Inspection on 22/11/06 for Charing Court

This inspection was carried out on 22nd November 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 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

Charing Court 14/12/05

Charing Court 20/07/05

Charing Court 29/09/04

Charing Court 11/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Charing Court Pluckley Road Charing Ashford Kent TN27 0AQ Lead Inspector Wendy Jones Unannounced Inspection 22 November 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Charing Court Address Pluckley Road Charing Ashford Kent TN27 0AQ 01233 712491 01233 712776 amanda.demezieres@tesco.net 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) Songbird Hearing Limited Mrs Amanda Ruth De Mezieres Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents under the age of 65 to be restricted to one whose DOB is 25/02/1944. 14th December 2005 Date of last inspection Brief Description of the Service: Charing Court is a Residential Care Home registered to provide accommodation, care and support for up to 33 adults over 65 years of age. The extended Victorian property is located on the edge of the village of Charing, 6 miles from Ashford town. The main line railway station is a 5minute walk away and local amenities and public transport are also nearby. There is parking for several vehicles to the side and rear of the building. The statement of purpose gives information about the home and the service provided there. A copy can be obtained from the home. The most recent inspection report is on display and can be seen in the home. Currently the scale of fees is between £317 and £395 per week. Hairdressing, chiropodist, newspapers and toiletries are at an additional charge. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of time and concluded with a site visit to the home between 11:00am and 3:30pm on 22 November 2006. A range of evidence has been used to inform this report and judgements have been made based on this evidence. Evidence used includes, concerns, complaints, allegations and other information received, reports of incidents and deaths that have occurred in the home since the last inspection, a tour of the home, inspection of some records, comments received from residents, their relatives, care managers, doctors and other healthcare professionals and discussion with the manager, residents and staff. What the service does well: What has improved since the last inspection? Staffing levels have been increased and are now higher than the level recommended by the residential forum. Time for activities is incorporated in these new levels and is provided on a regular basis by an activities person. Actions required from the Pharmacy Inspector’s visit have been carried out. The home now uses two drugs trolleys. One is kept on the ground and one on the first floor. The medication fridge has a lock on it and training records show that staff have received appropriate training. The OPUS model of assessment will be used to assess the staff’s competency in this area. All radiators throughout the home have been fitted with guards to remove the risk of burning if residents fall against them. Chemicals are no longer decanted into unmarked spray bottles so that staff can be sure what they are using and that they are being used safely. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 6 The freestanding support frames that were in place over some toilet seats at the last inspection have been removed. There are now bars fixed to the wall behind the toilets that can be pulled down for use when needed. 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. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ needs are assessed and they can make sure these will be met before they move into the home. EVIDENCE: Care plans contained an assessment of the resident’s needs that the manager had carried out before they moved into the home. Other assessments from their care manager and other healthcare professionals had also been used to identify their needs and goals. Risks for the resident had also been identified. Individual, specific assessments showing the actions to be taken to minimise or remove these risks were in residents’ care plans. Charing Court does not provide intermediate care. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 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 the following standard(s): 7 - 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents’ general health and personal care needs are met. EVIDENCE: Care plans clearly show the needs and goals of the residents and how staff are to help them to achieve these. Risk assessments are in place. These are comprehensive and individual to each resident. They show the risk that has been identified, what needs to happen to reduce or remove the risk and the outcome that is expected from putting this in place. Care plans are reviewed regularly and daily detailed records are being kept. Care plans contained detailed records of when the resident had seen their doctor, or district nurse and of optician, dentist etc appointments. An Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 10 arrangement has been made with the local GP surgery for a doctor to visit the home every Wednesday afternoon and the doctor arrived during the site visit. The manager said that this arrangement is working well. It gives residents the opportunity to speak to the doctor if they need to. Medication was being stored appropriately and medication administration records were up-to-date and accurate. Actions required from the Pharmacy Inspector’s visit had been carried out. The home now uses two drugs trolleys. One is kept on the ground and one on the first floor. The medication fridge has a lock on it and training records showed that staff have received appropriate training. Only senior staff are responsible for administering medication. Senior staff spoken with said they felt confident that they have the knowledge and skills they need to deal with residents’ medication safely. The manager has decided to use the OPUS model of assessment to assess the staff’s competency in this area. At the time of this inspection no residents were having medication that required the staff to be trained in specialist techniques. However, the manager confirmed that should this be needed staff would be trained and assessed by a nurse. Comments received from a GP surveyed before the site visit stated that they have clear communication with the staff in the home. Staff work in partnership with them. They felt that medication is managed appropriately and appropriate decisions are made when the home can no longer manage a resident’s needs. Overall they were satisfied with the care provided at Charing Court. Staff were helpful, patient and caring and had a good rapport with the residents. Residents who completed surveys prior to the site visit said they receive the care, support and medical support they need, that staff listen and act on what they say and are available when they need them. One resident commented, “the staff are all very nice and helpful to me”. A relative spoken with said, “I cannot fault the home”. They were very happy with the care provided and felt it was “over and above what you would normally expect”. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 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 the following standard(s): 12 - 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The daily routines and activities provided meet residents’ needs and are flexible. Residents keep in contact with their family and friends. EVIDENCE: A member of staff now has dedicated hours for providing activities for the residents. These include bingo, quizzes, watercolour painting, entertainers, church services, a library book service and a video/DVD service. Residents spoken with said they like to join in the activities. One said that they had been on painting holidays in the past. They and another resident had asked for watercolour painting to be provided and this has been done. Throughout the site visit relatives and friends came to visit residents. Copies of menus were seen. These had been planned with the residents and included a range of choices including Indian. Chinese, and Italian dishes that residents had asked to be added to the menu. The manager explained that if a Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 12 resident wanted something other than the main choice they could choose an alternative. Residents who completed surveys prior to the site visit and residents spoken with said they enjoyed the food and could have the portion size they wanted. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents’ and their relatives’ complaints are taken seriously and investigated. Residents are safeguarded from abuse. EVIDENCE: Information received before the site visit stated that there had been three complaints received by the home since the last inspection. These had all been investigated within the 28-day timescale and feedback had been given to complainants. The complaints procedure is on display in the entrance hall. It gives details of how to complain, timescales for investigating any complaint and details of how to contact the Commission. Training records showed that staff have attended training in the protection of vulnerable adults. Staff were clear about what to do if they suspected abuse. Action taken following a recent adult protection alert for a resident showed that the alert had been taken seriously and dealt appropriately. This resident and all others in the home had been protected. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 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 the following standard(s): 19 – 21 and 23 - 26 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and comfortable home with private and communal rooms that meet their needs. EVIDENCE: All areas of the building were pleasantly decorated and well maintained. home was clean and there were no unpleasant odours. The Residents’ rooms are attractively decorated, are individual to them and meet their needs and tastes. They have their own personal items including photos, pictures, televisions etc. Some have en suite facilities. There are a number of communal bathrooms and toilets around the home. Free standing support frames over toilet seats have been replaced with handles that are fixed to the wall behind the toilet. Residents can use these more safely. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 15 Plans to extend the home have been agreed by the local authority and work is due to start in March 2007. The extension will include extending the dining room to provide enough room for residents to eat there comfortably. A new kitchen and laundry will be provided. There will be four extra single en suite rooms provided as part of this work. Application will be made to the Commission for an increase in numbers from 33 to 37. Although sluice facilities are provided, these do not have impermeable floor coverings and wall finishes that are easily cleaned. These need to be replaced to be sure hygiene levels can be maintained to protect residents against the spread of infection. Despite this, the infection control procedures followed in the home are thorough. Residents are protected from the spread of infection. The sluice rooms will be updated and improved as part of the extension works. There are two large lounges and several other seating areas around the home for residents and their visitors to use. Staff are using the conservatory as a staff room at present. However, a new staff room will be provided when the extension works are complete. A decking area has been fitted outside the conservatory. The maintenance person was making a concrete ramp from this area to the path at the front of the home for residents who use wheelchairs to use. The kitchen was clean and contained appropriate equipment for the cooks to use. There was a commercial size fridge and freezer for storing food. The laundry is large enough to deal with clean and dirty laundry separately. There are two industrial washers and driers. This room is in the basement of the home. The floor covering is not appropriate and, as with the sluice rooms, needs to be replaced to be sure hygiene levels can be maintained to protect residents against the spread of infection. A new laundry is to be provided when the extension is complete. