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Inspection on 22/05/06 for Chaplin Lodge

Also see our care home review for Chaplin Lodge for more information

This inspection was carried out on 22nd May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Chaplin Lodge provides a comfortable, well-maintained and safe environment for up to 66 older people with a range of needs. In general the people living at the home and their relatives (based upon the responses received during the inspection and from those contacted by post) are satisfied with the care and services that Chaplin Lodge provides. The home is well managed and staff carry out their duties and care for residents in a kind and caring manner. Staff liaise well with other health and social care professionals including doctors, district nurses and social workers so that each person receives the care and attention that they need. Residents who were spoken with said that the food was good. One relative commented that her mother complained regularly about the food. There were no other adverse comments made and on the day of the inspection residents appeared to enjoy their meals.

What has improved since the last inspection?

There has been significant overall improvement in the services provided by the home since the last inspection. 9 of the 14 requirements identified at the last inspection had been met at the time of this inspection, 1 was not assessed and improvements had been noted in the issues as identified in the remaining 4. Improvements have been made in the way staff record information about the people living at the home although some more improvement and consistency is needed. The home provides more in the way of activities to keep residents occupied and to make their days more enjoyable. Staff have reviewed the way that residents are supported and helped at mealtimes so that residents have the assistance they need. The choice of drinks made available has improved and there are small tables in the lounge areas so that residents can have drinks available to them throughout the day. The way that complaints are recorded so as to show how they have been dealt with has also improved. The issues identified with hoisting equipment not being fully charged and in working order has also been addressed and staff move and handle living at the home in line with their training and the homes policies and procedures. There is evidence that staff in addition to the mandatory training also undertake a range of training including care planning and managing conditions normally associated with old age including incontinence and dementia care. The overall management of the home has improved and areas of good management as identified at the last inspection have been maintained. Staff are aware of what is expected of them in their work at the home and appear to understand their responsibilities and have a sense of accountability for what they do.

What the care home could do better:

More improvements are needed in the way staff record information about the people who live at the home and the care they receive. Assessment and care plan documents need to be kept up to date and accurate for all the people living at the home. Records also need to include particular wishes and preferences in more detail so it can be clearly evidenced that these wishes are met. One relative commented that staff could pay more attention to detail in particularly to ensure that resident`s nails and teeth are kept clean. More could be done to provide the less able people living at the home with activities to keep them occupied and stimulated and to avoid boredom. While the home is generally comfortable and well maintained there are a number of areas where improvement could be made by replacing worn carpets and redecorating areas, which have become worn and shabby with age. One resident`s relative commented that one of the shower areas on the first floor was in need of repair. This was not assessed on the day of the inspection as the information was received after this date. There are some areas within the home where there have been persistent odour problems and this must be addressed. The homes manager had implemented plans at the time of this inspection so as to replace carpets in one of these areas.

CARE HOMES FOR OLDER PEOPLE Chaplin Lodge Nevendon Road Wickford Essex SS12 0QH Lead Inspector Carolyn Delaney Unannounced Inspection 22nd May 2006 08:30 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 Chaplin Lodge DS0000018079.V293542.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 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. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chaplin Lodge Address Nevendon Road Wickford Essex SS12 0QH 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) 01268 733699 01268 570602 Ashbourne (Eton) Limited Mrs Claire Jane Collins Care Home 66 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (66) of places Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided to no more than 66 service users over 65 years of age. Total number of service users for whom personal care is to be provided shall not exceed 66. Service users with dementia to be accommodated in Parkview Unit only. 7th February 2006 Date of last inspection Brief Description of the Service: Chaplin Lodge is a care home which provides personal care without nursing for up to a maximum of sixty-six older people, including up to a maximum of eighteen people who have a diagnosis of dementia who are accommodated in a separate area of the home called Parkview which is accessed via a coded entry system so as to minimise the risks to those residents who are confused and tend to wander. Accommodation is provided in the main area of the house over two floors, which are accessed via a passenger lift. Residents have access to a number of communal areas including lounge and dining rooms. The home is situated in a busy residential area close to Wickford town centre. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key Inspection carried out between 08.30 and 20.00 on 22nd May 2006. The lead inspector for the service Carolyn Delaney and Michelle Love, inspector carried out the out the inspection. Records including assessments, care plans, daily care notes and risk assessment documents in respect of five people living at the home were examined. Eleven residents and five relatives were spoken with during the inspection. Two visiting professionals, one district nurse and one social worker were also spoken with to obtain their views about the service provided by the home. The relatives of fourteen residents at the home were contacted by post so as to offer them the opportunity to make comments about the services provided by the home. At the time of completing the draft version of this report eight responses (57 ) were received and a summary of the information provided has been included throughout this report. Eight members of staff including the homes manager were spoken with and a number of records including duty rota’s and staff recruitment files were examined. A tour of the premises was carried out and the serving of breakfast, lunch and evening meal was observed. All Key Standards as identified in the intended outcomes sections of this report have been inspected during this Key Inspection as they must be inspected at least once every twelve months. Where other standards have not been inspected on this occasion they will have been inspected at the previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. What the service does well: Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 6 Chaplin Lodge provides a comfortable, well-maintained and safe environment for up to 66 older people with a range of needs. In general the people living at the home and their relatives (based upon the responses received during the inspection and from those contacted by post) are satisfied with the care and services that Chaplin Lodge provides. The home is well managed and staff carry out their duties and care for residents in a kind and caring manner. Staff liaise well with other health and social care professionals including doctors, district nurses and social workers so that each person receives the care and attention that they need. Residents who were spoken with said that the food was good. One relative commented that her mother complained regularly about the food. There were no other adverse comments made and on the day of the inspection residents appeared to enjoy their meals. What has improved since the last inspection? There has been significant overall improvement in the services provided by the home since the last inspection. 9 of the 14 requirements identified at the last inspection had been met at the time of this inspection, 1 was not assessed and improvements had been noted in the issues as identified in the remaining 4. Improvements have been made in the way staff record information about the people living at the home although some more improvement and consistency is needed. The home provides more in the way of activities to keep residents occupied and to make their days more enjoyable. Staff have reviewed the way that residents are supported and helped at mealtimes so that residents have the assistance they need. The choice of drinks made available has improved and there are small tables in the lounge areas so that residents can have drinks available to them throughout the day. The way that complaints are recorded so as to show how they have been dealt with has also improved. The issues identified with hoisting equipment not being fully charged and in working order has also been addressed and staff move and handle living at the home in line with their training and the homes policies and procedures. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 7 There is evidence that staff in addition to the mandatory training also undertake a range of training including care planning and managing conditions normally associated with old age including incontinence and dementia care. The overall management of the home has improved and areas of good management as identified at the last inspection have been maintained. Staff are aware of what is expected of them in their work at the home and appear to understand their responsibilities and have a sense of accountability for what they do. What they could do better: More improvements are needed in the way staff record information about the people who live at the home and the care they receive. Assessment and care plan documents need to be kept up to date and accurate for all the people living at the home. Records also need to include particular wishes and preferences in more detail so it can be clearly evidenced that these wishes are met. One relative commented that staff could pay more attention to detail in particularly to ensure that resident’s nails and teeth are kept clean. More could be done to provide the less able people living at the home with activities to keep them occupied and stimulated and to avoid boredom. While the home is generally comfortable and well maintained there are a number of areas where improvement could be made by replacing worn carpets and redecorating areas, which have become worn and shabby with age. One resident’s relative commented that one of the shower areas on the first floor was in need of repair. This was not assessed on the day of the inspection as the information was received after this date. There are some areas within the home where there have been persistent odour problems and this must be addressed. The homes manager had implemented plans at the time of this inspection so as to replace carpets in one of these areas. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 8 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. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 9 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 Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 10 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, 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home cannot evidence consistently that the process for assessing the needs of prospective residents is such that it obtains sufficient information about each individual so as to determine that the home can meet these needs. EVIDENCE: At the time of this inspection the home did not have up to date information in respect of the services and facilities provided following the sale of Ashbourne Healthcare to Southern Cross Healthcare. Standard 1 will be fully assessed at the next inspection visit to the home. Chaplin Lodge does not provide rehabilitation or intermediate care. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 11 The recording of information in relation to the assessment carried out by staff of prospective residents needs prior to them being offered a place at Chaplin Lodge has improved since the last inspection visit. The homes new owners have introduced new documentation and assessment tools. These offer the opportunity for more comprehensive and detailed recording of information. However not all staff carrying out assessments are completing the assessment fully so as it can be determined that Chaplin Lodge can meet the needs of each person admitted to the home. In some instances large sections of the assessment document had not been completed which left a significant level of relevant detail omitted from the assessment. On the day of the inspection a resident was admitted and their relative was involved in the process for planning care for this person. In some instance the information recorded by staff at the home was different to that as provided in the social services assessment document (Comm5). However upon inspectors assessing this individual it was clear that at this time the information as recorded in the homes assessment was a more accurate indication of the persons needs. The manager was advised that a note regarding the contrasts in information would benefit staff and avoid confusion about individuals needs. In general prospective residents do not, due to physical conditions or hospital placements etc, have the opportunity to visit the home prior to making a decision to move in. However this opportunity is offered and in the majority of cases relatives visit the home on behalf of the person to be accommodated. The range of fees for the home at the time of this inspection are £426.09 £520.00. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 12 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recording of information about the care & treatment including any risks to health & welfare, wishes and preferences of each individual is not maintained in a consistent manner. However staff spoken with were aware of residents needs and observed on the day to treat residents in a positive and caring manner. Staff working at the home ensure that medicines are received, stored and disposed of in a safe manner according to the homes policies & procedures and that residents receive medicines as prescribed. EVIDENCE: Care plans; assessment documents including assessments carried out in respect of risks to the health, welfare & safety of the people living at Chaplin Lodge were sampled by both inspectors. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 13 Some care plans were very detailed and reviewed and amended according to changes in the care and treatment to be provided to the individual. A number of care plans included very clear and specific details about the care and assistance with daily activities of living that the person was to receive and included details of the person’s preferences and wishes for receiving care, assistance and for how they would like to spend their time. Others were incomplete and did not include what was considered to be sufficient information so as to ensure that the person’s needs could be met in accordance with their wishes. Staff caring for the people whose care plans were assessed were spoken with and they could clearly identify the persons needs, describe the care and assistance provided and details of particular wishes, likes & dislikes. Those residents who were spoken with during the course of the day spoke very highly of the care and attention provided by staff working at the home. This was also confirmed by a number of visiting relatives and other health and social care professionals, one district nurse and one social worker. Some recording of information in relation to risks to resident’s health and safety were not fully detailed. However others, in particular referring to risks to residents of developing pressure sores and risks of weight loss and malnutrition were generally very well written. It was also noted that where people has been identified as being at risk of losing weight or having problems with nutrition and appetite that these people were monitored regularly and had sustained no significant weight loss. Care notes maintained by District Nurses providing care for residents who had pressure sores / ulcers indicated that staff acted in accordance with the nurses plan of care. Some recording in daily care notes was very brief and did not accurately provide an account of the events of the day in respect of the individual. It has also been taken into account that at the time of this inspection that staff working at the home were in the process of introducing the new documentation used by Southern Cross Healthcare (who have recently taken over as providers from Ashbourne Healthcare). A further random inspection visit will be made to the home within 6 weeks of this inspection date so as to assess progress with way in which information as required by Care Homes Regulation is being recorded and reviewed in respect of the needs of the people living at the home. It was positive to note that the issues of concern as highlighted in the last inspection report regarding the safe and correct procedures for administering medicines had been fully addressed at the time of this inspection. Medication Administration Records (MAR) indicated that residents received their medicines at appropriate times and that staff informed resident’s general practitioners if residents refused medicines and treatment. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 14 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. There have been significant improvements in the way in which staff carry out their duties so as to improve the experiences for residents in relation to this outcome area. Staff generally encourage and support the people living at the home in making decisions about how they wish to live, including how they wish to spend leisure time and offer them the opportunity to fulfil these wishes. People living at the home receive a good choice of food and particular diets and preferences are catered for. Staff work hard to ensure that meals are provided in a congenial and suitable manner. EVIDENCE: It was not always clearly recorded in residents notes their preferences for how they would wish to spend their time, including leisure time and some records were not clear in respect of what activities had participated in and whether they had enjoyed the experience. The provision for social and leisure activities in Parkview had improved notably. The activities coordinator had a range of Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 15 planned activities so as to keep residents active, stimulated and occupied including movement to music, gentle exercise which residents appeared to enjoy. The activities coordinator for Parkview was spoken with and it was clear that the activities programme was flexible so as to fit in with the people living in the unit. The homes manager has purchased a range of games, books and a small pool table, which are readily available so as to prompt staff to encourage and assist residents in availing of opportunities for occupation and stimulation. The manager said that this has been very successful, however on the day of the inspection this room did not appear to be used. Residents did however make choices about the television programmes viewed and one resident was observed to spend time knitting, another making jigsaws, activities, which they clearly enjoyed. The home employs two activities coordinators for a total of 55 hours per week primarily between Monday and Friday. Both coordinators maintained detailed records pertaining to the range and frequency of activities provided. It was not clear that those people living at the home who were less capable of participating in group activities were well catered for. All of the residents and their relatives who were spoken with during the day of the inspection were generally complementary in their views about the home. Residents appeared to have control within reason in relation to how they spent their days. There were no restrictions on where residents spent