Inspection on 01/03/06 for Chantry Care Services

This inspection was carried out on 1st March 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 20 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chantry Care Services 07/01/10

Chantry Care Services 03/12/08

Chantry Care Services 10/12/07

Chantry Care Services 07/03/07

Chantry Care Services 20/06/06

Chantry Care Services 25/07/05

Chantry Care Services 11/09/04

Chantry Care Services 28/04/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Chantry Care Services 46 Dean Street Crediton Devon EX17 3EN Lead Inspector Unannounced Inspection 1st March 2006 10:00 Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 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 Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 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. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chantry Care Services Address 46 Dean Street Crediton Devon EX17 3EN 01363 772301 01363 772348 intotal@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) Chantry Care Services Care Home 16 Category(ies) of Learning disability (16), Physical disability (4) registration, with number of places Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2005 Brief Description of the Service: The Chantry is a listed building close to the centre of Crediton. The premises are two-storey and detached and an annexe previously known as ‘The Coachouse’ at No. 47. The large gardens includes various outbuildings at the rear. There is some private parking. The home offers accommodation and care to sixteen service users with learning disabilities. There are lounges, a study/activities room and dining room on the ground floor. None of the bedrooms have en suite facilities, but all have wash hand basins. Since there is no lift between floors, clients accommodated on the first floor must be fully ambulant. Whilst the Home is registered to care for people with physical disabilities, careful assessments would be needed should any further admissions in this category be considered. The Home has its own marked transport. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the last inspection the annexe at 47 know as ‘The Coachouse’ has been incorporated into the Chantry so that they are now one registration instead of two separate ones. There has also been a new manager appointed and two new deputies as the previous manager and senior team left. The new manager and deputies have considerable experience in residential care and the manager has several years experience of working with people with learning disabilities. They only commenced work at the home in January 2006 and the inspector was impressed with their assessment of the needs of the home and the plans they are hoping to put into place. The inspection was unannounced and the inspector spoke to residents and staff as well as one relative who was visiting. The Chantry provides one respite bed and some day care placements. Day Care is not currently regulated by the CSCI. Since the last inspection there have been two complaints made, in relation to the home, to the CSCI. One complaint was in relation to the environment and was partially upheld and one was in relation to the manager and some specific issues within the home. This was also partially upheld. What the service does well: What has improved since the last inspection? Since the last inspection the recording of PRN (when required) medication has improved and it is now possible to see that other methods are being used Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 6 before medication is considered. A hole in the wall of the corridor has been repaired. A fridge is available for the storage of medication and handwritten notes or alterations on the medication sheets are signed by two people. A bolt have been removed from a bathroom door. A toilet which was previously leaking has been repaired and sufficient crockery is available. No cigarette butts were visible outside of the home. 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. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 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 Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 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): 3 Inconsistent practice is limiting the ability of some residents. EVIDENCE: A requirement was made following the last inspection that the welfare needs of a resident should be met in relation to their communication needs. This relates to a communication board, which is not currently being used. The manager has made provisional arrangements for staff to attend a total communication course. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 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 Residents would benefit from being involved in the review process. Systems to be put in place will ensure that those residents’ views are sought and acted upon. EVIDENCE: Following the last inspections one recommendation was made in relation to care plans. It was recommended that resident’s involvement in the completion of the review of care plans was available. This remains outstanding but the new manager has produced a form to use in relation to this. Currently the manager is contacting relatives etc. to obtain information etc. for care plan reviews. It was noticed that the health issues in relation to one resident were not mentioned in the care plan and issues in relation to pressure relief for a resident needed to be expanded. Currently the manager is planning to set up regular residents meetings and to look at ways in which he can demonstrate how choice is made. The manager has informed the commission of the fact that he is appointee for most of the residents. