Inspection on 01/11/05 for Chard Manor

This inspection was carried out on 1st November 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chard Manor 18/01/07

Chard Manor 31/01/06

Chard Manor 09/11/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Chard Manor Tatworth Road Chard Somerset TA20 2DP Lead Inspector Belinda Heginworth Unannounced Inspection 1st November 2005 09:30 Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 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 Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chard Manor Address Tatworth Road Chard Somerset TA20 2DP 01460 261016 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) Voyage Ltd Mr Gary Bush Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two places are permitted for named individuals aged between 16 and 17 years 9th November 2004 Date of last inspection Brief Description of the Service: Chard Manor Farm is an attractive listed building. The house has been purchased, renovated and refurbished by Voyage Ltd, to a high standard. It provides personal and supportive care for up to ten people with a learning disability age 18 – 65. The home no longer has anyone under the age of 18 years. The home is not far from the town centre, off the Axminster Road, close to the Church. It is accessed by a private drive, shared by other properties nearby. It is surrounded by gardens that are partitioned to provide two separate enclosed, safe areas and other, more open garden facilities. There are ten single rooms, all with en-suite baths. Some rooms have also been fitted with shower facilities. There are two spacious living rooms, a large sunroom and a dining room next to the kitchen. The home also has en-suite facilities for staff on sleep-in duties. Eight of the ten rooms are occupied at present. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector would like to thank the staff and residents for the warm welcome and help throughout the inspection. This unannounced inspection took place over three and a half hours with the deputy manager being present throughout the inspection. Chard Manor currently has 8 residents living in the home. Many of the residents have limited verbal communication skills. Although seven residents were seen and consulted, not all were able to express an understanding or full opinion about life at the home. However all residents seemed happy and the relationships between staff and residents appeared good. Five staff were consulted and their views on the home and practices were discussed. The inspector looked around parts of the home and some records were inspected. The manager completed a questionnaire prior to the inspection. This along with written feedback from some relatives and residents provided additional evidence of how the home is run. What the service does well: What has improved since the last inspection? Medication records have improved. The home now informs the CSCI of any incidents that happen. Safety checks are completed regularly and recorded. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 6 Staff supervision has improved. 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. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Residents benefit from good admission and assessment practices, which ensure that the home is able to meet their needs. EVIDENCE: Not all residents spoken with were able to remember the assessment process prior to their admission, although some remembered visiting the home. A detailed assessment of need is completed to ensure the home is able to meet that person’s needs prior to admission. Care management assessments are also completed. Residents are admitted to the home on a trial basis before making a decision to live there. Residents are given a contract or statement of terms and conditions on admission. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Care plans and risk assessments provide staff with the information they require to meet residents’ needs safely. Some improvements are needed to the information in some risk assessments. Some improvements are needed in relation to decision-making arrangements. This is particularly important given that some residents have limited capacity to contribute to plans and decisions. EVIDENCE: Many residents have limited communication skills and have a limited understanding of care plans and are therefore unable to easily contribute to their formulation or reviews. It was clear through observations made that the staff team work hard to meet residents’ needs. Care staff demonstrated a good knowledge and understanding of the care plans and any associated risks. However, some wording in the risk assessments should be changed to make them clear and easier to understand. For example one risk assessment said, “provide an auditable and secure means of assisting, when managing money”. The meaning of this might be confusing to new staff. Another example said “if unwilling to cooperate, ask to service user to spend time in bedroom”. There Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 10 was no alternative offered as guidance if the service user did not go to their room. Care plans provide good information about residents’ needs but additional information is needed in relation to decision-making on behalf of residents. For example, many of the doors in the home are locked; this includes the front door. The kitchen door has a stable door. The bottom half of the door is kept locked by a bolt, which means some residents are unable to access it if they chose. The home has two large lounges but one is kept locked. Music equipment, a vacuum cleaner and a wheelchair were kept in the room on the day of the inspection. Staff said the reason the door was kept locked was because some residents might use some musical instruments to hit people with. The room is only used when the music therapist visits once a week. Apart from the issue of residents having restricted access, the staff should consider how the room could be better arranged to make it safe for residents to use at all times. Due to some complex behaviours of some residents it could be unsafe to have some of the doors unlocked; for example, the front door. The staff team want to ensure they meet their responsibilities under their duty of care by keeping residents safe. However, the decision to carry out these “restrictive practices” has not been discussed and agreed within a multidisciplinary setting. Individual care plans; risk assessments or the home’s Statement of Purpose and Service User Guide do not reflect the reasons for any restrictions or who was involved in the decisions. Discussions took place about how general decisions are made about the running of the home. For example, who decided to have the main meal at lunchtime? This is a normal practice in the home. A staff member said there would not be enough time to complete work and cook and evening meal before the day shift ended at 8.30pm. (See section 30 – 36) Most residents did not seem to mind when they had the main meal, although it was difficult to establish if it was a routine they were used to rather than a preference. A fairly new resident had been used to having their main meal in the evening prior to coming to live at the home. The assessment process had not asked if they minded the change. Residents’ meetings do not take place at the moment. Staff said they discuss care related issues with individuals. Residents have a “key worker” who is responsible for co-ordinating the resident’s care and for completing monthly summaries of care plans and general care. This helps to monitor residents’ needs. Daily records were not inspected on this occasion. