Inspection on 12/07/07 for Chaseborough House

This inspection was carried out on 12th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Chaseborough House 20/07/06

Chaseborough House 12/03/06

Chaseborough House 17/11/05

Chaseborough House 06/01/05

Chaseborough House 03/06/04

Chaseborough House 21/01/04

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 Chaseborough House Village Hall Lane Wimborne Dorset BH21 6SG Lead Inspector Trevor Julian Unannounced Inspection 12th July 2007 10:30 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 Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chaseborough House Address Village Hall Lane Wimborne Dorset BH21 6SG 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) 01202 822908 Mrs Sally Ann Marshall Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2006 Brief Description of the Service: Chaseborough House is a care home accommodating a maximum of 16 older people. The premises are situated in a rural setting between Verwood and West Moors at Three Legged Cross, with local amenities including a pub, shops and village hall available within a short level walk. Accommodation is offered on the ground and first floor. The communal lounge and dining room are on the ground floor. A passenger lift operates to the first floor. There are twelve single rooms and two rooms registered doubles. All but one room has en-suite facilities, including seven rooms with baths, WC, and hand basins. The premises consist of a large converted family house set in its own grounds. The owners live in the adjacent property. The fees for the home, as confirmed to the Commission for Social Care Inspection (CSCI) at the time of inspection, were £450 per week. Additional charges include hairdressing, chiropody and newspapers. The Office of Fair Trading has published a report highlighting important issues for many older people when choosing a care home, e.g., contracts and information about fees and services. The CSCI has responded to this report and further information can be obtained from the following website: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choosing a care home .aspx Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 10:30 and 16:30 on 12th July 2007. Mrs Marshall remained on the premises throughout. Before the visit Mrs Marshall had provided information on the general management and care needs of the residents through an Annual Quality Assurance Assessment. During the visit, further information was gained through discussion with residents, visitors and staff, a tour of the premises and the examination of records. What the service does well: The home provides very good levels of support and choice for the residents. Care plans have improved and there was evidence of risk assessment covering most areas. A visiting nurse confirmed that the staff call for assistance when needed and always take the advice given. The staff and owner continue to provide care with respect and courtesy. This was seen during the visited and commented on by all the people spoken with. The residents enjoyed the excursions and entertainments offered by Mrs Marshall and they appreciated the residents meetings which allowed them a chance to help develop the programme. The residents praised the quality and variety of food and they said that where they did not like the food on the menu there was always an alternative, which the staff were happy to provide. Mrs Marshall and the staff were described as very approachable by the residents, who all felt they could confidently raise any concerns directly. There were copies of the complaint procedure in the hall and there was a complaint register. Staff were trained in responding to allegations or signs of abuse. All the staff were aware of their responsibilities. The environment is comfortable and homely and the rooms were clean and well presented. The residents’ benefit from a loyal and dedicated staff team. There are rarely changes in staff and the home does not use agency staff to cover staff absence, this promotes good continuity of care which is recognised by the residents and their visitors. The home did not manage the finances of any resident. Some people deposited cash, for personal expenditure, with Mrs Marshall. Two were checked and the balances held matched the transaction records and receipts. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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 Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was evidence to show that assessments were completed to ensure the home could meet the identified needs of prospective residents. However, further work was needed to fully identify those needs. EVIDENCE: There was evidence on the files seen that pre admission assessments were completed prior to a placement being offered. There had been one new admission since the last inspection, the form was incomplete and there was no indication who had completed the form or who had been consulted. None of the people seen during the visit were able to recall the admission process, however all said they were more than happy with their choice. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home worked with community healthcare teams to meet the health needs of the residents, however some other agencies could also be used to assist further. Medication was well managed for the safe administration to the residents. EVIDENCE: The care records showed improved levels of recording. The care plans contained details of the care tasks and there were risk assessments for individuals. The files seen showed that the home had made referrals to community healthcare teams for community nursing and psychiatric support. The level of detail in the care plan was appropriate for most of the people living at the home, however it was noted that two people had become increasingly frail and their mobility had declined. In both circumstances, a moving and handling risk assessment should have been completed with possible referral to Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 10 an Occupational Therapist for further advice. The home was concerned about the nutritional intake for one person and additional monitoring had been put into place although there had been no referral for dietician advice. The files seen showed that there were reviews of care plans although the reviews did not always fully consider changes in need. The staff said that the needs of residents are fully discussed on staff changeover and as a small home the staff had clear understanding of the needs of the individual. The staff received regular training in safe moving and handling and they were very alert to changes in residents’ nutritional intake. A visiting nurse said the home had a good relationship with the local surgeries and they sought appropriate assistance and would seek clarification of instructions. She added that the staff were always welcoming and there was a very positive and supportive atmosphere in the home. During a tour of the premises, it was noted that one person had a bed lever provided to assist independent mobilisation from the bed. However, the device was incorrectly fitted and could lead to entrapment injuries for the resident. The matter was drawn to Mrs Marshall’s attention who immediately repositioned the item. Residents said they were well treated by the staff. They added that the staff arranged for Doctors and nurses to visit as needed. One person said that they had recently seen an optician and had new glasses. The residents were all well presented and they said that the staff worked hard to ensure that their clothes were returned to the rightful owner after washing. The home use a monitored dosage system provided by a chemist chain. The medication was safely stored and there was a clear audit trail for medication in use. The records seen were up to date. Where handwritten additions were needed, there were normally checks carried out by a second person, to reduce the risk of transcription errors. The staff were trained to manage the medication safely. There were reference books available to the staff. Residents said the staff managed the medication for them and they were very happy with the service. Throughout the visit, the inspector noted a relaxed and homely atmosphere in the home with the staff treating the residents with friendly respect and courtesy. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13. 