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s recruitment procedure. They are supported by staff who have the skills to meet their needs. EVIDENCE: At the time of the site visit there were 33 residents living in the home. The manager, five care staff (including a senior), a cook, a laundry assistant, a domestic and the maintenance person were on duty. This was clearly enough staff to meet the needs of the residents in the home at this time. The manager advised that staffing levels had increased since staffing information was sent to the Commission in July 2006. There are now five care staff on duty each morning and afternoon and two waking care workers every night. She also confirmed that one member of staff on each shift is a senior. In addition to this there is now one member of staff who is dedicated to arranging activities for the residents to take part in. Currently 20 care staff work in the home. Six of these have achieved an NVQ in care. A further five are undertaking an NVQ in care at the present time. This means that just over 50 per cent of the care staff are trained to NVQ level 2 or equivalent. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 17 Files were seen for three members of staff. One had been recruited in recent months. All relevant checks and documentation including CRB and POVA first checks had been obtained. All staff follow an induction course when they first start. Completed records showing when they had done this and an assessment of their competence in each area was seen. Information received prior to the site visit showed that staff had attended training in a number of subjects since the last inspection. These included first aid, moving and handling, health and safety, medication, fire, POVA, mental health, adult protection, continence care, risk assessment, food hygiene and diabetes. Staff said they have been able to attend the training they need to be confident they can care for residents well and meet their needs. Staff files contained details of the training staff had attended, the dates and certificates. Further training planned for November was displayed in the staff area. Courses in infection control, manual handling and food hygiene were planned for November 2006. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 18 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 and 35 - 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-managed home that is run in their best interests and safeguards their rights. EVIDENCE: The manager has been managing the home for a number of years. She has relevant qualifications, has achieved the Registered Managers Award and has kept her skills and knowledge up to date in the management of care. The manager has an “open door” policy and likes to work “on the floor” in addition to the care staff on duty so that she is available for residents and their Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 19 visitors to speak to. It also helps her to keep an overview of how things are going. The atmosphere in the home was calm and unhurried. Visitors were made to feel welcome and there was a good relationship between the manager, staff and residents. One resident thought the staff were “wonderful”. A relative of a resident said “the home is fantastic”, “the staff are really good”. Quality assurance surveys are carried out once a year to get the views of residents and their families about the home. The manager explained that two surveys had, in fact, been carried out this year. One was a normal quality assurance survey and the other a survey for residents to give their meal preferences when the winter menu was being put together. From the results sample menus were put together. Residents then tried the meals and let the cooks know what they thought of them. A 4-week menu has been agreed and is now in place. Information received before the site visit indicated that the home does not act as appointee for any residents. Small amounts of money are kept for some residents. Records are kept of how much is spent, on what and receipts. The audit trail for tracking payments for goods that were part of one receipt for several residents, e.g. chiropodist and newspaper bills, were not easy to follow. Copies of the receipts are kept in the back of the file, but these did not clearly identify which residents had paid what. This system should be improved so that the payment on the residents’ finance sheets can be easily tracked back to the receipt. The balance of cash showing on residents’ finance sheets was checked against the money held for two residents. These tallied. Each resident’s money is kept separately and securely. Supervision records were seen in staff files. These showed that staff are supervised regularly. Staff files and residents care plans are kept in locked cabinets. However, daily notes for each resident, which also contained a copy of their care plans, were kept on an open shelf. The area this was in was not locked and so these records were not secure. The manager said that she would change this arrangement and the files would be kept locked away when staff were not using them. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 20 Information received prior to the site visit showed that all relevant maintenance and checks have been done and are up to date. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 3 3 X 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 3 2 3 Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP26 Regulation 13(3) Requirement Suitable arrangements must be made to prevent infection, toxic conditions and the spread of infection at the care home. Both sluice rooms and the laundry must have impermeable floor coverings and wall finishes that are easily cleaned to maintain adequate levels of hygiene and prevent the spread of infection and communicable diseases. Extension plans that include refurbishment of sluice areas and the provision of a new laundry must be completed within the timescale planned for completion of the extension. This requirement is carried forward, in part, from previous inspection reports dated 20 July 2005 and 14 December 2005. 2. OP37.3 17(1) (b) Records in respect of residents must be kept securely and confidentially. Daily records DS0000043997.V302379.R01.S.doc Timescale for action 31/08/07 23/11/06 Charing Court Version 5.2 Page 23 must be kept securely and locked away when not in use. 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 OP35.3 Good Practice Recommendations A more robust audit trail should be implemented that links individual residents’ payments to joint receipts. Charing Court DS0000043997.V302379.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Place Maidstone Kent ME16 9NT 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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