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 16 Links with the community are good and staff support residents’ social and educational opportunities during the day. The home needs to improve such opportunities in the evenings. Improvements are needed to residents’ access to parts of the home and the gardens. EVIDENCE: Residents use the local and surrounding facilities for swimming, horse riding, shopping and walks. The home employs a music therapist to come to the home for sessions with the residents. The majority of activities take place during the day apart from planned evening activities. For example, staff took residents to the local carnival recently. However, because the day shift ends at 8.30pm when three night staff start duty, residents do not have the opportunity to go out on unplanned evening activities. One resident said they would like more opportunities to go out in the evening. The majority of residents require a minimum of two staff when out of the house, therefore after 8.30pm there is not enough staff on duty. A review of the rota system has been recommended. (See section 31 – 36) Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 12 During the last inspection it was highlighted that the use of the “digit–pad” locks should be reviewed to find locks that are more suitable for the needs of the residents and promotes independence. Most bedrooms doors are kept unlocked so residents are able to access their bedrooms at all times. However, the rooms would have to be locked by staff if residents entered each other’s rooms. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17, 18, 19 & 20 Residents benefit by receiving personal support in the way they prefer. Residents’ health needs are well met. Residents benefit from a varied and healthy diet. EVIDENCE: Residents said that staff were kind, caring and respectful. It was clear through observations that relationships between residents and staff are good. Personal care and support is provided by staff. Care plans describe preferences, likes and dislikes. Staff demonstrated a good knowledge and understanding of the information in the care plans. Health needs are well met. Good records are kept and key workers monitor health needs regularly. Medication is supplied through a monitored dosage system. Accurate records are kept of all transactions. Residents said they enjoyed the food in the home and said alternatives are provided if they do not like the food on offer. Menus show healthy and varied foods are offered. Main meals are served at lunchtime. (See section 6 – 10) Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Residents are protected from abuse, neglect and self-harm. EVIDENCE: Residents who were able said that they felt safe living at the home. They said that staff treated them with respect and kindness. The inspector was told that all staff have received training in the Protection of Vulnerable Adults. Staff knew what to do if they suspected any kind of abuse. Relevant policies and procedures relating to abuse are in place. Residents’ monies were not inspected on this occasion. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Residents benefit from a homely, safe, clean and comfortable environment. EVIDENCE: The house is decorated and furnished to a high standard, creating a homely atmosphere. Residents have single bedrooms with en-suite facilities. Residents said they personalised their rooms to their preferences and tastes. There are two large lounges (See section 6 – 10), a dining room, kitchen and sun room. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35 & 36 Residents benefit from a competent and effective team of staff. Some improvements are needed in relation to meeting residents’ social needs in the evenings. EVIDENCE: Staff receive support and supervision on a regular basis. They receive an in depth induction training linked to the Learning Disability Award (LDAF). In addition staff attend courses such as epilepsy awareness, communication skills, abuse awareness and many more. The training helps to ensure that residents are protected by suitably trained staff. (NVQ training was not inspected on this occasion) Staffing arrangements during the day appear to meet the needs of the residents. Wide and varied activities take place, in and out of the home, because there is a good ratio of staff. The current shift pattern does not take into account residents’ social needs in the evening. Day shifts end at 8.30pm when three staff take over for the night shift. Due to the complex needs of the residents, unplanned social and leisure pursuits cannot be provided outside of the home with three staff. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Residents’ health, safety and welfare are well protected. EVIDENCE: The registered manager completes a questionnaire prior to the inspection. The questionnaire provides information about staff and residents. It also describes policies and procedures that the home has and includes dates of when they were reviewed. The policies ensure residents’ safety and welfare are well protected. The fire logbook was found to be up to date and included regular fire training and evacuation drills. Fire risk assessments were not inspected on this occasion. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 2 17 Standard No 31 32 33 34 35 36 Score X X 3 4 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chard Manor Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000060801.V261025.R01.S.doc Version 5.0 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard YA7 Good Practice Recommendations Residents rights to make decisions is limited only through the assessment process, involving the resident and as recorded in the individual residents care plan. Any decisions made by others should be recorded, including the reasons why and involving a mulitidisciplinary approach. (This refers to the lack of residents’ meetings, the locks on doors making some areas inaccessible to residents and times of main meals). Some of the wording in some risk assessments should be clearer to make it easier to understand. The locking systems within the home should be reviewed to ensure wherever possible residents have unrestricted access to all parts of the home. This should be part of care plans and risk assessment. (See also recommendation number one) 2 3 YA9 YA16 Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 20 4 YA33 The registered person should review staffing shifts to ensure the home is able to meet social needs at all times of the day and evening. Chard Manor DS0000060801.V261025.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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