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Chaseborough House offers high levels of choice for the residents’ daily lives, helping individual to feel valued and supported. EVIDENCE: The home arranges a variety of activities both in and out of the home. The previous day a number of residents had gone into the local village to join in with an activity group. Mrs Marshall and the residents who had attended had voted the trip as a great success and there were plans to repeat the event to attend armchair exercise sessions at the same venue. One person who had attended said she had enjoyed the opportunity to re visit the village and meet new friends. The home had also arranged a coach excursion during August, 10 people had expressed an interest in the trip. Residents said they enjoyed the entertainers who regularly visited the home, there were two pianists, one playing classical music, the other popular songs, which they could join in with. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 12 The care plans considered social needs and pastimes, one showed that the person enjoyed reading the paper and completing the crossword and the home had sent up the newsagent account. One visitor said that he had been very pleased with the home over the three years he had visited his relative, he always found the staff friendly and approachable and that they had kept him informed about changing needs. Residents were recently given the opportunity to vote in local elections through postal ballot papers. People said the staff helped them maintain good levels of independence and they were able to exercise choice in their daily lives. They said they were able to get up at their preferred times; several said they were quite early to bed but this did not present a problem to the staff. The residents were unanimous in their praise for the food offered. They said the food was described as homely and traditional. There was good variety. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems and training in place to ensure that concerns were properly addressed. This helps to ensure the safety of the residents. EVIDENCE: The home has a copy of the complaints procedure in the main entrance accessible to residents and visitors. The home reacts to concerns raised by residents and visitors immediately and there have been none recorded recently. The records also contained letters and cards from appreciative families of the residents. Residents said the Mrs Marshall was always accessible and they were able to discuss any worries with her directly. Any issues they had were dealt with promptly and without fuss. The staff receive training in responding to signs or allegations of abuse. The staff seen during the visit were aware of their obligations and would contact external agencies if the circumstances warranted. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Chaseborough House provides a homely and supportive environment. Some areas need attention to improve safety and reduce risk to the residents. EVIDENCE: The premises provide a comfortable and clean environment for the residents. They say the home is kept heated to a comfortable level all year. Most radiators had been covered as a precaution to reduce the risk of burns. The remainder had been turned off with no marked impact on the comfort levels for the residents. The rooms visited were personalised by the occupants’. There were accessible call points for the residents to call for assistance as needed. Lifting seating in the bathrooms had recently been serviced. There were soap and paper towels provided in the bathrooms and toilets. One bathroom on the ground floor had been locked to prevent residents from Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 15 entering unattended. There were other accessible toilets nearby. The staff toilet on the ground floor was fitted with an internal draw bolt and could result in a resident locking themselves in, this should be replaced with a suitable lock. One cupboard containing cleaning materials was unlocked and could pose a risk to the residents. There was a bottle of toilet cleaner left unattended in one toilet. Staff had access to disposable gloves and aprons to help prevent the risk of cross infection. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The workforce have appropriate training and skills to ensure that the residents are properly cared for. EVIDENCE: The home benefits from having a stable and loyal workforce creating very good continuity of care for the residents. The home was staffed by two carers between 08:00- 22:00 with one wakeful and one sleep-in the remainder of the time. Mrs Marshall confirmed that the night times are generally quiet and she is seldom called unless one of the residents is unwell. She added that a sleepin person is employed when she is away from the premises. A cleaner supports the carers during the morning. Residents said the staff were busy but they took time to spend with the residents. There had been no new staff employed since the last inspection and Mrs Marshall had procedures in place to ensure that any new recruitment would meet the required standard. There were plans to ensure that future induction would meet the National Training Organisation’s standards. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 17 Two carers were finishing their NVQ level 2 in care all others had either NVQ level 2 or 3. One member of staff said she had completed her NVQ through a local training provider and found the training rewarding. She had also been trained in managing medication using a monitored dosage system. There had been recent training updates for manual handling, infection control, dementia awareness and fire safety. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to be appropriately managed for the benefit of the residents. There were areas where further attention will improve the overall rating. EVIDENCE: Mrs Marshall had recently completed her NVQ level 4 Registered Manager Award. She had operated the home for many years and had a wealth of experience. Mrs Marshall’s relationship with the residents and their families ensures that the home is run in the best interests of the residents. Annual surveys are completed to ensure that no issues are missed. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 19 The home looked after spending money for some of the residents; a sample of two showed the balances held matched the transaction records and receipts. The home did not manage finances for any of the residents. The home did carry out formal supervision, although recently they had not been carried out. The staff did say that informal supervision took place daily. The home’s completed accident records were safely stored. Staff had access to the blank forms. During discussion with Mrs Marshall, it was clear that notification, to the commission, of significant events which affect the well being of residents was not always carried out. The home’s fire safety systems and training records were up to date and the staff confirmed that regular drills and training was carried out for all staff including those working at night. As stated above there were safety issues regarding the storage of cleaning chemicals, and the use of a draw-bolt on a bathroom door. An Environmental Health Officer from the local authority had visited the previous week and had given advice re the kitchen cupboard surfaces and Mrs Marshall was considering taking action to address this. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 4 2 x x x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 X 2 Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP3 Good Practice Recommendations The pre-admission assessment should:• include all recommended topics • be signed and dated • identify those involved. Where residents’ mobility is reduced, the home should develop a manual handling risk assessment for that individual. Where necessary a referral to an Occupational Therapist should be made. Where specialist equipment is provided it should be safely installed in line with the latest guidance. The home should ensure that all hazardous chemicals are safely stored. 2 OP8 3 4 OP8 OP19 Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 22 5 OP19 The registered person should ensure that appropriate locks are fitted to all doors. Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Chaseborough House DS0000026779.V345127.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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