Inspection on 09/02/06 for Charlton House

This inspection was carried out on 9th February 2006.

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

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

Other inspections for this house

Charlton House 31/08/05

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 Wendy Kirby Unannounced Inspection 9th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Charlton House 85 High Street Address Wickwar South Glos GL12 8NP 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) 01454 294167 NONE Mr John Anthony Addle Mrs Teresa Addle Mrs Teresa Addle Care Home 5 Category(ies) of Old age, not falling within any other category registration, with number (5) of places Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 5 persons aged 65 years and over requiring personal care only 31st August 2005 Date of last inspection 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, flowerbeds 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 Wotton-under-Edge. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process. During the inspection the inspector spent time with the manager to examine a number of records, including case tracking all four residents care plans, and records relating to the day-to-day running and management of the home. The inspector spent time with most of the residents in the home throughout the course of the visit and spoke with one visitor. A member of staff was observed on duty and the inspector had a brief discussion with her. The inspector had a tour of the whole building. What the service does well: What has improved since the last inspection? There has been no change since the last inspection. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 6 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. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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 Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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): 1,2,3,4,5,6 The prospective residents are provided with necessary information to help decide if the home is suitable. Residents have contracts and terms of conditions. Prospective residents needs are assessed prior to admission to determine the suitability of placement to ensure that their needs can be met, however this information is not processed in written format and does not provide a benchmark of the residents ability and state of health prior to admission. Prospective residents are encouraged to stay on a trial basis before making any commitment. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 9 EVIDENCE: The inspector looked at the homes Statement of Purpose and a coloured brochure the home produces, which acts as a users guide. Information contained within this documentation includes services and facilities available and how to make a complaint about the service provided should this be necessary. The brochure details the homes aims and the level of support the resident may expect. The terms and conditions are given to the residents on admission and are clear and straightforward. The Inspector looked at four residents care records. The prospective resident, family and carers are involved in the pre-assessment and all information is used to determine the suitability of the placement. Where possible the manager had also obtained comprehensive assessments and care plans from other professionals involved for example, social workers and hospital staff. Mrs Addle is a trained nurse and through her knowledge and expertise she was able to demonstrate a vast account of her current residents, their medical history, personal background and their subsequent needs. However this information is gathered in note pad form and not available in the residents care files, therefore it does not provide a benchmark of the resident’s ability and state of health prior to admission. All pre-assessment knowledge is cascaded verbally to the two staff members who work at the home. The staff member on duty was able to demonstrate a caring, warm attitude to the residents and knowledge on how their needs could be met. The manager agreed with the inspector that written assessments needed to be developed. One resident and family member were talked to at length during the inspection; they explained that the residents first initial contact with the home had been following a fall at the residents own private dwelling where as a result he was admitted to hospital. The resident was transferred to Charlton House for intermediate care before going back home. Subsequently the resident has come back to Charlton House on long-term respite with a view to staying permanently. Confidence was expressed by the resident and family member that all needs were being met within the home and that relationships and bonds with other residents and the staff had been formed. A month’s trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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 the following standard(s): 7,8,10 Individual care plans are not well written and require further development. Access to health care is maintained and residents are treated respectfully. EVIDENCE: All four residents care plans were examined. The written care plans did not hold enough information and were unable to show evidence of identified needs, action plans, evaluations and review of care. Residents risk assessments were also not in place and did not cover issues such as insulin dependent diabetes, self-medication, and risk of falls. Health Care needs were documented including monthly weights, General Practitioner, District Nurse, Chiropody and Dentists visits to the home, which supported that health care needs were being met by appropriate available community resources. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 11 Mrs Addle explained that she and her staff make every attempt to care for the residents as their health deteriorates for as long as possible before considering other alternatives. Community resources are accessed for suitable equipment such as hospital beds and commodes if required. Mrs Addle and her staff were able to demonstrate a great awareness of the residents needs and with a small home such as Charlton House, resources are such that the care is delivered and tailored so individually that they are able to provide one to one care throughout the day. The resident’s spoke very highly of the home and the care they receive. Two newest members said “they had settled in well” and that “it was like living as one big family” Medication charts were examined and showed continuity in dispensing. All staff are currently enrolled in a distance-learning course on the Safe Handling of Medication with Stroud College. Medication will be looked at in more detail at the next inspection. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15 Routines at the home are flexible and family and friends are encouraged to visit. Catering at the home is very good and the residents are provided with a healthy varied diet. EVIDENCE: Mr and Mrs Addle and their family live on the premises and spend a lot of time with the residents throughout the day. The resident’s daily routines are tailored to their requirements and the routines are relaxed and flexible. Trips to the shops, garden centres, pubs and local coffee shop are always offered to the residents on a weekly basis. One gentleman resident particularly enjoys going out with Mr Addle when running errands. Another resident talked about how she enjoys her daily constitution with a fellow resident, weather permitting. One gentleman particularly enjoys reading and takes advantage of the visiting library. The local shop also delivers newspapers to the home daily. One lady resident often visits the local church. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 13 The hairdresser visits weekly and staff enjoy pampering the residents with nail care. Family contact is encouraged and two visitors were witnessed spending quality time with the residents. The garden is very pretty and has two greenhouses. One resident particularly misses his garden at home and has been encouraged by Mrs Addle to start potting plants as soon as the weather is warmer. Entertainment is provided, particularly to celebrate special occasions and resident’s birthdays never go by without a party tea and birthday cake. Resident’s comments were very positive about the food and described it as “wholesome traditional home cooked meals”. Residents expressed that they never felt hungry and one resident had said he had been asking for smaller portions lately as he had gained weight since his arrival to the home. There is a well-balanced, varied two-week menu; residents are asked on a daily basis what they would prefer to eat at each mealtime. Breakfasts consist of various types of cereal and toast, and residents are offered a full English daily. Meals are traditional in nature and seasonal trends are followed. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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 the following standard(s): 16,18 Information is provided on how to make a complaint, should residents and families wish to do so. There are procedures, and training provided to help protect residents from harm or abuse. EVIDENCE: The home has a complaints procedure, which is displayed on the notice board in the dining room. This procedure is also given to the residents and their families on admission. The procedure gives clear instruction on how to contact the Commission for Social Care if required. Residents told the inspector that they would always speak to Mrs Addle should they have any concerns or worries. Mrs Addle has not had any complaints since the last inspection. The home has a Protection of Vulnerable Adults policy in place and staff completed training through South Gloucestershire Council in July 2005. All accidents/incidents are logged in a book, with descriptions, dates and outcomes. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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 the following standard(s): 19,20,21,22,23,24,25,26 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 is comfortable and safe to live in. EVIDENCE: The inspector had a full tour of the home. 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 flowerbeds and a well-tended lawn. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 16 The Home has a number of rooms for communal use including a large dining area and a spacious lounge. The lounge and dining room are homely, welcoming and tastefully decorated. Toilets and bathrooms are spacious and decorated to a high standard, which meet the needs of current residents and are fitted with grab rails and a bath hoist. Residents have a bedroom for their own use, the rooms are spacious, and had been individualised by residents, reflecting their own particular tastes with personal photographs and possessions. Two bedrooms are 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. The laundry room has been recently refurbished, providing suitable equipment to wash, dry and press the residents clothes. The kitchen was spacious, clean and tidy. The cupboards, fridge and freezer contained an abundant food store and were all clean and well maintained. The fridge and freezer temperatures were recorded and consistent. Records also evidenced the food probe temperatures were being taken on a daily basis. Residents are able to access the bedrooms via the stair lift. The Home was clean and tidy throughout and free of any odours. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Charlton House is adequately staffed by trained people to meet the needs of residents. However staff are not up to date with mandatory training requirements. EVIDENCE: At the time of the inspection, the Registered Manager Mrs Addle was on duty and one care assistant. 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. During the inspection it was evident that the staff have effective, good working relationships. The care assistant said that Mrs Addle was very approachable and that she had enjoyed the two years she had worked at the home. 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. Staff records were looked at and contained, references, relevant CRB checks, contracts of employment and job descriptions. Mrs Addle is required to produce a training programme, as some training certificates were out of date, including Food Hygiene and Manual Handling. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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): 31,32,33,36,37,38 The manager is qualified and competent to run the home The manager’s approach and presence within the home ensures a positive atmosphere for the residents to live in. Staff are supervised, however this is not formerly documented. Policies and procedures are satisfactory but need to be updated to ensure the health and safety of the residents. Residents are not fully protected from fire hazards. 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. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 19 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. The staff member on duty when spoken with by the Inspector felt they she was well supported and supervised by Mrs Addle on a daily basis. Mrs Addle has close daily contact with her two staff members, however this form of supervision has not been documented and will be a requirement from this inspection. Process and formats of supervision were discussed between the inspector and Mrs Addle and will be looked at in more detail at the next inspection. 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 was identified at the previous inspection. The policy file has out of date information and the documentation needs updating. This has not been done since the last inspection and a requirement will be made. Records gave evidence that fire drills had been completed as had fire alarm tests, however Staff had not received fire safety training since 2001. All service contracts were seen and all tests had been carried out at the relevant times, including fire alarms, gas supplies and the stair lift. There were no risk assessments for the home. Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 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 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 2 2 2 Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement A pre-assessment format must be developed and a full written pre-assessment must be carried out with all future admissions and kept in the care files. Care plans should be developed with the residents and/or their representatives. All residents must have care plans, which accurately reflect their needs and how they will be met. Previous requirement. All residents must have risk assessments to support identified needs in care plans. A training plan must be developed to ensure all staff receive mandatory training and updates Care staff must receive formal supervision at least 6 times per year. The home policies and procedures must be reviewed and updated All staff must attend fire safety update training. Timescale for action 04/05/06 2 3 OP7 OP7 15 15 04/05/06 04/05/06 4 5 OP7 OP30 15 18(c) 1 04/05/06 04/05/06 6 7 8 OP36 OP37 OP38 18(2) 17 23(4) (d) 03/08/06 03/08/06 09/03/06 Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 22 9 OP38 17 (1) a Risk assessments must be carried out for safe working practise on all areas of the home. 03/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Charlton House 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bristol North LO 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 85 High Street DS0000003317.V278016.R01.S.doc Version 5.1 Page 24 - 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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