Inspection on 31/08/05 for Charlton Kings Care Home

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 Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Charlton Kings Care Home 03/01/07

Charlton Kings Care Home 15/02/06

Charlton Kings Care Home 02/03/05

Charlton Kings Care Home 27/06/04

Charlton Kings Care Home 02/03/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Charlton KingsCare Home Moorend Road Charlton Kings Cheltenham Gloucestrshire GL53 9AX Lead Inspector Sharon Hayward-Wright Unannounced 31 August 2005, 11:00 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 KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Charlton Kings Care Home Address Moorend Road Charlton Kings Cheltenham Gloucestrshire GL53 9AX 01242 521812 01242 517773 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) Charlton Care Ltd Mr Richard Royle Care Home 25 Category(ies) of OP Old Age (25) registration, with number LD(E) Learning Disability - over 65 (3) of places Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) To complete the managerment part of NVQ4 by September 2005. 2) To complete the care part of the NVQ by September 2006. Date of last inspection 2/3/05 Brief Description of the Service: Charlton Kings Care Home is a large detached Edwardian family house that has been adapted and extended to provide personal care for older people. It is situated in Charlton Kings, on the outskirts of Cheltenham. Local amenities are close by. The home has added additional bedrooms onto the home increasing the number of service users they are able to care for. All bedrooms are single occupancy and have either en suite facilities or a hand washbasin. Bedrooms are located on the ground and first floor, which is accessed by stairs, a stair lift or a recently fitted shaft lift. The communal space consists of three lounges and a dining room with patio doors leading into the garden and a recently added conservatory that is accessed through a new lounge. The Registered Provider had greatly improved the environment for service users. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours on one day in September 2005. Part of this inspection was to investigate several concerns given to the Commission for Social Care Inspection. Ten service users and one visitor were spoken with to gain their views on the home; the Registered Manager, Registered Provider and four staff members were also spoken to. Staff were observed going about their duties and interacting with each other and service users. The requirements and recommendations issued at the last inspection were followed up and records relating to medication, duty rotas, Statement of Purpose and Service Users Guide were inspected and a part tour of the home took place with a number of service users rooms inspected. Three requirements remain outstanding since the last inspection and now must be addressed. Of the five concerns given to the Commission for Social Care Inspection only one of these was upheld. These are discussed further, later in the report. What the service does well: Recent investment has significantly improved the appearance of this home creating a comfortable and homely environment for those living there and visiting. The Registered Manager is supported well by his senior staff in providing clear leadership throughout the home with all staff observed demonstrating an awareness of their roles and responsibilities. Staff felt their morale is good resulting in an enthusiastic workforce that works positively with service users to help improve their quality of life. The meals in the home are good offering both choice and variety. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 5 Prospective service users and their relatives/friends are able to have the information needed and visit the home to assist them in making an informed choice about where to live. EVIDENCE: A requirement issued at the last inspection for the home to add additional information to their Statement of Purpose has been addressed. One recently admitted service user said his friend had visited the home prior to him moving and that he trusted their judgement. He said his friend turned up at the home unannounced and was shown round. He is very happy with their choice of home. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9 & 11 The home had not improved their procedures for managing service users medication therefore service users are being placed at risk. Service users felt they are treated with respect and their right to privacy is upheld. EVIDENCE: Care plans were examined only to see if the requirement and the recommendations made at the last inspection had been addressed. Medication systems were examined and the requirements of the last inspection followed up. The home has not addressed the requirements from the last inspection and serious concerns were highlighted at this inspection. The Registered Manager agreed that the best way forward was for the Commission for Social Care Inspection Pharmacy Inspector to visit the home and provide advice and guidance. A date has been arranged for this visit. One of the concerns given to the Commission for Social Care Inspection was that the staff in the home were ‘potting up’ medication into a plastic containers with the service users name on and leaving it for service users to take. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 10 This part of the concern was upheld; a plastic container with a service users name on a piece of paper was found on the table by the main entrance to the home. This is not a safe practice and must stop as it is a potential risk to service users. One of the concerns given to the Commission for Social Care Inspection was that service users post goes to the office and is looked at before it is given to service users. From talking to service users and staff there was no evidence to suggest this is happening. Service users said they all receive their post unopened. The Registered Manager and Registered Provider said that for confused service users they open any hospital appointments as these often go missing and the service user misses the appointment. Service users confirmed that the staff in the home maintain their privacy and dignity; examples given besides the unopened post were staff knocking on their door prior to entering and staff addressing them with their preferred choice of address. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Social activities are organised on a planned basis, and links with the local community and service users’ family and friends are encouraged and maintained. Service users where able can exercise choice and control over their lives. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choice. EVIDENCE: The home has an activities coordinator who also arranges service users GP and hospital appointments. Activities are arranged on a group or individual basis. Outside entertainers visit the home and these include the ‘music man’ twice weekly and exercise class every fortnight. The hairdresser was visiting the home on the day of the inspection. The Registered Manager said trips out are arranged, but this is dependent on the service users. The mobile library visits the home on a planned basis. Service users confirmed they are happy with the activities provided and they are free to choose how they spend their time each day. One service user confirmed they could get up and go to bed at a time they chose. