of need. Assessments included all aspects of personal care and social support. Survey responses indicated that relatives and prospective residents were given the chance to visit the home before deciding if the placement would be acceptable. Residents confirmed that either they, or their families had visited Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 9 the home to look around, meet the staff and other residents and see the vacant room. People referred to the home for intermediate care were helped to maintain their independence. Staff were aware of the need to help them reach optimum potential, prior to returning home. Chandos House DS0000002344.V311266.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ care needs were acknowledged and met. They had satisfactory access to health care professionals and such visits were recorded. Policies and procedures ensured medication was administered in a safe manner. Residents were accorded dignity and respect by staff. Residents’ end of life wishes were discussed and recorded. EVIDENCE: The care of four residents was case tracked. The care plans gave clear information and relevant information for carers to deliver appropriate care. Residents confirmed that they had been involved in reviews and they and their relatives were informed of any changes. The home’s policies relating to medication were satisfactory. All staff responsible for giving medication had received appropriate training. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 11 Residents said they had been able to see a doctor when needed and care records confirmed this. General care practices were observed. Staff addressed residents by their preferred name, as recorded on their care plans. The home operated a key worker system and workers were knowledgeable about the social history, likes, dislikes and needs of residents they were key worker for. One resident said, “The service is excellent. The staff are very friendly; they treat me with respect”. End of life wishes were recorded in care plans. Staff received training on death and dying and were knowledgeable about issues of bereavement. Chandos House DS0000002344.V311266.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 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. Residents were able to take part in a range of activities of their choosing and maintain links with family and the local community. They enjoy a varied, balanced diet. EVIDENCE: The home employed an activities co-ordinator for 15 hours a week. Residents said she had asked what activities they would like to do. Many residents took daily newspapers and were discussing current events between themselves and the activities worker. Entertainers often visited the home and there were links with local schools and other groups. The activities programme had been designed after consultation with all residents and there were activities to suit everyone, male, female and people with different levels of ability. Some residents chose not to join in with organised events, preferring more personal pastimes on a one-to-one basis with the activities worker. On the day of inspection most were preparing for a balloon game, whilst others were waiting for the hairdresser to arrive or have hand and nail care. The lunch menu was displayed on the board and residents were aware of both options. All said they enjoyed the food. “It’s very good, and there’s plenty of it Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 13 … we have a choice of hot, cold, or vegetarian … it’s lovely”. Staff were confident that the home would be able to provide for the dietary needs and preferences of people from ethnic minorities. Residents had been able to bring items from their former home, to personalise their rooms. One resident said she had been able to bring a complete bedroom suite. They spoke to visitors in their rooms, or the dining room, as they preferred. Relatives said, via letters and surveys that, “There was always the offer of a welcome cup of coffee … I appreciated the friendship shown me”. Chandos House DS0000002344.V311266.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 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 good. This judgement has been made using available evidence, including a visit to this service. Residents were protected by a clear, efficient complaints procedure and cared for by well-trained staff. EVIDENCE: The home’s complaints procedure was clear, giving stages and time scales for the process. The information was included in the service user guide and displayed in the home. The complaints log was inspected. No complaints had been received since the last inspection. The adult protection policy reflected local authority procedures. Residents and relatives said they would approach any member of staff to raise concerns but none had had reason to do so. Staff had recent training on, and were knowledgeable about, adult protection issues. They identified various types of abuse and said they could approach the manager at any time with concerns. They were aware of the ‘whistle blowing’ process and said they felt able to approach the manager at any time if they had any concerns. Residents or their relatives managed personal allowances. The home employed an administrator who acted as liaison between the home, resident and relatives in all financial matters. Recording and accounting systems for residents’ monies were satisfactory. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 15 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): 19,20,25,26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents live in clean and comfortable surroundings, with access to safe outdoor facilities. EVIDENCE: The communal and private areas of the home were clean, warm and comfortable with no odours. Six bedrooms had recently been redecorated and there was an ongoing programme of redecoration. Residents said they liked their rooms and that they could bring in their own possessions. Remarks included, “I have a very nice room, with all my things around me … it’s always clean and warm … my son chose this room, he knew I’d like it, and I do”. The home had large gardens and residents said they enjoyed sitting on the patio in warm weather. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 16 Residents said the laundry service was very good. None had had clothing spoiled or lost since moving to the home. All staff received training on infection control. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence, including a visit to this service. Residents’ needs were met well-trained staff in adequate numbers and they were protected by the home’s recruitment procedures. EVIDENCE: One resident said staff were usually available when needed but “thought more bells should be available to get in touch”. However, during the inspection visit it was noted that residents had access to call bells and they were answered promptly. Staff said they got good induction to the home. Induction lasted 2 weeks and they did not work alone until confident to do so. Some staff had been working at the home for several years. All remarked on the good teamwork and management support. They said they had good access to training. 79 of staff had National Vocational Qualification (NVQ) level 2 or above. Staff said there were enough workers on shift to meet residents’ needs. Internal bank staff were used to cover shortfalls, in order to maintain consistency for residents. Four staff files were inspected. All demonstrated that correct recruitment procedures had been followed and contained the information required by National Minimum Standards. Staff confirmed they had clearly defined job descriptions. The training programme demonstrated that staff received foundation and regular Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 18 mandatory training, in addition to more specialised training to meet the needs of residents. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 19 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): 31,33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home was generally well managed but staff were not receiving formal supervision. Arrangements need to be improved to ensure staff comply with best practices and the philosophy of care within the home. Health and safety issues were promoted by safe working policies and procedures but there was no evidence of checks that these were put into practice. EVIDENCE: Staff said the registered manager was very supportive. She had completed the Managers’ award and had over 20 years experience in delivering care for older people. There was no evidence of her having undertaken other training since Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 20 the last inspection, except fire marshal training. She was on sick leave and unable to be present for the inspection. The trust’s headquarters managed the home’s quality assurance programme. Resident and relative were given surveys annually. The responses were analysed and used to improve the service. There were feedback forms available for residents or relative to complete as issues arose. These responses were made available, along with letters from relatives. All were positive about the service provided. Relatives had written, “Thank you for your kindness and patience…she had a comfortable home with you and wanted for nothing…you could not have done more to make her happy”. Staff said they were encouraged to give feedback in informal discussions but staff meetings had not been held since May 2006. The home held no personal allowances of residents. An administrator managed all financial issues. Recording policies for handling residents’ monies were satisfactory. Care staff said that they had annual appraisals and personal development reviews every six months but did not receive formal supervision. Staff received training on issues relating to health, safety and welfare. However, one staff member said she had not been observed whilst working with residents to ensure she followed policies and procedures. A requirement was made that staff received regular formal supervision. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 22 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 OP36 Regulation 18 (2) (a) Requirement The registered person must ensure that staff are appropriately supervised to ensure policies, procedures and best practices are employed. Timescale for action 01/03/07 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 OP36 Good Practice Recommendations It is recommended as good practice that staff meetings take place at regular intervals to ensure information is relayed to all staff and they have the opportunity to contribute to improvements in the service. Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Chandos House DS0000002344.V311266.R01.S.doc Version 5.2 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. 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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