Inspection on 08/02/06 for Chase Lodge Care Home Ltd

This inspection was carried out on 8th 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chase Lodge Care Home Ltd 29/08/07

Chase Lodge Care Home Ltd 10/08/05

Chase Lodge Care Home Ltd 10/02/05

Chase Lodge Care Home Ltd 20/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 Chase Lodge Care Home Ltd 4 Grove Park Road Weston Super Mare North Somerset BS23 2LN Lead Inspector Juanita Glass Unannounced Inspection 8th February 2006 09:30 Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 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 Chase Lodge Care Home Ltd DS0000046197.V282475.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 Adults 18-65. 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 Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chase Lodge Care Home Ltd Address 4 Grove Park Road Weston Super Mare North Somerset BS23 2LN 01934 418463 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) Chase Lodge Care Home Ltd Mr Henry James Murray Bladon Care Home 19 Category(ies) of Learning disability (19), Learning disability over registration, with number 65 years of age (19), Mental disorder, excluding of places learning disability or dementia (19), Mental Disorder, excluding learning disability or dementia - over 65 years of age (19) Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 19 persons aged 30 years and over requiring personal care only. 10th August 2005 Date of last inspection Brief Description of the Service: Chase Lodge is a care home catering for 19 people with mental health problems. The aim of the home is to provide a caring and supportive environment, which is relaxed and comfortable. The intention is for service users to function in a stress free atmosphere where demands put on them are minimal. The home does not set out to rehabilitate service users, however there are skills which they are encouraged to acquire leading to an enhancement in their life. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in the presence of the acting manager, Mr James Dillon, over seven hours. Most of the residents in the home were met and three members of staff spoken to. All the residents stated that they were happy and that staff supported them in leading their preferred lifestyle. Two requirements were outstanding from the last inspection and three further requirements were made. These are discussed in full in the relevant sections of this report. A review of resident and staff records was carried out however the focus on this inspection was the outcomes for residents; in general these outcomes were good. What the service does well: What has improved since the last inspection? Since the last inspection staff morale in the home has improved, all staff have attended training in the handling and administration of medication. Areas in the home that had needed decoration had been addressed and the hall was much improved. The support provided by the new pharmacy contract was evident in the approach adopted by the manager. Chase Lodge Care Home Ltd DS0000046197.V282475.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. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 Prospective service users are provided with adequate information to make an informed choice about where to live. A full needs assessment is carried out prior to admission, and service users are given the chance to visit the home and stay for a trial period. Each service user has an individual written contract or statement of terms and conditions. EVIDENCE: The home has a very clear statement of purpose and service user guide which sets out the information required for residents to make an informed choice, there is no tariff of extra charges as the providers feel the fees should cover everything the residents need to lead a fulfilling life. The manager carries out a preadmission assessment and residents are not accepted into the home unless both the manager and the prospective resident feel that it can meet their needs fully. Resident records reviewed showed evidence of preadmission assessments, and all new residents are offered a trial period so that they can determine whether the home can meet their needs. Resident’s records all contained signed contracts of residence. None of the residents spoken to commented on the admission procedure. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Service users have clear assessed care plans they now evidence service user involvement. Service users are supported to make decisions about their lives. Service users are assisted to take risks however records dont evidence service user involvement. EVIDENCE: Six resident care plans were reviewed they were all very clear and concise; the plans are developed from an initial assessment and show evidence of regular review, they provide very clear directions for staff, and risk assessments identified that residents who may be at risk received guidance and assistance from staff to overcome that risk, these included tasks such as tea and coffee making, those residents who wanted to involved in their care plans do so others have expressed the wish not to be consulted. Residents spoken to confirmed that they knew they had care plans and risk assessments, some said they didnt want to get involved. Residents records showed that they were encouraged to make their own decisions about life choices, residents were observed doing as they wished through the day, one resident spoken to the said that staff always helped him when he asked. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 10 Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15, 16 and 17 Residents are encouraged to take part in the local community. Residents are encouraged to maintain contact with families and friends. Residents’ rights are respected. Residents receive a healthy and nutritious diet. EVIDENCE: Staff actively assist service users to develop new skills and maintain independent living skills, residents records showed that they take part in the local community going to church, clubs and the local library, some service users have placements at the Charlton centre. An activities diary is kept and activities that are followed are agreed with the residents. Residents spoken to said that there was always plenty for them to do, one service user talked about the poems he writes and that he is still being published. The inspector joined the residents for lunch, which was an unhurried affair, the menu does not show a choice, however residents make requests during the morning and these are accommodated when possible, the meal served was wholesome, nutritional and appetising. Residents spoken to said that they always got a decent lunch and could request snacks throughout the day. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 12 Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users receive personal support in a way they would prefer their physical and emotional health needs are met. Policies and procedures for self-medication are in place. Storage and administration of medication do not meet current guidelines. EVIDENCE: The home does not provide nursing care, however staff were observed to recognise residents needs for dignity and privacy, however the one shared room still does not have appropriate screening, this is discussed further under the relevant standard. Residents spoken to said that staff are always nice and polite and understood when they wanted to retire to their rooms alone. Records reviewed showed that the home enables residents to access health care services, which included opticians, chiropodist, dentist and the community psychiatric nurse. It was also evident that the home enabled residents to attend outpatients’ clinics and assist them to stop smoking this demonstrates good practice. The receipt, storage and administration of medication was discussed with the manager, the home has taken up a new pharmacy contract, which appears to be working well the staff said they did not have problems obtaining medication and advise. All staff administering medication have received training, and are continuing with the distance training course which provides more in depth Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 14 knowledge. During a review of the documentation it was noted that handwritten entries had not been signed by the person making the entry, and that Temazepam was not being stored in the Controlled Drugs cupboard and a record and audit was not being maintained. The manager agreed to contact the pharmacy and point out that Temazepam must not be dispensed in the nomad system. It was also noted that the new medication trolley was not attached to the wall, however the manager stated that the maintenance person had been asked to do the job but had been off sick. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Service users views and opinions are listened to and acted on. The homes recruitment procedure does not protect service users from harm. EVIDENCE: Resident’s views and opinions are regularly sort at resident meetings. Residents spoken to said that they felt their opinions were taken into account and that they could approach any member of staff with a concern or complaint, minutes from resident meetings supported this. Staff have clear guidelines in place for the protection of vulnerable adults, however it is recommended that staff attend formal training in the policies and procedures for North Somerset. Whilst checking staff records it was noted that new staff had been employed without a POVA 1st confirmation, this is discussed further under the relevant section of this report. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 and 30 Chase Lodge provides a homely and safe environment, with bedrooms and communal areas that suit the service users needs. The home is clean and hygienic. EVIDENCE: All residents have access to adequate and well-furnished communal areas and safe and comfortable bedrooms. It was noted that the screens still had not been provided in the large shared room, this was discussed with the manager who stated that the maintenance person had been off sick, and it would be dealt with as soon as possible. Residents spoken to were happy with their rooms and evidence was seen of redecoration and on going maintenance. The home was clean and tidy and staff were observed working in a way that showed an awareness of infection control issues. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Adequate numbers of competent staff are in the home to meet the residents’ needs. The homes recruitment practices do not follow requirements and do not protect service users. EVIDENCE: Staff are encouraged to obtain their NVQ In Care and to attend training that is relevant to the residents needs, the duty rotas and discussions with staff showed that the home is adequately staffed at all times. Residents said there were always enough staff to attend to their needs. The records for newly appointed staff were examined and showed that new staff had been appointed without two references and a POVA 1st Confirmation being received, this is not good practice and puts residents at risk of possible abuse. A POVA 1st confirmation must be received before staff can commence employment they must then work supervised until the full CRB is received. Staff confirmed that they received all mandatory training and were encouraged to attend further training in Mental Health issues. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40 and 42 The home is well run with and the manager and staff are open and approachable. The homes policies and procedures safeguard service users with the exception of recruitment practices. The health and safety within the home does not meet current standards. EVIDENCE: The management ethos in the home is both open and approachable; staff and residents said that they could talk to the manager and owners at any time and about anything a friendly and relaxed rapport was observed throughout the inspection. The acting manager has commenced the Registered Managers Award and has found it very helpful with keeping abreast of current trends in management. The homes policies and procedures continue to be reviewed as necessary and protect residents from abuse with the exception of the recruitment procedure previously discussed. Health and Safety in the home is generally satisfactory a review of the fire log showed that the manager must be more consistent with checking fire fighting Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 19 equipment and the emergency lighting in line with current guidelines, the manager has commenced the fire risk assessment. Staff have received training in Fire procedures and regular fire drills are carried out which also involves the residents. All staff handling food have food hygiene certificates and food was appropriately stored in the kitchen, which was clean and tidy. Chase Lodge Care Home Ltd DS0000046197.V282475.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 Adults 18-65 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 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 2 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 3 34 2 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 3 X 3 X 2 X Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 21 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 2 3 Standard YA18YA25 YA20 YA20 Regulation 16 (2) 13 (2) 13 (2) Requirement Screening must be provided in the shared room Handwritten MAR sheets must be signed by the person making the entry. Temazepam must be stored in the Controlled Drugs cupboard and a clear record and audit maintained in the CD book. New staff must be subject to robust recruitment procedures including CRB/ POVA first checks The manager must be consistent in checking fire extinguishers and emergency lighting. Timescale for action 08/04/06 08/02/06 08/02/06 4 5 YA34 YA42 19 23 (4) 08/02/06 08/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA23 Good Practice Recommendations Staff need to attend training in the North Somerset Policies and Procedures for Adult Protection. Chase Lodge Care Home Ltd DS0000046197.V282475.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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