Inspection on 28/09/05 for Chase House Ltd

This inspection was carried out on 28th September 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

Chase House Ltd 20/03/07

Chase House Ltd 30/12/05

Chase House Ltd 29/06/04

Chase House Ltd 02/02/04

Similar services:

Claremont House

Chesham House

Argyll House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Firstlings

Dolphin Court

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

CARE HOMES FOR OLDER PEOPLE Chase House Ltd House Lane Arlesey Beds SG15 6YA Lead Inspector Sally Snelson Unannounced 28 September 2005 th 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. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chase House Ltd Address House Lane Arlesey Beds SG15 6YA 01462 731276 01462 731276 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) Chase House Limited Deidre McGuire Care home with nursing 36 Category(ies) of PD(E) Physical disabilities over 65 - 36 registration, with number DE(E) Dementia over 65 - 36 of places Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To admit two named service users under the age of 65 years of age. Date of last inspection 29.03.2005 Brief Description of the Service: Chase House was a two storey Victorian building, which had an extension built on in the style and character of the original building. The home accommodated thirty-six people and provided accommodation in single and shared bedrooms. The majority of the individual bedrooms were situated on the first floor. Two shaft lifts were provided. The lounges and dining facilities were on the ground floor. There was a large conservatory overlooking extensive landscaped gardens that had a very attractive water feature and countryside views. The home was situated within easy walking distance of Arlesey Village, which was on the main bus route from Hitchin to Bedford. The towns of Letchworth Garden City and Hitchin were three and four miles away respectively. The home offered nursing and social care to older people including those with a physical disablement or dementia. The home offered a wide range of activities and excursions including holidays. Staff would help organise these breaks and accompany service users as necessary. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place from 08.15hrs on the 28th September 2005. A charge nurse, Mr Jim Allen, was present throughout and the manager, Mrs Deidre McGuire, was present for the feedback. The method of the inspection was ‘case tracking’. This involved looking at the care records, speaking to and tracking the care received by three of the service users. The inspector also spoke and looked at some aspects of care for other service users and spoke to a number of staff and visitors to ascertain that outcomes for the service users were positive. The inspector would like to thank all those who participated in the inspection. What the service does well: Chase House has an established staff team, some who have worked at the home for 15 years or more. Most of the staff and many of the service users come from the village and therefore many staff, visitors and service users know each other. This gives the home a large family atmosphere. As soon as one of the service users heard that an inspection was taking place she asked to speak to the inspector to have it recorded that “ Jim is lovely, he is the best boss”. Another service user whose care was being tracked, when asked about the care she received said “ there is not a lot to say as all the staff do such a good job and are always so happy”. The décor in the house is clean and very homely with photographs of the trips that service users have been on in the last year on the walls. Fish tanks, a budgie in a cage and knick-knacks placed throughout the home make it a pleasant environment for service users to live in. The home provides a range of activities including a number of trips out, a variety of games, activities and holidays. These activities are inclusive and can be adapted to make them suitable for those service users with limited mobility and/or a degree of memory loss. Because so many of the staff and the service users come from the village, the home is well known in the local community, and service users are therefore invited to community events. For example on the day of the inspection a group of service users went to the local school to take part in the harvest celebrations also during the week service users had been invited to a coffee morning in the village hall that was part of the McMillan nurses big coffee morning national event. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.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. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.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 Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.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) 1,2,3,4,5,6 The information that service users and their families were provided with prior to admission ensured that when they made the decision to move into Chase House it was an informed one. EVIDENCE: On display in the home was a copy of the Statement of Purpose, the Service Users Guide and the last inspection report. The charge nurse confirmed that these documents were made available to prospective service users and/or their families when they made an initial visit to the home. In addition quality assurance surveys were also available. The Statement of Purpose and the Service Users Guide had been updated in January 2005. The Service User Guide detailed information about the home, including information such as mealtimes. It also included a copy of the complaints procedure and a copy of the contract. The contract clearly outlined what was and was not covered by the fees. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 9 Service users reported that they had been invited to look around the home before making the decision to move in, and that the first four-weeks of their stay was a trial period in order to allow them to settle before making such an important decision. The care plans sampled confirmed that service users were assessed prior to admission. It was noted that some of the assessments were more thorough than others and it was therefore not always clear how the decision that Chase House could meet the assessed needs of a particular service user had been made. During the inspection it became evident that the less-detailed assessment seen was because that particular service user had first been admitted for day care that was extended to respite care was now permanent care. Displayed staff certificates and the variety of certificates seen in staff files confirmed that staff had the qualifications and experience to care for the categories of service users for which they were registered; namely, those with conditions associated with old age and those service users with a diagnosis of dementia. Chase House did not offer intermediate care. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 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) 7,8,9,10 Well-written care plans ensured that service users care needs were met. Appropriate routine assessments provided an early indication that there maybe a need for specialist equipment, support or advice. EVIDENCE: During the inspection three of the service users care plans were looked at in detail. In all the plans there was sufficient information to ensure that staff could care for the service users and meet their assessed needs. It was noted that a service users who had diabetes had a plan for the routine treatment and monitoring of her condition. The plan for her diabetes needed to be expanded a little to include details of the action that were necessary, if the blood sugar results deviated from the normal. This omission to the care plan did not compromise the service users care as the staff spoken to were fully aware of her optimum blood sugar levels and the care she needed. Each of the care plans included a detailed plan for the service users night. Plans had been reviewed regularly and there was evidence that as care needs changed plans were altered appropriately. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 11 As part of the care tracking methodology it was noted that health assessment had been completed and where indicated appropriate nursing aids and equipment supplied. For example, a service user who had become less mobile and therefore at greater risk of sustaining a pressure sore had been provided with a pressure relieving cushion for her chair and an air mattress for her bed. This service user was also turned regularly and a record kept. It was noted that records of turns and fluid input and output were accurately documented. There was evidence that health advice and support was requested appropriately. On the day of the inspection the General Practitioner (GP) made his routine weekly visit to the home and service users were encouraged to consult him if they had any problems. One service user asked to see the GP because he felt under par; this request was taken seriously and he had the opportunity to consult the GP in private. A service user who the GP suggested should attend the hospital for an X-ray was taken in the homes transport and escorted by a carer. The inspector witnessed two medication rounds in the home and looked in detail at the records of the three service users being tracked. Medications were appropriately signed into the home when they were delivered and there were complete records of administration. One of the Medication Administration Record (MAR) charts suggested that a dose of medication was being administered at a different time to that prescribed. The manager immediately checked the previous MAR charts and confirmed when the medication was due to be given and made plans to change the charts. The practice of care staff carrying more than one medication in unlabelled pots to first floor bedrooms on breakfast trays must cease as the pots could become muddled. Also the nurse signing to confirm the medication had been taken had not witnessed the procedure. It was noted that most of the medication was administered from the medication trolley that had been taken to the lounge by the nurse-incharge and one carer; however the nurse signed all the charts retrospectively at the end of the medication round which could lead to mistakes. Privacy and dignity was respected in the home with the use of doors, curtains and choices. Members of staff addressed all service users appropriately while caring for them. It was noted that this respect was also give to visitors into the home. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 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) 12,13,14,15 Two activity co-ordinators led the staff team to provide a wide range of activities so that many of the service users could, if the chose to, remain active and busy while living at Chase House. The Chef prepared a menu that was varied and nutritious and used fresh produce wherever possible. EVIDENCE: On admission service users were asked about their interests and hobbies and activities were planned taking this information into consideration. During the morning all of the service users were asked if they wanted to join in a floor game. The activity co-ordinator set up a game of quoits and left care staff with the service users while she took a small group to the harvest festival service at the local school. Two of the service users told the inspector about a holiday three of them and three staff members had recently taken at a holiday resort in Norfolk. They had particular enjoyed the dancing and the social activities. A staff member stated that there was never a shortage of staff prepared to go away or out for the day with the service users and it was planned that there would be at least three such holidays a year. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 13 The home offered a wide range of activities and excursions. Service users spoke of visits to local flower festivals and animal parks in addition to shopping, gardening, cooking and playing games in the home. One of the service users enjoyed placing a bet on the horses and would walk to the local betting office whenever his finances allowed. In the lounge there were a number of photographic collages of the various trips excursions and holidays that the service users had been on during the year. Breakfast and Lunch was served during the inspection. The majority of the service users had their meals either in the dining room or in a conservatory area that was used as a dining area. Those who choose to could have their meals in their bedroom or in one of the lounges. Three service users who were immobile and required help with eating remained together in one of the lounges. A visitor, who was with her mother at lunchtime, stated that she came during a mealtime not because she was concerned that her mother would not be fed adequately but because it was something she could do for her mother and it also helped the staff. The chef provided a varied nutritious menu using fresh food as often as possible. On the day of the inspection the main choice for lunch, was lamb casserole mashed potatoes, fresh carrots and cabbage followed by pears poached in sherry and spice, served with a vanilla sauce. Supper was to be homemade tomato soup accompanied by homemade bread. Service users confirmed that they had plenty of choice at mealtimes. A service user who was a vegetarian said “I am always well catered for and have a nice meal” Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 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, A clear well publicised complaints procedure ensured that service users and visitors were aware of how to raise any concerns. EVIDENCE: A copy of the complaints procedure was displayed in the home. The complaints procedure detailed how a complaint should be made and the timescale in which the complainant could expect a response. The inspector looked at the complaint book; it had not had to be used for a number of years. The charge nurse confirmed that visitors were encouraged to voice any concerns they had at early stage and that there was an ethos in the home that encouraged this. Service users had regular meetings in which they could raise concerns. Minutes of these meetings suggested the type of bread served was the most discussed topic, along with where to go for the next trip. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 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) 19,20,21,24,26 The home and the garden provide service users with a comfortable, homely place to live. EVIDENCE: The interior and the décor of the home was clean, tidy and fit for purpose. Bedroom accommodation was provided in single and shared rooms on the ground and first floor. The home had adequate communal space comprising of a dining room and two lounges one with two large conservatories. The separate dining room was well used at mealtimes and the inspector noted this encouraged service users to move around the home. The layout of the home with its long corridors also enabled those who enjoyed walking to be able to do so. The management were in the early stages of looking at extending the home to provide some extra bedrooms that would enable them to convert shared rooms into single occupancy accommodation. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 16 Service users had the opportunity to lock their bedroom doors if they wished and were able to personalise their bedrooms with small items of furniture or ornaments from home. Each of the bedroom doors had the service users name and photograph on. There was a good range of chairs in the two lounges with recliner chairs available for those service users with little or limited mobility. At the time of the inspection only one of the service users was staying in bed for the majority of the day. The home stood in a large landscaped garden. There was outdoor seating available and both staff and service users commented on how much the garden was used and enjoyed. Raised flower beds had been built to allow service users to tend to the garden if they wished. The main feature of the garden was a pond that was well stocked with fish. The pond had been appropriately fenced off for health and safety purposes. Chase House had adequate bathroom and toilet facilities. During the inspection it was noted that staff had left some prescribed bathing lotions in the bathroom; this was a health and safety issue as those service users with dementia who wandered about the home could ingest them. In one of the toilets a disposable glove had been discarded onto the floor. Staff must be responsible for picking things up off the floor so that service users do not slip on them or pick them up. The home had a good selection of ceiling and floor standing fans that were used in the hot weather. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 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) 27,28,29,30 Robust recruitment processes and a commitment to training meant that qualified and experienced staff met the service users needs. EVIDENCE: The manager ensured that there was always a sufficient number of suitably qualified and trained staff on duty. The rotas planned for eight staff to be on duty during the morning; this ratio allowed for staff to be odd-duty and not have to be replaced and for carers to take service users out or have one-toone time with them. Staff stated that Chase house was a friendly place to work and many of the staff were also friends outside of work. Nearly all the staff had completed NVQ level 2 with many staff going onto complete NVQ level 3. Many of the cleaning staff were also completing the appropriate NVQ training Two staff files were sampled both had all the required information. The manager stored the Criminal Record Bureau checks and the supervision records separately from the personnel files. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 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) 31,32,33,36,37,38 Chase House had an experienced committed manager who provided strong leadership. EVIDENCE: The manager was also the owner of the home. She was a nurse with many years experience of caring for older people. She had recently completed the Registered Managers Award. The nurse-in-charge stated that supervision was up-to-date and was offered to staff at least every two months. Supervisors had completed or were about to complete courses on supervision. Staff confirmed that they were offered regular supervision and had signed a contract with their supervisor detailing how the sessions would be run and the level of confidentiality they could expect. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 19 The manager had an audit programme that questioned stakeholders about the care provided by the staff at Chase House. These questionnaires were used to provide an action plan for the next year and consequently influenced change. There were a number of well-signed fire exits and fire points, even in the garden. Fire and other safety checks were carried out in the expected time intervals. Records kept by the home were generally up-to-date and accurate and kept securely in the main office. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 4 3 x x 3 3 3 Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13 Requirement Staff must a) give medication in accordance to the original prescription b) sign medication charts as medication is administered c) not carrying medication to more than one service user at the same time. Timescale for action 01.11.05 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 3&7 26 24 Good Practice Recommendations Care plans should include all the information necessary to provide all os aspects of care to a service user. Bathrooms should be kept free of all hazards at all times. There should be evidence as to how service users have made the decision to share a bedroom. Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF 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 Chase House Ltd I51 S15034 Chase House V235148 280905 Stage 4.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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