Inspection on 16/11/05 for Chapel Brook House Nursing & Residential Care Home

This inspection was carried out on 16th November 2005.

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

Chapel Brook House Nursing &... 17/04/07

Chapel Brook House Nursing &... 16/06/05

Chapel Brook House Nursing &... 08/12/04

Chapel Brook House Nursing &... 27/07/04

Chapel Brook House Nursing &... 30/03/04

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

CARE HOMES FOR OLDER PEOPLE Chapel Brook House Nursing & Residential Care Home Moody Street Congleton Cheshire CW12 4AN Lead Inspector June Shimmin Unannounced Inspection 16th November 2005 09:45 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 Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.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 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. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chapel Brook House Nursing & Residential Care Home Moody Street Congleton Cheshire CW12 4AN Address 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) 01260 277364 01260 277364 info@chapelbrookhouse.com www.chapelbrookhouse.com Stylepeople Ltd Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability (2) of places Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 32 service users to include:* Up to 32 service users in the category of OP (old age not falling within any other category) * 2 named service users in the category of PD (physical disability under 65 years) may be accommodated within the maximum of 32 beds The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 16th June 2005 2. Date of last inspection Brief Description of the Service: Chapel Brook House Nursing and Residential Care Home is a Grade II listed building of Georgian style situated in its own grounds and wooded areas. It is just a few minutes walk from the town centre of Congleton and close to local amenities such as the library, shops, bus station, theatre, churches and railway station. Accommodation is provided on three floors with access between floors being provided by a passenger lift or staircases. Communal areas include a large lounge and conservatory on the ground floor. Part of the conservatory is used as a dining area. The home provides 22 single bedrooms, 5 of which have en suite facilities. There are also 5 double rooms, 3 of which have en suite facilities. Bedrooms without en suite facilities have a wash hand basin. A nurse call system is supplied in all bedrooms. The home provides a number of aids and adaptations for residents who need assistance. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 and three quarter hours. 11 residents, several relatives, the homeowner, manager and 6 staff members were spoken with. Written comments were received from three residents and two relatives. A tour of the home was undertaken. Care records for three residents were looked at, as well as records on fire safety, staff supervision and medication. What the service does well: What has improved since the last inspection? The owner has removed the carpet from the floor of the medication room and is in the process of laying an alternative floor covering. The number of hours allocated for activities has increased since July 2005. The owner has attended a course on the protection of vulnerable adults to familiarise himself with all aspects of this subject. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 6 New armchairs have been purchased. The percentage of care staff who have achieved NVQ level 2 or above has increased from 25 to nearly 50 . The manager has worked full time since September 2005. 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. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 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 Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 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): 3, 4 and 6 Residents are assessed prior to moving into Chapel Brook House to ensure that their needs can be met. Staff individually and collectively have the skills and experience to care for residents. Chapel Brook House is able to meet the needs of residents admitted for respite care and under the rapid response scheme. EVIDENCE: Either the manager or the deputy matron carry out assessments of new residents before they move into the home. This is to ensure that Chapel Brook House can meet their needs. The assessments of two residents recently admitted to Chapel Brook House under the respite and rapid response scheme were looked at. The content was generally of a satisfactory standard but provided little information about the social interests, hobbies, religious and cultural needs as well as carer and family involvement and other social contacts/relationships of either resident. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 9 Written assessments may also be provided by nurses or social workers who have been involved with caring for the resident. If the needs of residents change, the manager takes action to have their needs reassessed. This process may involve talking to doctors, nurses and social workers. The care plans of these two residents were also looked at. They described the actions to be taken by staff to meet most needs but did not include a care plan for communication and an infection where these had been identified as care needs. A visiting health professional described staff at Chapel Brook House staff as “very professional.” Care staff at Chapel Brook House are skilled and experienced. Residents and relatives described them as being “wonderful” and “very good.” Staff are encouraged and supported to undertake appropriate training. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 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): 8, 9, 10 and 11 Care staff at Chapel Brook House ensure that contact is made with other health professionals regarding any additional health care needs of residents. One aspect of the management of medication is not satisfactory. The dignity and privacy of residents is respected. The care needs of dying residents are met. EVIDENCE: The care plans indicated that prompt advice had been sought from a number of health care professionals. Chapel Brook House is included in the Nursing Home Doctor scheme, whereby a doctor visits once a week to review the health care needs of residents. Medication is generally well managed. However, several gaps were noted on medication administration records. When medication is not administered a reason should be recorded for non-administration. The floor covering of the medication room is being replaced. Although there are hand-washing facilities in the medication room there was no liquid soap or paper towels available. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 11 Residents and relatives were complimentary about staff at Chapel Brook House, “kind staff and well looked after.” They confirmed that staff knocked on their doors before entering and that their dignity was preserved at all times. The care plan of a resident who had recently died was looked at. This indicated that the wishes of residents are discussed with families. There is good communication between the manager and relatives. Relatives are able to stay as long as they wish and may stay overnight. The manager and another nurse are undertaking a course in palliative care. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 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 and 15 Routines are flexible at Chapel Brook House to suit residents` individual preferences. A range of activities are provided. Visitors are made to feel welcome. The standard of food is good. EVIDENCE: Chapel Brook House employs an activities co-ordinator for three afternoons a week. The activity co-ordinator also accompanies residents to hospital appointments if a family member is not available. Activities provided at Chapel Brook House are bingo, music, quizzes, organist, videos, discussions, outside speakers, aromatherapy, foot massage and manicures. Many residents take a daily newspaper. Members of a local church visit monthly, providing a service and hymns. The standard of catering is good. There is a choice at all meals and several residents spoken to were aware of the choices available. The cook was aware of the individual preferences of residents and those who required a special diet. Meal times are flexible so that the individual needs of residents can be met. This was evident on arrival when some residents were still enjoying breakfast. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 13 Meals are not rushed and the home was commended for the calm atmosphere evident during lunch. Those residents requiring assistance to eat were helped in a sensitive and discreet manner. One resident said that there was enough to eat. Another commented that food brought to the room was sometimes cold. Supper is available in the evening so that there is not a gap of more than twelve hours between meals. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 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): 18 Policies, procedures and staff training are in place to protect residents from abuse. EVIDENCE: The owner of Chapel Brook House has recently attended a course on the protection of vulnerable adults. Training in this subject is planned in collaboration with another care home in the Congleton area in the very near future. Care staff also undertake training in adult protection as part of the NVQ training programme. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 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, 22, 25 and 26 Residents live in a comfortable and pleasant environment. Chapel Brook House is generally clean and tidy. The owner provides new furniture when needed. EVIDENCE: The environment at Chapel Brook House is comfortable and homely. New lounge chairs have been provided. A range of aids and adaptations suitable for the needs of residents are provided. Radiators in bedrooms are covered to protect residents from possible contact burns. The temperature of the hot water in a first floor bathroom was tested and found to be within acceptable limits. The owner said that the maintenance man was monitoring the temperature of hot water outlets. Most parts of the home were clean and tidy. Residents and relatives commented about the high standards of cleanliness. An accumulation of dust was noted on pipes, windows and the ceiling of the laundry. A number of tiles were missing from the laundry walls, which means that they are not readily cleanable. The extractor fan in the adjacent toilet was also dirty. Adequate supplies of protective clothing were seen to help the control of possible infection. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 Staffing levels at Chapel Brook House are satisfactory. Staff are well regarded by residents and relatives. The management encourage and support staff to undertake training relevant to their role. EVIDENCE: Staffing levels at Chapel Brook House remain the same as at the previous inspection and are adequate. Staff spoken with said that they enjoyed working at the home and that there was a good team spirit. Residents and relatives spoke highly of all staff. There is very little use of agency staff and minimal staff sickness. Staff said that they were given opportunities to undertake training. Chapel Brook House has nearly achieved the target of 50 of care staff with NVQ level 2 or above. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 17 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): 32, 33, 36 and 38 Chapel Brook House is well managed. The owner is very involved with the day-to-day running of the home. Mechanisms are in place to ensure that feedback is obtained from residents, relatives and staff about the running of the home. Evidence is needed that formal supervision of staff is taking place. All food handlers should undertake basic food hygiene training to ensure food safety. Fire safety is maintained. EVIDENCE: The manager of Chapel Brook House has worked in a full time capacity since September 2005. She is supported in her role by a full time deputy manager. The owner is very much involved in the daily running of Chapel Brook House. Residents, relatives and staff were complimentary about the management team. Staff said that they were able to air their views at staff meetings. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 18 The management team have developed a questionnaire to distribute to residents and their families. The owner said that this would be completed by Christmas. Meetings are held with families. The last one was in February 2005 and a further meeting is planned. The owner said that Chapel Brook House has introduced a system whereby they meet with families once a year to discuss relatives` progress. This is in addition to the reviews of care held with social workers. The manager has been completing staff appraisals, but has not yet introduced a system of formal supervision. This is to be developed. The cook had not completed a basic food hygiene course. To ensure food safety it is recommended that all food handlers complete a basic food hygiene course (Level 1) and that cooks undertake the Level 2 food hygiene course. The owner said that the cook was to attend a course but that the course had been cancelled. He was trying to access an alternative course. Fire safety records were looked at and found to be satisfactory. Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 19 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 2 3 X 2 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 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 X 17 X 18 3 3 X X 3 X X 3 2 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 3 X x 2 X 2 Chapel Brook House Nursing & Residential Care Home DS0000058768.V267304.R01.S.doc Version 5.0 Page 20 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 OP9 Regulation 13 Requirement There must be no gaps on medication administration records. A reason must be recorded for non-administration of medication. Timescale for action 16/01/06 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 OP3 Good Practice Recommendations Assessments should include details about the residents` social interests, hobbies, religious and cultural needs; carer and family involvement and other social contacts/relationships. Care plans should be provided for all identified needs. Liquid soap and paper towels should be available in the medication room. Missing wall tiles in the laundry should be replaced so that the wall finishes are readily cleanable. The laundry room should be kept clean. All staff should receive formal supervision at least six times a year. All food handlers should undertake level 1 in basic food hygiene and cooks level 2. DS0000058768.V267304.R01.S.doc Version 5.0 Page 21 2 3 4 5 6 7 OP6 OP9 OP26 OP26 OP36 OP38 Chapel Brook House Nursing & Residential Care Home Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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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