Inspection on 17/04/07 for Chapel Brook House Nursing & Residential Care Home

This inspection was carried out on 17th April 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

Chapel Brook House Nursing &... 16/11/05

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 17th April 2007 10:00 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 Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 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 Ann Louise Oldham 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.V321670.R01.S.doc Version 5.2 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) * Within the maximum of 32 beds, two named service users may be accommodated in the category of PD (physical disability under 65 years) Date of last inspection 16th November 2005 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. Shared areas for the residents include two lounges and a conservatory on the ground floor. The home has 22 single bedrooms, 5 of which have en suite facilities. There are also 4 double rooms, 3 of which have en suite facilities. Bedrooms without en suite facilities have a wash hand basin. An emergency call system is supplied in all bedrooms. The home has a number of aids and adaptations for residents who need help with moving around. There is also a garden area with seating. The weekly fees are £470 to £625. There are additional charges for hairdressing, toiletries, newspapers and chiropody. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 17th April 2007 and lasted seven hours. It was carried out by one inspector. The visit was just one part of the inspection. Other information received about the home was also looked at. Before the visit the home’s owner completed a questionnaire providing up to date information about Chapel Brook House. CSCI questionnaires were also given to residents, families, health and social care professionals, such as doctors, nurses and social workers, to find out their views. During the visit various records and the premises were looked at. A number of residents and relatives were spoken with and they gave their views about Chapel Brook House. What the service does well: What has improved since the last inspection? The management of medication has improved to make sure that all the people living at the home get their medicines as prescribed. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 6 The home has obtained a Safer Food, Better Business certificate from the Food Standards Agency, which shows that people living at the home receive food that is prepared safely. An extra lounge and two shower rooms have been added to improve the facilities for the people living at 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. The summary of this inspection report can be made available in other formats on request. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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 Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given information, and have their needs assessed before deciding to move into the home so they know that their needs can be met. EVIDENCE: The service user guide (information booklet) about the home was updated in December 2006 and contains full information about Chapel Brook House. There was a copy on display in the entrance area of the home, together with the two most recent CSCI inspection reports for the home. The manager said that copies of the service user guide are given to all prospective residents before they move in to help them decide if their needs can be met at the home. One resident said that his mother had chosen the home for him and that he had been offered a choice of rooms when he moved in. Assessments done for three residents were checked; two were for people who had moved in recently and one was for a person who was living at the home for a short period under the Intermediate Care Scheme. The registered Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 9 manager or her deputy had carried out the assessment. Further information is often provided by health or social care professionals. The content of the assessments was thorough. The life history of one resident was recorded by one of the activity coordinators, so that care staff have a better understanding about the person’s life before they moved into the home. One family had provided a life history, which included some useful background information about the resident. Staff at the home were aware of the spiritual needs of residents and this was recorded. Chapel Brook House offers intermediate care if it has vacancies; this involves people moving in from hospital for short periods of time to recover fully before they go back to their own homes. The assessment for a person who was in the home for intermediate care was thorough and a care plan had been drawn up to show how their needs would be met. The care file also showed that there was good liaison between care home staff and staff from the Intermediate Care Scheme. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The way in which people’s needs are met means they receive all the care they need with respect and dignity. EVIDENCE: The care plans of three people who live in the home were seen. The plans showed what should be done to meet people’s needs and included relevant risk assessments. The care plans and risk assessments had been written within five days of the people moving into Chapel Brook House so staff would know quickly how to provide care for those people. The care plans used at the home are mainly pre printed with additions made for each individual. In some cases these additions did not include enough information. For instance, one person was identified as being verbally aggressive when they moved in but there was nothing to show what staff should do to manage this. Care plans and risk assessments had been reviewed every month but the reviews did not always show whether the care Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 11 being given had been effective. For instance, one person had a painful shoulder when they moved into the home but there was no reference to this in the review. Information provided from the home identified that four residents had pressure sores. At this inspection visit, the manager was able to show that great improvements had been made so that all the people with pressure sores were now much more comfortable. The care files checked showed that referrals had been made to healthcare staff such as doctors and nurses, when needed. Feedback from them to CSCI about the home was very complimentary, identifying “good relationships with myself and staff”. Medication was well managed. Residents at Chapel Brook House are treated with respect and dignity. Staff were seen knocking on the doors of residents before entering and talking to the people who live in the home in a respectful manner. Residents said they were well treated and received excellent care. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12. 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. . Residents are able to take part in activities that suit their lifestyles and are able to make choices so they stay as active and independent as possible in their daily lives. EVIDENCE: Two activities co-ordinators work at the home from Monday and Friday and at weekends on special occasions. There is a wide range of group and individual activities available. During the inspection visit there was a Tai Chi session taking place in the morning and one resident was taken shopping into Congleton town centre during the afternoon. Residents said that they were able to take part in activities if they wanted. The activity coordinator working in the home on the day of the inspection visit home said that when residents did not want to join in activities she would visit them in their room for a chat or to discuss what they would like to do. A weekly programme of activities was displayed but the activity coordinator said that she often preferred to be flexible and ask residents what they wanted to do on the day. Trips out of the home include visits to the theatre, pub lunches Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 13 and a visit to the Blue Aquarium in Ellesmere Port. Family members are encouraged to join in if they wish and a barge trip is currently being planned for the summer. Photographs of recent activities were displayed and the activity coordinator was waiting for photos of a recent Easter bonnet and party to be developed so they could be put on show. One activity enjoyed by a number of residents was a baking session in the dining area of the home. Those who could not take part were able to watch. When