their time, what time they got up and went to bed and where they chose to take their meals etc. Relatives said that they were always welcomed to the home. Two residents relatives who were spoken with commented about the positive impact moving into the home had made to the residents lives in terms of safety and improvement in general health and wellbeing. All of the residents who were spoken with made positive comments about the food provided by the home. The serving of breakfast, lunch and evening meal was observed. Residents were offered choices and catering staff were aware of particular likes and dislikes. Meals were observed to be served promptly and were well presented in good-sized portions. Condiments and sauces were readily available for those more able residents and provided according to wishes for other people. It was also positive to note that there was a range of beverages available at meal times and during the day including water and that residents had access to drinks with the provision of small tables in the lounge area. Staff were seen to assist and support residents at meal times according to the individuals specific needs. One resident was noted to have to wait for a significant length of time for her lunchtime meal due to an allocation error. It Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 16 was clear that this was an isolated incident and the homes manager apologised to the resident and made arrangements so as to prevent this happening again. One resident chooses to eat tinned spaghetti and potatoes or corned beef for each lunchtime meal. This is his expressed choice and he complains if there is any alteration. (Weight monitoring records indicate no weight loss as a result of this choice). Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents and relatives feel that complaints are dealt with in a satisfactory manner. Staff and management act in accordance with current legislation & guidelines so as to minimise the risk of harm and / or abuse to the people who live at the home. EVIDENCE: Chaplin Lodge has a clear and concise policy and procedure for dealing with complaints and concerns. There have been no complaints made directly to the Commission since the last inspection. There have been 11 complaints made to the home in the past twelve months. Of these 4 had been fully substantiated and the remaining 7 partially substantiated. None of these complaints had been of a serious nature. However a number of complaints were as a result of staff practices, in particular relating to items such as dentures an, hearing aids and spectacles being misplaced and lost. Records indicated that they had been investigated according to the homes policy and procedure. Three of the eight relatives who completed questionnaires said that they had cause to make complaint about the home. All indicated that they were happy with the way their complaints were received and dealt with. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 18 Staff working at the home receive training and relevant information in relation to the protection of vulnerable people. There have been 6 Adult Protection alerts raised at the home in the past 12 months. These have been dealt with appropriately by the homes manager who is very proactive in dealing with any issues in respect of protecting vulnerable people living at the home. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 19 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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Chaplin Lodge, while providing a homely and safe environment is in need of some redecoration and areas where unpleasant odours are persistent need to be dealt with more effectively. EVIDENCE: A number of relatives who responded to the survey questionnaire commented that some areas of the home could do with redecoration. Some walls and carpets looked scuffed and worn. However a number of bedrooms have been recently redecorated in and furnished nicely in accordance with the homes redecoration plan and the garden areas outside Parkview had been improved allowing residents to enjoy the area. New carpets had been ordered for some parts of the home. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 20 All of the equipment as required for the safe moving of residents such as wheelchairs and hoist equipment was noted to be in good working order and well maintained. The home employs dedicated domestic and cleaning staff and all areas were noted to be clean. With the exception two areas of the home there were no unpleasant odours detected. However in the two areas where odours were detected these were quite strong. The manager reported that new washable vinyl flooring had been ordered for one room so as to minimise the odour problem. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 21 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. Staff are recruited and selected to work in the home according to a robust and consistent process. Staff working practices are monitored and staffing levels are reviewed on a regular basis and all practicable measures are taken to ensure that the home is staffed according to the needs of the people living there. EVIDENCE: Staff duty rotas were well maintained. While these records indicated that a small number of staff regularly work up to 60 hours per week there was nothing to indicate at this time that this impacted adversely upon the care received by people living at the home. This will be monitored at future inspections. Two of the eight people who responded to the questionnaire sent out by the Commission commented that in their opinion that staffing levels were not always sufficient for the needs of the people living at the home. One complaint received by the home also referred to staff shortages. This element of the complaint had not been substantiated. None of the residents of their relatives who were spoken with said that they felt that there were not enough staff on duty and all commented positively about the care and attention that they Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 22 received. There was evidence that staffing levels are reviewed according to the needs of the people living at the home. On a number of occasions during the month prior to this inspection it was noted that the numbers of staff employed for night duty had dropped from 5 to 4. The manager said that this was due to the large number of beds vacant at this time and undertook to keep the Commission informed of any reductions in staff numbers and the reasons for this action. It is noted that the registered manager keeps the Commission informed of any instances where staffing levels drop due to sickness and staff absences, the actions that are taken to replace staff and / or minimise the impact upon residents when staff cover cannot be found. At the time of this inspection seven staff had National Vocational Qualification (NVQ) level 2 in care and a further ten staff were