Inspection on 31/08/05 for Charlton House

This inspection was carried out on 31st August 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

Charlton House 09/02/06

Charlton House 29/03/05

Charlton House 03/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Charlton House 85 High Street Wickwar South Glos GL12 8NP Lead Inspector Chris Lewis Unannounced 31 August 2005 09:30 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. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Charlton House Address 85 High Street Wickwar South Glos GL12 8NP 01454 294167 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) Mr John Anthony Addle Mrs Teresa Addle PC Care home 5 Category(ies) of OP Old age (5) registration, with number of places Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 5 persons aged 65 years and over requiring personal care only. Date of last inspection 29-March-2005 Brief Description of the Service: Charlton House is a small privately owned residential care home situated on the High Street in the village of Wickwar. It can cater for up to five elderly residents. The house was built in 1821 and has been refurbished to a high standard. There are three single rooms and one double, a well-furnished lounge and dining room and a large kitchen. There is a large and attractive rear garden with lawns, flower beds and a fishpond. The owners live on the third floor of the house which is situated close to several small shops in the village. Large shopping areas are available several miles away in Chipping Sodbury or Yate. The Home is close to the bus route for Chipping Sodbury, Yate, Bristol and Wooton-under-Edge. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an unannounced visit to Charlton House by Christopher Lewis, Locum Regulatory Inspector. On the day of the inspection, the Inspector met the two residents at present living in the Home and a visitor. Comments they made about the Home were extremely positive and included “it’s just like being in your own home”. Also spoken with at length was the Manager and staff. Staff were also observed going about their duties. All residents’ bedrooms were seen, as were the gardens. All care records were also viewed, as were the home’s policies and procedures. What the service does well: What has improved since the last inspection? What they could do better: The Home has two residents at present, which makes it straightforward for someone of Mrs Addle’s experience to provide excellent care to suit their individual needs. However, the written care plans for one of those residents in particular were somewhat sketchy and need to be clearer to ensure that residents continue to receive good care especially should Mrs Addle be absent for any significant period of time. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 6 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. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 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 Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 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) 1, 2, 3, 4 and 5. Charlton House provides information necessary to help prospective residents decide whether the Home would be right for them. Residents have clear contracts and terms and conditions. The Home is able to meet the assessed needs of residents, who express a high degree of satisfaction with the care they receive. People are encouraged to try out the services on offer before making any commitment. EVIDENCE: The Inspector viewed a copy of the Home’s Statement of Purpose and a brochure the Home produces which acts as a User’s Guide. The Statement of Purpose outlines for prospective residents the facilities that are available at the Home. It also contains information on how to make a complaint about service should this be necessary, the Home’s policy with visitors, equal opportunities and so on. The colour brochure sets out in summary the Home’s aims and the level of support a resident may expect. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 9 The terms and conditions which are made available to residents on admission were seen and were very clear and straightforward. The Home is a member of the Avon Registered Care Homes Association. The assessed needs of residents are easily met in such a small home. Evidence was seen of the involvement of local district nurses and GPs. Mrs Addle, as a trained nurse with a great deal of experience of caring for older people, is well able to evaluate the care individual’s need and deliver that care. The staff team spoken with by the Inspector also demonstrated a considerate attitude towards residents and a knowledge of how their needs could be satisfied. Discussions with the Manager and an examination of files gave evidence that relatives had been involved in admissions. A month’s trial period (on both sides) is usually undertaken to make sure that all are happy with arrangements – particularly important with a small community such as Charlton House. Mrs Addle emphasised that some residents and relatives find that they do not care for the intimate nature of the home and prefer the anonymity of a larger concern. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Individual care plans are completed in a relatively satisfactory fashion but one was sketchy and needs to be more clearly reviewed. Procedures for the storing, recording and the use of medication was in order. Access to health care is maintained and residents are treated respectfully. EVIDENCE: The care plans for the two residents of Charlton House were examined – each plan is prefaced with a profile information sheet which gives particulars of such matters as date of birth, date of admission and relatives. Each plan is then detailed in its description of the medical conditions and the appropriate level of support that individual residents require. The plan for a resident who has lived in the Home for some time was clear and had been reviewed regularly. With a more recently admitted resident, the plan was more sketchy and the recording needs to be tighter. The Inspector agreed with Mrs Addle that, with only two residents, her personal knowledge of those two individuals will, of course, be great. However, it will be a requirement that all written action plans for residents are completed and reviewed thoroughly. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 11 It was evident from discussions with Mrs Addle and her staff that the individual health care support of residents is good. All residents are registered with a local GP who visits the Home should this be necessary. Care records confirmed that primary health care needs are met through appointments with opticians, chiropodists etc. No resident is in need of pressure area care at the moment, though Mrs Addle remains mindful that one resident may do so in the near future. Mrs Addle stated that the Home aims to hold on to residents whose health may deteriorate for as long as possible before considering alternatives. At present, no resident self-medicates and Mrs Addle administers all medication. She has sought training for staff in medication but this has proved difficult to organise. The majority of medication is dispensed through a blister pack system. Medication administration sheets were looked at and appeared to be accurate. A medication policy is in place, which includes procedures in the event of drug errors. Medicines are kept in a locked cupboard, no controlled drugs are at present in use at the Home. Systems are in place for the return of unused drugs to the pharmacist. A record of the temperature in the drug cupboard is kept. The two residents and a friend of one who was visiting were spoken with; they all spoke very highly of Charlton House. One described it as “just like home really” and there were no complaints, with residents saying they were well looked after. Staff were seen to speak to residents in a respectful and friendly manner. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. Routines at the Home are flexible and friends are encouraged to visit. Catering at the Home is very good. EVIDENCE: Relatives told the Inspector that they could use their time as they wished, coming and going at they pleased. Mrs Addle emphasised the relaxed style of living that a small home such as Charlton Home could offer with its “unregimented” approach. Days are tailored to the individual needs of the residents. During the inspection, residents were seen at various times in various places in the Home, moving freely from room-to-room as they wished. One resident received a visit from a friend; they were soon seen to be engaged in animated conversation in the lounge. Mrs Addle said that friends and relatives are welcome at any time within reason. Mrs Addle, with just two residents, is well aware of the relationships that exist between the residents and their relatives and whom to contact should there be any concerns that need to be passed on. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 13 Residents were very positive about the food served at the Home. Staff emphasised that it is easy to cater for likes and dislikes and appeared to offer a varied and appealing choice of meals. The dining room is very homely, although residents are free to eat in their own room if they wish. On the day of the inspection, residents had a choice of lemon sole or salmon with croquet potatoes and peas for lunch, followed by baked or stewed apple. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Information is available for residents and their relatives which advises them on how to complain should they wish to do so. Staff have received POVA training. EVIDENCE: The Home has a complaints procedure which was on display in the dining room and also included in the documentation provided to each resident. Details on how to contact the Commission for Social Care Inspection if necessary was also in this documentation. No complaints were voiced to the Inspector either by residents or staff. The two residents when spoken with felt that standards of care in the Home were high and they said that they would have no problem in speaking to Mrs Addle if they were unhappy about anything. The Home has a Protection of Vulnerable Adults Policy in place. All staff have undertaken the training offered by South Gloucestershire Council and POVA has been part of their NVQ (National Vocational Qualification) training. Staff were able to show the Inspector that they were aware of their responsibilities towards residents. Accident logs were seen and were in order. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. Charlton House is well-maintained, clean and tidy throughout. It is decorated to a high standard. Communal areas are well furnished and homely. The garden is very pleasant and accessible to residents. The Home overall is comfortable and safe to live in. EVIDENCE: Charlton House is an elegant period property built originally in the Nineteenth Century and completely refurbished to a high standard. The Home is well maintained throughout and contains good quality furnishings and fittings. The back of the house has a large patio and a landscaped, walled garden with flower beds and a well-tended lawn. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 16 The Home has a number of rooms for communal use including a large dining area and a spacious lounge. The lounge is particularly homely and welcoming and tastefully decorated. Toilets and bathrooms meet the needs of current residents and are fitted with grab rails. Each resident has a bedroom for their own use, all of which were viewed by the Inspector, including those vacant at present. Rooms are spacious and in line with National Minimum Standards and fitted with call systems. Bedrooms have been individualised by residents, reflecting their own particular tastes with personal photographs and possessions. Two bedrooms are now en-suite and Mrs Addle is considering converting another room to the same standard. She is also considering converting the double room to a single as no interest has been expressed from a couple in occupying this room since the Home opened. The ground floor toilet has been recently re-decorated. All rooms are centrally heated and residents are able to control the temperature in their bedrooms. Lighting is of domestic style and emergency lighting is fitted throughout the Home. Evidence was seen that this is checked on a monthly basis. Water temperatures, which were of concern at the last inspection, are now satisfactory. The Home was clean and tidy throughout and free of any odours. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 28. Charlton House is adequately staffed by trained people to meet the needs of residents. EVIDENCE: At the time of the inspection, the Registered Manager Mrs Addle was on duty with two care assistants. The two care staff employed at the Home have NVQ (National Vocational Qualification) 2 in direct care, Mrs Addle has achieved NVQ Level 4 in Management. The two staff when interviewed commented on how well the staff team work together and how approachable as a manager Mrs Addle is. One said she was almost treated as a member of the family, the Home is so friendly and supportive. The Home has an Equal Opportunities Policy in place plus a code of conduct for staff. A copy of the General Social Care Council’s Code of Practice for Care Staff was also available. Mrs Addle occasionally has students on work experience from a local secondary school which she says the residents particularly enjoy. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 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 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, 33, 36 and 38. The Manager at Charlton House is experienced and well-trained. Health and Safety procedures in the Home are satisfactory. EVIDENCE: Mrs Addle has been the Registered Manager of Charlton House since 1999. She is a trained nurse and midwife and has a wide range of experience in different care settings. She has NVQ (National vocational Qualification) Level 4 in Management. Mrs Addle appears to have a very approachable manner, both to staff and residents and a clear understanding of residents’ needs and how they may best be met. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 19 The two staff members when spoken with by the Inspector felt they were wellsupported and supervised by Mrs Addle and able to go to her with any problems without fear of recriminations. Mrs Addle had begun to implement a quality assurance process to see if needs are truly being met and to see if any aspect of the care offered might be improved. As part of this process, a questionnaire has been prepared for residents; one of these was also recently sent to the nephew-in-law of a previous resident. Polices and procedures which aim to ensure the health, safety and general welfare of residents were seen by the Inspector. These are due for review, which Mrs Addle ensured the Inspector was a task, high, on her list of priorities. Records gave evidence that fire drills had been completed as had fire alarm tests. All fire equipment had been checked by contractors in June 2005. Food hygiene certificates were seen and a public liability insurance certificate was on display. Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 21 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 7 Regulation 15 Requirement All written care action plans must be completed and reviewed throughly. Timescale for action 1/11/2005 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 Good Practice Recommendations Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Charlton House D56 D05 S3317 Charlton House V228743 310805 Stage 4.doc Version 1.30 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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