the weather is fine several of the people who live at the home are able to use the garden and plant flowers in pots. Relatives said that they were made to feel welcome by staff and friendly interactions were seen between staff and visitors. People living at the home are able to meet their visitors in their own rooms or any of the shared rooms in the home and visitors are welcome at any reasonable hour. Residents are able to make choices about what they do. For instance, electoral cards were seen for several residents for the forthcoming local elections. People can have their meals in one of the lounges or in their own rooms. One resident said that he is able to get up and go to bed when he chooses and is used to getting up very early due to the job he used to do. Another resident had chosen to have a long lie-in. Meals were of a good standard and people had a choice of food at each meal. Fresh vegetables were being used and home baking was done, so people were given a healthy, varied diet. Residents all commented about the good quality of food provided. For people who have pureed food, each part of the meal was pureed separately to make it look and taste better. Individual trays were used to serve food to people, so that their meals were served hot. Desserts were served to people only when they had finished their main course so they could enjoy their meals at the pace that suited them. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to raise any concerns and there is policy on protecting people from abuse but those staff who have not done training on this should do so to make sure that residents are fully protected from possible harm and poor practice. EVIDENCE: There have not been any complaints about the home since the last inspection nearly eighteen months ago. The complaints procedure is included in the service user guide and is displayed at the home. Residents and relatives were aware of the complaints procedure and who to speak to if they had any concerns. There is a policy for the home on the protection of vulnerable adults. The manager said that eleven staff members had undertaken training on protecting adults from abuse but remaining staff still needed to attend. The information provided before the site visit indicated that the home had identified residents who needed an advocate for issues not related to finance. In most cases this was a family member and in two cases Social Services were providing this service. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean and tidy so that people live in safe and comfortable surroundings. EVIDENCE: A tour of the premises took place. The environment at Chapel Brook House is pleasant, comfortable and homely. Various improvements have been made since the last inspection. These include two new shower rooms and the provision of another lounge near to the entrance of the home. New non-slip oak flooring has been laid in one lounge and the original oak floor restored in the second lounge. The large bay window of the second lounge has been double-glazed. New curtains and lighting have been provided in both lounges. The dining area has been moved into the middle lounge, which is nearer to the kitchen and the new floor covering makes food spillages easier to clean up. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 16 New non-slip flooring has been laid in the corridors leading to the laundry and kitchen areas, which is more hygienic. Fifteen bedrooms have had new bedspreads and curtains. The front of the home was repainted in summer 2006 and rotten window frames replaced around the home. Waste ground has been cleared and a new car park added to the side of the building. Rose borders have been planted at the back of the home. All parts of the home were clean, tidy and free from unpleasant smells. Adequate supplies of protective clothing were seen to help the control of possible infection. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have had training to make sure they develop their skills and provide safe care. Recruitment procedures are thorough enough to ensure that residents are protected. EVIDENCE: Staffing levels at Chapel Brook House are good. There were sufficient numbers of staff working in the home to meet the needs of the residents on the day of the site visit. Staff were sensitive to the needs of residents and were cheerful when carrying out their role. Recruitment records were looked at. These contained all the necessary information including two references and Criminal Record Bureau checks. However, there were no copies certificates to show that staff had achieved the training they had identified on their application forms. Staff said that they enjoyed working at the home. People who live at the home and their relatives spoke highly of all staff. There is very little use of agency staff and low staff turnover. Although 50 of care staff have not yet achieved a national vocational qualification in care, they are being encouraged to work towards this award. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 18 Staff said that they were given opportunities to undertake training and the owner provided a list of training courses that staff had attended on a variety of subjects. Although staff undertake induction training, the current course does not follow the national Skills for Care foundation standards so that staff may not acquire the depth of knowledge provided through Skills for Care. For instance Skills for Care foundation standards include a standard on the protection of vulnerable adults. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run so that the best interests of the service users, including their health and safety, are promoted. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection and has recently completed NVQ level 4 in management. She is a registered general nurse and has many years experience of working with older people. There is also a deputy manager, which means that staff and residents know who to approach when the manager is not at the home. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.R01.S.doc Version 5.2 Page 20 Staff and residents spoken with were complimentary about the management and said that they felt they could approach the manager if they had any concerns or problems. A survey to find out what the people who live at the home and their relatives thought about Chapel Brook House was carried out in August 2006. The survey was followed this up with a meeting in September 2006 to discuss the results. The registered manager and her deputy carry out monthly audits on the management of medicines and pressure sores. The owner provided information about the home before the site visit. The questionnaire stated that only one resident handles her own financial affairs with support from a relative. The home has a number of residents who have arrangements in place so that their financial affairs are managed for them. Health and safety systems in the home were found to be satisfactory. A sample of maintenance records was looked at. The records showed that the essential equipment in the home is serviced regularly. Records of fire tests were also satisfactory. Staff have undertaken annual fire training courses and regular fire drills so they know how to protect people in the home in an emergency. Only one staff member has a current first aid certificate although there is a recommendation that there is always a person who is qualified in first aid on duty. The home has recently achieved a Safer Food, Better Business certificate from the Food Standards Agency. Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP7 OP18 Good Practice Recommendations Care plans should be more specific about all the actions to be taken to meet the care needs of residents. The review of care plans should evaluate care delivery and care plans should be updated to reflect changing needs. Those staff who have not already done so should undertake training in adult protection so that the people living at the home are fully protected from possible abuse and harm. A minimum of 50 of care staff should achieve NVQ level 2. Copies of training certificates should be kept on file as proof of achievement. The induction framework should be based on the nationally recognised Skills for Care foundation standards. There should be a staff member qualified in first aid on duty at all times. DS0000058768.V321670.R01.S.doc Version 5.2 Page 23 4 5 6 7 OP28 OP29 OP30 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: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chapel Brook House Nursing & Residential Care Home DS0000058768.V321670.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!