currently undertaking this training. A further 2 members of staff had NVQ level 3 training. The recruitment files for six members of staff who had been recruited to work at the home since the last inspection, were assessed. Overall there was evidence that staff were recruited in a consistent and robust manner so as to best protect the interests and welfare of the people living at the home. For one member of staff their employment history was not clear and this had not been explored fully. There was evidence that the necessary checks including obtaining satisfactory references from previous employers and that PoVA First and Criminal Records Bureau (CRB) disclosures had been obtained to assist in determining the suitability of people to work at the home. It was positive to note that where a reference in respect of one applicant had indicated poor work attendance, that a decision had been made to employ this person on a ‘bank’ basis so as to assess their commitment to working at the home. All staff had undergone an interview process so as to further determine their fitness and suitability to work at the home. The records maintained in relation to staff interviews could be more detailed giving indication/evidence in respect of decisions made to employ staff. There was evidence that staff receive regular training updates in respect of mandatory training including safe moving & handling, basic food hygiene, basic health & safety and training in relation to the protection of vulnerable people. There was also evidence of planned training to include care planning, continence and pressure area management and caring for people who have dementia. The records evidencing staff training could be better organised and this was discussed with the homes manager. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 23 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Chaplin Lodge is well managed and staff are aware of their roles and responsibilities and responsibilities in terms of meeting the needs and protecting the welfare of the people who live there. EVIDENCE: There was clear evidence that the management of the home had improved significantly since the last inspection. Staff, residents and visitors to the home spoke very highly of the manager and there appeared to be a good working team spirit. All of the residents, their relatives and other visiting professionals who were spoken with on the day of the inspection spoke highly about the homes staff Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 24 and management. Each of the eight relatives who responded to the survey sent out by the Commission said that overall they were happy with the care provided by the home. It is positive to note that 9 of the 14 requirements identified at the last inspection had been met at the time of this inspection, 1 was not assessed and improvements had been noted in the issues as identified in the remaining 4. People living at the home may retain control of their monies and are provided with lockable storage should they choose to do so. The home also provides a system for holding monies and valuables on behalf of residents. The records maintained in respect of monies received and any financial transactions such as expenditure for hairdressing etc were well maintained and accurate. The system for holding receipts could be better organised so as to better audit income and expenditure and advice was given during the inspection. There were no health and safety issues identified during the course of the inspection and all moving equipment was noted to be in good working order. Records indicated that regular checks were carried out in respect of the maintenance, repair and renewal of gas, electrical and mechanical equipment in the home. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 25 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X 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 2 X X 3 X X X 2 STAFFING Standard No Score 27 3 28 3 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 3 Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 26 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4&5 Requirement The registered persons must ensure that the information provided in relation to the homes service provision be kept up to date. Previous ‘Timescale for action date’ 30/03/06 requirement was not reviewed. This will be assessed at the next inspection. 2. OP3 14(1)(2) 30/07/06 The registered persons must ensure that people are only admitted to the home following a detailed assessment of the individuals care and safety needs and taking into consideration the needs of the people already living at the home and the homes resources it is determined that the home can meet each persons needs. (Previous timescale 30/03/06 following the last inspection has not been met.) 3. OP7 15(1)(2) The registered persons must DS0000018079.V293542.R01.S.doc Timescale for action 30/08/06 30/07/06 Version 5.1 Page 27 Chaplin Lodge ensure that information about residents needs is recorded clearly in the plan of care and that this information is kept up to date in accordance with any changes to care and treatment. (Previous timescale 30/03/06 following the last inspection has not been met.) The registered persons must 30/08/06 ensure that all areas of the home are maintained so far as it is possible free from unpleasant odours. (Previous timescale 30/03/06 following the last inspection has not been met.) 4 OP26 16(2)(k) 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 Where information in Comm 5 assessments conflicts with the findings of the homes assessment this should be clearly clarified so as to minimise confusion and ensure that residents needs are best met. Some more information should be included in assessments pertaining to risks posed to residents and daily care notes should clearly indicate how staff on a daily basis act so as to minimise these risks in accordance with the information contained in the risk assessment. It is recommended that wherever it is practicable that residents wishes in relation to end of life issues and preferred arrangements following death be obtained, recorded and kept under review. This standard was not fully assessed at the time of this inspection. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 28 2 OP8 3 OP11 4 5 6 7 OP12 OP27 OP30 OP35 Staff recording could evidence more the opportunities made available to people living at the home who are less able-bodied and residents responses and wishes. Staff should keep the Commission informed of any reductions in staff numbers and the reasons for this action. Records in respect of staff training and development could be better organised. Records and receipts in respect of resident’s monies could be better organised. Chaplin Lodge DS0000018079.V293542.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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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