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 10 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): 12 The lack of individual activities means that residents lack stimulation and variety in their daily occupations. EVIDENCE: The home is currently having difficulty arranging educational and occupational opportunities for residents as they are short staffed. On the day of the inspection the staff were holding a music/karaoke session with residents but this was being undertaken in a large group. The home needs to be able to arrange activities in smaller groups to meet the needs of individual residents and to make use of community facilities. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 11 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): 20 Lack of detail in relation to medication has the potential to place residents at risk. EVIDENCE: It was noted that some eye-drops which have been sent in by a resident’s family are not labelled. It was also noted that one resident using the home for respite care has medication prescribed on a PRN (when required) basis for a specific medical condition. There are no guidelines available as to when this is to be used and it was not clear that there was a member of staff on each shift who has been trained to undertake the procedure. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 12 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 core standards were assessed on the last inspection. EVIDENCE: Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 13 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, 28 & 30 The quality of furnishings, fittings, repair and unpleasant odours to the building do not create a pleasing and pleasant environment for residents to live in. Resident’s communal space is limited. EVIDENCE: A tour of the home took place. Generally the home is in need of redecoration in many areas. In the corridors paper is coming away from the wall and there are small dents. Much of the finishing in the bathrooms and toilets look poorly finished. All this contributes to giving the home a shabby appearance. It was noted that the roof in the main house is leaking and staff report that large amounts of water come through when it rains. A container has to be in place in the corridor to collect the water. A requirement was made following a complaint received, in relation to broken and damaged tiles in the bathrooms and toilets and sealant around baths and washbasins. This remains outstanding. In room 10 bare electrical wires were visible on the light fitting. The two sofas in the lounge are torn. In 47 it was noted from outside that one of the windows had a large hole in it. This window is understood to be in the loft space. It still has shards of glass hanging from it. An immediate requirement was issued in relation to this. On a previous inspection a recommendation was made that the aerial cable be removed from under the Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 14 carpet in one of the bedrooms. This remains outstanding. In the rear garden of the home there are disused white goods and furniture. The manager said that he has looked into getting a skip to remove these things. A room on the first floor in no.47 has been in the past locked although it is part of the communal space for residents. On this occasion the room was unlocked but the sleep-in bed was down and it was obvious that it is still being used for storage. There were also care plans left in the room. On the day of the inspection one of the washing machines had broken and as the other machine had previously broken the home had no washing machine. An immediate requirement was issued in relation to this. In three of the bedrooms there were unpleasant odours. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 15 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, 33 & 35. Residents will benefit from qualified staff. Improvements are needed in some training to meet the needs of the home. Lack of staff numbers means that resident’s needs are not being fully met EVIDENCE: Currently the home has three members of staff undertaking NVQ 3 and four undertaking NVQ 2. Both deputies are doing or have completed NVQs. The new manager has not recruited any new staff but is in the process of doing so and the paperwork was seen for these prospective new staff. The new senior team at the home have identified that staffing levels are insufficient to provide residents with stimulating and varied activates. At 5pm the staffing levels drop to three members of staff in the main house which means that residents are not able to go out to clubs or outings etc. They have also identified that at night there needs to be waking staff rather than sleep-in staff. Due to the needs of one resident at night the kitchen door now has to be locked. This should not be a long-term solution. Currently the home has five vacancies these are being covered by existing staff undertaking overtime. The amount of hours staff work must be closely monitored to ensure that they do not become over tired. The inspector was informed that the home is not able to employ agency staff and they were only able to advertise in a very local paper for new staff. It was noted in the smaller unit although there were two members of staff on duty one of those members of staff was employed for the majority of the Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 16 morning doing the cooking. The current staffing situation has been further exacerbated by two members of staff who undertake care duties as well as other duties, being taken to work in another home belonging to the company for one day this week. A recommendation was made following the last inspection that statutory training beyond induction is in more depth. The new manager is currently looking into this and trying to arrange some courses for staff to attend. It was also recommended that the induction and foundation training was LDAF (Learning Disability Award Framework) accredited. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 17 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): 37 & 42 Residents and staff benefit from a professional management team. Residents are potentially at risk in relation to the lack of attention in certain areas. EVIDENCE: A new manager has been appointed to the home as well as two new deputies. They seem keen to ensure that resident’s needs are being met in all areas and have some good ideas, which they plan to put in place. One member of staff said that she found the senior team very professional and approachable. It was noted that the fire alarms are not being tested weekly and the manager was unable to provide evidence that all staff have received fire safety training twice in a twelve-month period. An immediate requirement was issued in relation to this. In room 7 it was noted that there was only a window restrictor fitted to one side of the window and the window even with the restrictor opens too far. Outside 47 there were several bags of rubbish which animals had been able to get into. There is insufficient space in animal proof containers. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 18 Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 X 2 X 3 1 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 1 29 X 30 1 STAFFING Standard No Score 31 X 32 3 33 1 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X X X LIFESTYLES Standard No Score 11 X 12 2 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 1 X 3 X X X X 1 X Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 20 No 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 YA3 Regulation 12 (1) (a) Requirement You are required to ensure that the welfare of service users is met in relation to their communication needs by all staff. (Previous timescale of 26/08/05 not met) Timescale for action 30/04/06 2. 3. YA20 YA20 13 (2) 13 (2) You are required to ensure that all medication taken into the home is labelled. Clear guidelines must be available of when PRN medication is to be administered in respect of specific medical conditions. A minimum of one member of staff trained to administer emergency medication must be available when the identified resident is in the home. You are required to ensure that the roof to the home is repaired. You are required to ensure that all parts of the home are free DS0000022048.V270426.R01.S.doc 02/04/06 02/04/06 4 YA20 13 (2) 02/04/06 5 YA24 23 (2) (b) 31/03/06 6 YA24 16 (2) (k) 02/04/06 Chantry Care Services Version 5.1 Page 21 from offensive odours. 7 YA24 23 (2) (b) You are required to ensure that broken and damaged tiles are repaired or replaced and that sealant around baths and washbasins is clean and intact. (Timescale of 31/12/05 not met) You are required to ensure that the broken window identified at the inspection is repaired. You are required to remove all the disused furniture and equipment from the grounds. You are required to ensure that the washing machines are in working order. You are required to ensure that the sofas in the lounge are replaced. You are required to ensure that there is no visible electrical wiring in bedrooms. You are required to submit to the CSCI a redecoration programme with timescales. You must ensure that the first floor room in The Coach House is available for residents’ use at all times. (Timescale of 27/12/05 not met) You are required to ensure that the home is free from offensive odours. You are required to ensure that there are sufficient numbers of staff on duty both day and night to meet all residents’ needs. You are required to ensure that window restrictors are fitted to all windows and that they do not open too wide You are required to ensure that rubbish is stored in animal proof containers. DS0000022048.V270426.R01.S.doc 02/04/06 8 9 10 11 12 13 14 YA24 YA24 YA24 YA24 YA24 YA24 YA28 23 (2) (b) 23(2) (o) 23 (2) (c) 16 (2) (c) 23 (2) (b) 23 (2) (d) 23 (2) (e) 03/03/06 30/04/06 07/03/06 31/05/06 02/04/06 03/04/06 03/04/06 15 16 YA30 YA33 16 (2) (k) 18 (1) (a) 01/04/06 01/04/06 17 YA42 13 (4) (a) 02/04/06 18 YA42 16 (2) (k) 01/04/06 Chantry Care Services Version 5.1 Page 22 19 YA42 23 (4)(d) 20 YA42 23 (4) (c) You are required to ensure that all staff are up to date with their fire training and thereafter to receive training twice in a twelve-month period. You are required to ensure that fire safety checks are completed within the timescales. 14/03/06 03/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations It is recommended that evidence of service user involvement in the completion and review of care plans is available 2 3 YA12 YA24 It is recommended that more individual activities and opportunities are offered to residents both within the home and community. It is recommended that the aerial cable is removed from under the carpet 4 YA35 It is recommended that statutory training beyond induction is more in depth and that the induction and foundation training is LDAF accredited. Chantry Care Services DS0000022048.V270426.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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. 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