Inspection on 09/09/05 for Chaplin Lodge

This inspection was carried out on 9th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Chaplin Lodge 07/05/08

Chaplin Lodge 14/05/07

Chaplin Lodge 22/05/06

Chaplin Lodge 07/02/06

Chaplin Lodge 08/02/05

Chaplin Lodge 24/06/04

Chaplin Lodge 04/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Chaplin Lodge Nevendon Road Wickford Essex SS12 0QH Lead Inspector Carolyn Delaney Un-announced 9 September 2005 th 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 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 I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chaplin Lodge Address Nevendon Road Wickford Essex SS12 0QH 01268 733699 01268 570602 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashbourne (Eton) Limited Vacant CRH 66 Category(ies) of DE Dementia 18, OP Old Age 66 registration, with number of places Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2005. Brief Description of the Service: Chaplin Lodge is registered with the Commission for Social Care Inspection to provide personal care and accommodation for up to a maximum of sixty-six older people. Chaplin Lodge can provide care for up to eighteen people who have a diagnosis of Dementia in a unit called Park View. The home is situated in a mainly residential area close to Wickford town centre. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on 9th September 2005 by Inspector Sarah Axam and Lead Inspector Carolyn Delaney. The inspection took place between the hours of 12.30 and 16.45. Information about the residents who live at the home, such as assessment documents and care plans were sampled and examined and seven residents were spoken with. Records in respect of the recruitment, training and supervision of staff who work at the home were sampled and examined and four members of staff were spoken with. The serving of the lunchtime meal was observed. Records in respect of the receipt, administration and storage of medicines were examined. A brief tour of the premises was carried out. What the service does well: Chaplin Lodge provides a comfortable place for older people who require assistance with aspects of daily living. Staff working at the home were seen to interact well with the people who live at the home and relatives said that they were made to feel welcomed when they visited. There is a programme of activities, which meets the needs of the more able residents and activities coordinators support those who can to access activities outside of the home, such as shopping and eating out. Staff act in a manner so as to ensure that residents living at the home are treated with respect and their dignity and privacy is promoted. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 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 standard(s) 3 Records did not evidence that residents needs were consistently assessed prior to their moving into the home, so as to determine that taking into account the needs of other people living at the home and the available resources, including staffing, that the home can meet these needs. EVIDENCE: The records for one resident who had moved into the home one week prior to this inspection were incomplete. There was no available evidence that a preadmission assessment had been carried out prior to the person being offered a place at the home. There was also no evidence that an assessment had been carried out upon this person’s admission to the home. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7,8, 9 &10 Information in respect of residents needs was generally very detailed and kept up to date so as to ensure that staff are aware of each persons needs and any changes to these needs. Assessments in respect of assessing and managing risks to residents such as risks of falls, developing pressure sores etc lack detail in respect of level of risk and how these are to be managed. Records in respect of the receipt, administration, storage and disposal of medicines were well maintained, however staff do not always make every effort to ensure that residents receive the medication, which has been prescribed for them. Staff act in a manner so as to ensure that residents living at the home are treated with respect and their dignity and privacy is promoted. EVIDENCE: Care plans were well written and updated by staff on a regular basis according to when resident’s needs changed. Some care plans did not include the reason Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 10 for example why some residents were to spend all day in bed or the reason why they were given pureed meals. For other residents the reason such as personal preferences or medical condition was clearly recorded. The format used by Ashbourne homes in respect of assessing risks to residents and determining how these risks are to be managed All staff who administer medication receive training. One resident living at the home at the time of this inspection had been refusing to take medication and staff had discussed this with the resident’s family and general practitioner and had permission to crush medicines and some liquid medicines had been obtained. One the day of the inspection it was noted that one resident did not have their medication for the morning. When questioned staff said that this was not given as the resident left the home early that morning g to attend a day club which they did on a weekly basis. There was no evidence that this resident was offered their medication Prior to them leaving the home. Staff were advised that all efforts must be made so as to ensure that all residents living at the home receive the medicines, which have been prescribed for them. Residents and their relatives who were spoken with during this inspection confirmed that staff acted appropriately and maintained resident’s privacy and dignity. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12 & 15 The provision of stimulating and meaningful activities is not consistently suited to the needs of all of the people living at the home. Residents of the home are offered a varied menu, which meets their assessed needs. EVIDENCE: The home employs two activities coordinators to provide a range of activities for the people who live in the home. Some residents who were spoken with said that they were happy with the activities provided by the home. A number of them went out to local restaurants for lunch on occasions. The activities coordinator was advised that where residents were taken out for meals which they would normally have as part of the service provided by the home that these meals must be paid for by the home. While staff were noted to interact well with the residents who have dementia living on Park View unit, there appeared to be little in the way of planned meaningful activities for this resident group. The activities coordinator commented that care staff could be more involved in providing activities in her absence, and that they could do more so as to maximise the time spent providing actual activities input for residents as she Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 12 said some of the time was spent assisting residents to the area where planned activities were to be carried out etc. The serving of the lunchtime meal was observed. There were alternatives to the planned menu offered to residents and those spoken with said that they were happy with the food provided by the home. It was noted that residents were only offered one type of juice at lunchtime and were not offered a choice including water. There was no choice of hot beverage, only tea, offered during the afternoon. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 18 Service users have not always been protected from abuse, however staff report any incidents promptly and appropriate action is taken in the event of allegations or witnessed abuse of people living at the home. EVIDENCE: Staff who were spoken with during the inspection could demonstrate that they were aware of the action to take in the event that they witnessed or suspected abuse of people living at the home. There were no records to evidence that all staff had received training in respect of the protection of vulnerable people. On two separate occasions monies went missing from residents bedrooms. Staff acted promptly to report this and acted upon the wishes of the residents in respect of the actions taken. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 0 Standards in respect of the homes environment were not assessed on this occasion and will be assessed at the next inspection. No health and safety issues or concerns were identified on the day of the inspection. EVIDENCE: Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The current practices in respect of staff working hours at the home may affect the quality of care provided to the people who live there. Staff are not consistently recruited robustly so as to ensure to protect the interests and welfare of the people living at the home. There was no evidence that all staff working at the home have been trained in respect of meeting the needs of the people who live there. EVIDENCE: Staff duty rotas indicated that some staff were regularly working in excess of sixty hours per week, which could potentially affect the care received by the people living at the home. The acting manager said that she intended to review staff working practices and to reduce hours where appropriate. Recruitment files did not evidence that the appropriate checks including checking applicants previous employment history, validating references and obtaining Criminal Records Bureau (CRB) disclosures were consistently carried out prior to employing staff to work at the home. For example PoVA First / CRB disclosures were obtained after staff had been employed and some references had been accepted from people who were not the applicants previous employer. Staff training files were disorganised and the acting manager said that she had carried out a training needs audit and was intending to develop a plan so as to Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 16 address training shortfalls, ensuring initially that all staff were up to date with their mandatory training. Staff induction files were not available for inspection. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, & 35 There have been some management issues at the home since the previous registered manager left the home. These had affected the quality of service provided to residents, however the new registered manager for the home was now addressing these issues. Staff and management working at the home have not consistently ensured that the financial interests are protected. EVIDENCE: At the time of this inspection a care manager from one of the other Ashbourne homes had been employed to act as manager following the departure of the registered manager. Since the previous manager had left there have been a number of issues in respect of the day-to-day management of the home and both staff and residents who were spoken with commented that there had been an ‘unsettled Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 18 period’ but that things had improved with the employment of the acting manager. At the time of writing this report, a registered manager from another Ashbourne home had taken up the permanent post as registered manager. There have been two incidents where resident’s monies went missing from their bedrooms. These residents were compensated for their loss and provided with lockable storage facilities for valuables. During a brief tour of the premises there were no health and safety issues identified. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 1 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 2 28 x 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 3 x x 2 x x x Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1) (2) Requirement The registered persons must ensure that people are only offered a place at the home following a detailed assessment of their care needs, and taking into account the needs of the people already living at the home and staffing resourses, it is determined that the home can meet these needs. The registered perons must ensure that so far as it is practicable that all risks to the health and welfare of people living at the home are fully assessed and managed. This with particular reference to assessing risks of falls and developing pressure sores. The registered persons must ensure staff working at the home make all practicable efforts so as to ensure that residents receive the medication for which they have been prescribed. The registered persons must ensure that the range of activities provided for people living at the home are suited to the individuals needs and wishes. Timescale for action Immediate & ongoing 2. OP7 OP8 13(4) 30/12/05 3. OP9 13(2) Immediate & ongoing 4. OP12 16(2) 30/12/05 Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 21 5. OP18 13(6) 6. OP27 18 7. OP29 19 & schedule 2 8. OP30 18(1) (c) 9. OP35 16(2) (l) The registered persons must ensure that so far as it is practicable that people living at the home are protected from abuse. The registered person must ensure that staff working at the home are not working excessive hours, so as to ensure the welfare and safety of residents are protected. The registered persons must ensure that all appropriate checks in respect of each applicants fitness to work have been carried out prior staff commencing work at the home. The registered persons must ensure that all staff working at the home receive training in respect of meeting the needs of the people who live there. The registered persons must ensure that so far as it is practicable that residents are provided with a safe place to keep their monies and valuables are kept safe. Immediate & ongoing Immediate & ongoing Immediate & ongoing Immediate & ongoing Immediate & ongoing 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 OP15 Good Practice Recommendations It is recommended that a choice of hot and cold beverages are made available at meal and other times. Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on sea 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. Extracts may not be used or reproduced without the express permission of CSCI Chaplin Lodge I06-I56 S18079 Chaplin Lodge V240856 090905 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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