Inspection on 02/11/06 for Chasedale

This inspection was carried out on 2nd November 2006.

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

Chasedale 10/02/10

Chasedale 21/01/10

Chasedale 27/10/09

Chasedale 28/01/09

Chasedale 22/04/08

Chasedale 29/10/07

Chasedale 02/02/06

Chasedale 20/06/05

Chasedale 06/01/05

Chasedale 11/08/04

Chasedale 09/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Chasedale Tynedale Drive Cowpen Estate Blyth Northumberland NE24 4LH Lead Inspector Suzanne McKean Key Unannounced Inspection 09:30 2 November 2006 nd 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 Chasedale DS0000000508.V300606.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. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chasedale Address Tynedale Drive Cowpen Estate Blyth Northumberland NE24 4LH 01670 - 365997 01670 - 365732 chasedale@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) 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) Care Home 60 Category(ies) of Dementia - over 65 years of age (50), Old age, registration, with number not falling within any other category (10) of places Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named service users under the age of 65 years can be accommodated. Any changes to the named service users must be notified to the Commission. 2nd February 2006 Date of last inspection Brief Description of the Service: Chasedale Nursing Home is a two storey, purpose built facility of traditional brick build and tiled construction. It is situated on the edge of a large residential estate approximately two miles from the centre of the town of Blyth. The home is well served by public transport. The home has a car park to the front from which there is level access to the main entrance. There are grassed sitting areas, which are accessible to, and for the use of, residents and visitors. The home is registered to provide care to 60 persons 10 of which are the category of old age requiring nursing care and the remaining 46 under the category of dementia care (nursing). The home charges fees of between £380.42 and £400.78 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a total of 10 hours during two visits. Ten residents and four staff were spoken to at some length and others chatted to briefly. Five relatives were spoken to directly as they were in the home. Six care plans, and records for medication were examined. Also staff files, training records and health and safety documentation was looked at. There was one requirement made at the last inspection, which has been met. Three requirements have been made as a result of this inspection although it will take very little for them to be met as the Manager had taken action to start to address them prior to the end of the inspection. What the service does well: What has improved since the last inspection? The Manager is now registered with the Commission for Social Care Inspection and is working hard to improve standards. She is active in promoting the welfare of the residents as the primary aim of the service. The social care element of the care planning has been improved. And, the introduction of a very motivated social activities co-ordinator has been a positive step in giving the residents more choice and opportunity in their social lives. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 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. Chasedale DS0000000508.V300606.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 Chasedale DS0000000508.V300606.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have written contracts and terms and conditions of residency. These set out the rights, and obligations of all parties. The resident needs are identified during the detailed assessment carried out both before and after admission. Residents or relatives can visit the home before making any decisions to stay and receive information to help them make up their mind. EVIDENCE: Five care plans were examined and each has comprehensive pre-admission assessments, which were undertaken by the Manager or the senior staff in the home. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 9 The residents also have a care management assessment, which is provided to the home on admission. An individual care plan is produced from these documents. The home is not registered for, and therefore does not provide, intermediate care. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have a care plan and the care is given as it describes in these plans. The residents are having their needs met. They are being given their care with courtesy and in privacy. The social care element of the assessment and care planning is now detailed. The residents receive their prescribed medication according to safe working practices. The medicines in the home are well managed. EVIDENCE: All residents have a care plan which includes a detailed assessment and a plan of care. Five care plans were looked at closely during the visit and were a good standard. Relevant risk assessments are completed for: prevention of falls, wound care, moving and assisting, and continence promotion. There is an assessment to look at residents’ food and fluid intake. If a resident has any unplanned weight loss a plan is drawn up to address this. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 11 Residents access NHS services and facilities as necessary. The care plans showed that specialist advisors are used for individual residents. There are no residents currently in the home who have pressure damage wounds. The care plans show that the personal and health care needs of the residents are being met. The care being given during the visits also showed this for personal and health care areas. The care planning in the all male unit are particularly detailed and show good evidence of the resident being involved in them being written. They are very detailed and offer good mental health assessments and detailed planning for delivering the care. The social assessment now describes the resident’s social needs. The planning in this area was therefore not in sufficient detail to reflect the way the resident would have their social needs met. There are a number of social opportunities available in the home and this is not fully reflected in the individual care plans. They were dressed for the activities they were undertaking and looked smart and tidy. The four residents who were able to speak to me were positive about the care being given. Comments made included “its lovely here” and “she’s lovely (pointing at the nurse) I really like it here”. Medicines management was appropriate. The staff record the medicines correctly when they are ordered. The prescriptions are then checked when they are received in the home from the General Practitioners and are then sent to the Chemist for dispensing. The medicines received from the pharmacy are checked against the record of what was ordered and prescribed so that any errors can be picked up. Medicines no longer required are disposed of safely. No resident manages his or her own medication. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are offered some social activities and are encouraged to take part in those they find interesting and able to take part in, and this is being developed further. The residents are being encouraged and supported to maintain contact with their families. The residents are given a balanced, nutritious diet given at appropriate times in a satisfactory environment. EVIDENCE: There is a new activity co-ordinator employed who works 35 hours a week. She has worked hard to improve the social opportunities for the residents. She has introduced a shopping trolley and has planned a Christmas party and carol singers. The activities co-ordinator organises Bingo and trips to the local public house. A number of residents have been assisted to visit the local Asda for shopping and to have a coffee. She has introduced a “trolley” containing sweets and soft drinks as well as some toiletries and items for person use. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 13 Relatives commented that this was an improvement as residents can now choose their own treats and personal items. There are plans to further improve the individualised social planning to ensure that the needs of the residents are more clearly identified and fully met. During the second visit some of the residents were involved in playing dominoes and the staff were assisting them in playing. On the first visit day the food was tasted; it was being served at the appropriate temperature and was tasty. The residents were complementary about the food during the mealtime and appeared to enjoy it. Alternatives were offered for both the main meal and the pudding/sweet. The morning “tea trolley” offered a varied selection of drinks. There was tea, coffee, or cold drinks of either juice or milk. There were biscuits provided. The bedrooms are personalised according to the taste of the resident and where possible they choose their own decoration. Two residents said they were happy with their rooms and that they had a lot their own personal items around them. Residents have visitors at any time and are able to use their own rooms, or the lounges to see them. Three relatives said that they are welcomed into the home. Residents said they were happy with the arrangements for visitors. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are made aware of the complaints policy and it is available in a variety of places. There is a system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. The Manager is very responsive and effective in dealing with Protection of Vulnerable Adults issues. EVIDENCE: The complaints procedure is available in the service users guide and a copy is available at the front entrance as well as being displayed in the home. The records of the complaints made to the home were examined. There have been five complaints recorded and the records of these were detailed including the response to the complainants and the action taken in response to the issues raised. Two of the residents were asked about the way in which they would have any problems dealt with. Each was able to identify the way this would be done. Three relatives who were visiting the home were aware of the complaints procedure but had not needed to use it. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 15 The home has been subject to two Protection of Vulnerable Adult investigations since the last inspection both of which were reported by the Manager. These were resolved by the home with the support of the Social Services department and showed the Manager, Mrs Gibbon’s, continued determination to ensure the safety of the residents in her care. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well organised and the staff are knowledgeable regarding the ways to prevent the risk of cross infection in the home. The environment is well decorated and maintained the only exception to this being the need to replace the lounge carpet on the ground floor general care unit. Good records are maintained of the health and safety practices and maintenance of the building and facilities. EVIDENCE: A tour of the home was conducted both with staff and alone; the home is clean and was odour free on the day. The entrance to the home is particularly Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 17 attractive and is warm and welcoming. The home is well decorated and maintained. The Manager is aware of the need to continue the redecoration programme to deal with any wear and tear occurring. The residents and relatives who were asked about the bedrooms said they were happy with the decoration and that the rooms were kept clean by the staff. The laundry was clean, organised and well equipped. The laundry staff use gloves and aprons as necessary. There are three washers, which have a sluice facility and two dryers. The laundry is equipped with a roller press and domestic type iron. The sluices were tidy and clean and the disinfectors operational. Staff follow infection control policies and use appropriate equipment. The kitchen area was clean and well organised and there is an up to date cleaning schedule which identifies all areas to be cleaned, how often they are completed and who was responsible for undertaking it. There are two bathroom and showers on each floor were tidy and clean. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is an effective recruitment and selection system, which ensures that residents are cared for by well-trained, skilled staff and are in safe hands. The training programme is up to date and covers a large spectrum of both clinical and statutory areas with the exception of moving and handling. EVIDENCE: On both of the visits there were staff on duty in line with the staffing levels agreed with the Commission for Social Care Inspection. The first day of the visit there was the Deputy Manager, two qualified nurses and nine carers. There were sufficient domestic and catering staff on duty. There is a full time administrator employed who was also on duty on both of the visits. The staffing rota showed that the following staffing levels are currently followed: General elderly unit for 10 residents - 1 qualified nurse and 1 carer (need 1 and 2 on the general unit for 10 residents all of which are highly dependent. Male unit for 7 residents - 1 qualified and 1 carer Dementia care unit (first floor) for 34 residents - 1 qualified nurse and 5 carers Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 19 There is sufficient night staff on the rota to meet the needs of the residents. The residents on the general nursing unit are all assessed as having a high level of dependency. They all require two staff to provide care to them for all of their care needs. This leaves the other residents having a lower level of supervision during the periods when one resident is receiving care, therefore increasing their level of risk. There has not been a review of staffing levels in this unit to ensure that it is adequate to meet the needs of this current resident group. Staff records are completed according to the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check is applied to all of the staff in the home. The training records were looked at. There is training in both statutory and clinical areas and staff are given training in line with the company policy. Training provided includes moving and handling, health and safety, skills for care induction, first aid, and food hygiene all of which were up to date. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mrs Gibbon has been appointed as the Manager since the last inspection and has completed the “fit person process” with the Commission for Social Care Inspection. She has put in place systems manage the home effectively taking into account the needs and wishes of the residents. She demonstrates a very pro-active attitude to improving the standards in the home. There are effective health and safety systems, which include staff training and risk assessments, with the exception of the fire risk assessment. Staff supervision is up to date. Resident’s personal finances are managed appropriately. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 21 EVIDENCE: There is a system and records to review health and safety; it involves all of the staff. There are records of regular staff meetings and the contents suggest that there is broad spectrum of relevant issues discussed. The Manager continues to consult the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. The manager does regular tours of the building herself when she speaks to residents and relatives, who at the visits knew her well. She has audits for care plans, medication administration and the kitchen, as well as accident analysis for each of the units and resident at risk reports. There are relatives meetings arranged, the last of which were in October 2006 and before then in June and April 2006. And, although they were not well attended (usually around seven relatives) there was information recorded of the topics discussed. Staff meetings are conducted for qualified and care staff as well as the other ancillary staff. The fire records are up to date and the training is being provided to staff as necessary however there is no fire risk assessment in place. The Manager is awaiting further advice to complete this, but this is must now a matter of urgency. There is a system in place for undertaking staff supervision and this is up to date. The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. There is still a shared bank account in place. However, the administrator has examined the records and has made changes to ensure that all residents who can have their money saved in their own bank account can do so. Where Northumberland County Council is appointee and the resident has sufficient money in the home for their needs they are having their money stopped from being transferred to the home. There is new system in place for purchasing residents items on behalf of residents, the administrator sees the items and checks them against the receipts, which are then signed and kept. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 22 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 2 Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 23 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. Standard OP19 OP27 Regulation 23 (2) 18 (1) Requirement The lounge carpet in the general nursing unit is damaged and must be replaced. Staffing levels must be reviewed to ensure that sufficient staff are provided to meet the needs of the residents. A fire risk assessment must be completed and available. Timescale for action 01/01/07 01/12/06 3. OP38 23 (4) 01/12/06 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 OP15 Good Practice Recommendations It is recommended that the Manager review the dining areas and setting arrangements to make them more stimulating as an eating environment. Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Chasedale DS0000000508.V300606.R01.S.doc Version 5.2 Page 25 - 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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