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 12 Service users and a visitor to the home confirmed that visiting is flexible. Service users where able can go out in to the local community and a number of service users said their friends/family take them out. Service users personal possessions were seen in their rooms. The home has a poster advertising advocacy services near to the dining room. A requirement issued at the last inspection in relation to the kitchen has not been addressed. However the home has recently had an Environmental Health Department visit and the home is working towards addressing these with the requirement issued at the last inspection. Service users all said they enjoyed the food provided and that choices are offered if they do not like what is on the menu. One service user said they do not like certain meats and they were given an omelette. Service users have more of a choice over what is offered for the teatime menu. Service users were seen enjoying lunch in the dining room and assistance was offered discreetly when needed. Service users confirmed that drinks are provided at regular intervals throughout the day and this was witnessed during the inspection. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Service users said they are confident that their concerns or complaints will be listened to and acted upon. The home is looking at ways to ensure service users are protected from abuse. EVIDENCE: The home has a complaints procedure in line with the Care Homes Regulations and this is displayed by the main entrance to the home. Part of this inspection visit was to investigate some concerns given to the Commission for Social Care Inspection. Each of the concerns has been divided into the relevant standards. Of the five concerns given only one has been upheld. A requirement has been issued in the relevant standard for the home to address this. Service users and a visitor said they felt comfortable in approaching the Registered Manager or Registered Provider if they had any concerns and that they would be dealt with. A requirement issued at the last inspection for the home to provide training for staff in the protection of vulnerable adults has been addressed as nine members of staff have received training. However the local Adults at Risk team have said that any training will be delayed until next year. It is recommended that the home obtain a copy of the ‘Alters Guide’ for the Gloucestershire area. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: Since the last inspection the home has redecorated one of the lounges by the main entrance. Staff were seen wearing protective clothing when necessary. The home is one domestic under their required numbers therefore the overall cleanliness is not to the normal high standards. The home is however actively recruiting another domestic. It was mentioned during the inspection that the entrance to the lift on the ground floor has an odour, but there was no odour found during the inspection. The laundry room is in the process of being redesigned to build another entrance so that staff do not have to go through the office to access it. The requirement to repair the laundry floor has been addressed. Once the laundry has been completed new flooring will be fitted. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 15 The home does not have a designated staff room at present. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 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 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 & 28 Staff morale is good resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: The duty rotas were seen as evidence of staffing levels. Four care staff are on an early shift, three on an afternoon shift and two waking night staff. Ancillary staff hours cover additional tasks. The Registered Manager is on duty office hours Monday to Friday and is on call alternate weekends. Service users and the visitor all praised the staff saying nothing was too much trouble for them. One of the concerns was that if service users were uncooperative with staff then the staff would withhold drinks. No evidence was found to uphold this element of the concern. Another concern was that staff were working long hours and not getting breaks; again no evidence was found to uphold this concern. Staff spoken with all said they enjoy working at the home. The home has one member of care staff with NVQ 2, one has just completed and two have started the course. Four care staff are undertaking the NVQ 3 training. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 32 Service users and staff feel the Registered Manager is of good character, approachable and able to discharge his responsibilities. EVIDENCE: Since the last inspection the Manager has been registered with the Commission for Social Care Inspection and is working to meet the conditions issued at his registration in relation to the NVQ 4. Service users and the visitor confirmed they could approach the Registered Manager or Registered Provider with concerns and complaints and they felt these would be dealt with. Staff demonstrated an awareness of their roles and responsibilities and when they would need to report to the Registered Manager or Deputy Manager. Two recommendations made at the last inspection that relate to Standards 33 and 38 have been made again at this inspection. Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 18 Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 2 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 2 2 3 x x x x x x Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(2) Requirement The Registered Person must ensure that when staff administer medication they do not administer into their hand but into a pot or the service users hand to reduce the risk of cross infection. Timescale of the 15/3/05 was not met. The Registered Person must maintain records of all medication received into the home. Timescale of the 15/3/05 was not met. The Registered Person must ensure that the MAR sheets (medication administration record) are completed in full, so there is an accurate record of what medication is taken or the reason why it was not. Timescale of the 15/3/05 was not met. The Registered Person must ensure that service users only receive the medication that is perscribed for them. The Registered Person must ensure that the staff in home do not leave service users Timescale for action immediate and ongoing 2. 9 13(2) immediate and ongoing 3. 9 13(2) immediate and ongoing 4. 9 13(2) immediate and ongoing immediate and ongoing Page 21 5. 9 13(2) Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 6. 15 13(4c) medication in a plastic container with their name in, unattended or not stored securely. The Registered Person must ensure that temperatures are taken of food deliveries and records maintained to ensure any unnecessary risks to service users health are minimised. Timescale of the 20/3/05 was not met. 30/9/05 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. 2. 3. Refer to Standard 38 9 9 Good Practice Recommendations Any hand written entries on the MAR sheets are PP for the GP making the alteration and checked and signed by a second person. All medication is dated on opening (except for the Nomad packs) Temazepam and Oramorph 10mg/5mls should be stored as a controlled medication in a locked controlled medication cupboard as required under The Misuse of Drugs (Safe Custody) Regulations 1973 The home should devise a hazard analysis for the kitchen. The home should obtain a copy of the Gloucestershire Alters Guide The home should consider providing a staff room. The home should devise an annual development plan based on the outcomes for the service users. The home should complete risk assessments for the hot water outlets that do not have pre set valves that service users have access to. 4. 5. 6. 7. 8. 15 18 19 33 38 Charlton KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 KingsCare Home D51_D03_42519_Charlton Kings_v239400_020805_UI_stage4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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