Inspection on 26/05/05 for Chaseview Care Centre

This inspection was carried out on 26th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Chaseview Care Centre 25/01/07

Chaseview Care Centre 17/05/06

Chaseview Care Centre 14/11/05

Chaseview Care Centre 15/12/04

Chaseview Care Centre 26/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Chaseview Care Centre Off Dagenham Road Rush Green (hospital site) Romford Essex RM7 0XY Lead Inspector Edi OFarrell Unannounced Inspection 26 May 2005 09:20 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. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chaseview Care Centre Address Off Dagenham Road, Rush Green (hospital site), Romford, Essex RM7 0XY 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) 020 8517 1436 020 8595 8960 BUPA Care Homes (CFH Care) Ltd CRH Care Home 120 Category(ies) of DE(E) Dementia - over 65 (30) registration, with number OP Old age (90) of places Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15 December 2004 Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Chaseview Care Centre is a registered care home with nursing operated by BUPA, a large, private sector, provider with similar homes across the UK. It is situated in a residential part of Romford, on a main bus route to both Romford and Dagenham town centres and rail/tube links. There are 120 places in total spread across four houses, each of which provide 30 places. Ford House offers specialist nursing and personal care for older people with dementia; Kennedy House and Nicholas House each provide nursing and personal care for older people who have physical and psychological disabilties/illnessess; and Hart House provides residential care for older people whose nursing needs can be met by visiting professionals. Each house has a similar layout of 30 single, ensuite bedrooms, communal bathrooms, shower rooms and toilets, large lounge/dinning area, small kitchen, staff office, sluice room, and clinic room. All areas are fully accessible to wheelchairs, and have aids to assist people with disabilities. The accomodation is spread over two floors, and there is a lift in each house. A central kitchen and laundry service all four houses. Two of the houses have sensory gardens and a volunteer runs a gardening club. Three staff are employed specifically to organise activities, and the nursing and care staff are supported by a team of catering, domestic, adminsitrative and maintenance staff. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This, unannounced, inspection took place on a weekday over an eight hour period. The main focus was on checking progress in response to 27 Requirements and four Recommendations set at the previous, announced, inspection, and on assessing how well each house was meeting the health and personal care needs of the service users. The manager was on annual leave but came in to assist with the inspection, and is thanked for that, as are the other staff and the service users who contributed during the day. Evidence to support the findings of this report was gathered by meeting service users, and where possible obtaining their views; discussions with staff and managers; examination of records; direct and indirect observation during the visit; and from information held by the Commission in relation to recent incidents and complaints. The Standards relating to health and personal care were assessed in all four houses, whilst other Standards were only assessed in one or two of the houses. To take account of this examples have been used in the body of this report that refer to specific houses. However, the Commission has registered all four houses as one home, so all the Requirements set must be applied across all four houses, even if the Standard was not assessed in a particular house. The vast majority of the time on this inspection was spent on checking on the quality of direct care to service users. For this reason some sets of Standards were only assessed to see if the Requirements and Recommendations set at the previous inspection had been implemented. A through assessment of these Standards will be made at the next inspection. What the service does well: Although this is a large home with a total of 120 places the design of the building, with the four separate houses, means that living there is like living in a smaller home. Each house has a separate team of nurses and carers and this means that they and the service users can get to know each other well. This is particularly important where service users have limited verbal communication due to disability or illness. As one of the houses is residential and the other three are nursing this should mean that residents of the former would not have to move from the home if their needs increase, therefore reducing the level of disruption to their lives. The houses are bright and airy, and well decorated and maintained. All bedrooms have an ensuite toilet, and service users are encouraged to personalise their rooms. This includes small items of furniture and personal Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 7 bedding, where wished. There is ample internal communal space, and some pleasant outdoor seating areas. There is a varied activity programme, which both service users, and their friends and relatives, are encouraged to take part in. The home has a good assessment and care planning system, which means that service users’ needs, including changing need, can be identified and met. Specialist visiting professionals, such as nutritionists, and speech therapists are asked to provide advice where necessary, to ensure that service users’ needs are met. What has improved since the last inspection? What they could do better: As stated above there is a good assessment and care planning system, but it is not always used consistently. Whilst there has been an improvement in this since the last inspection this inconsistency could result in some service users’ needs not being fully met. Ford House provides a specialist service to people with dementia, many of whom, due to their level of disability, will present a challenge in relation to both communication, and behaviour. This can affect the environment within the house, and make some areas look very sparsely furnished. This can affect the quality of life of the people living there. The environment can also be used therapeutically to reduce the impact of dementia on the daily lives of service users, and some efforts have already been made, such as large signs for Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 8 different parts of the house. This work needs to continue, so that the overall quality of care will be improved. 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. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 9 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 Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 10 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, 3, 4 & 5 Service users have the information they need in order to make an informed choice about where to live, but in many cases it is relatives who make the decision. Service users’ needs are fully assessed before they move into the home, but some needs may not be met during their initial stay in the home, as only some of this assessment information is being used to develop initial care plans. Prospective service users and their relatives and friends have an opportunity to visit the home, speak to other service users, and to staff. EVIDENCE: The Statement of Purpose has been revised in response to a Requirement set at the previous inspection, and now reflects the current management arrangements at the home. Prospective service users for the three nursing care houses are, in the main, referred from hospitals or residential care homes, and do not often get to visit before admission. There is a four-week trial period, which allows for their, and their representatives’ views to be Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 11 sought. In the residential unit prospective service users visit for tea prior to making a decision. The care files examined in all four houses demonstrated that pre-admission assessment is thorough, and is carried out by competent professionals. Community care assessments, where carried out, were on file, as were preadmission assessments carried out by the home. In Ford House the file for a service user admitted during the past week showed that only some of this information had been used in developing an initial care plan. This is covered in more detail in the following section but refers to Requirement 1. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 12 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 & 11 Service users’ needs are set out in care plans, but these are not always completely accurate. Inconsistencies in record keeping may mean that some health and personal care needs are not fully met. The home’s policies and procedures for dealing with medicines are not being fully complied with, which could result in service users not receiving food supplements as prescribed. Management and staff have worked hard to meet the nine Requirements and one Recommendation set under these Standards at the previous inspection, but further work is still needed to ensure that all parts of the service meet all needs in a consistent way. EVIDENCE: Nine care files were examined across the four houses, and compared with the care being provided during the visit. Where possible each of the nine service users were asked for their views, but in some cases the level of disability/illness meant that they could not express their views. The care of these nine service users was discussed with either the manager and/or the nurse in charge of the house, as well as being cross-referenced with other records such as complaints, accidents and incidents. The nine Requirements Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 13 and one Recommendation set at the previous inspection were checked for action. The home has a comprehensive system of assessment, care planning, and recording, which when fully followed means that service users’ needs are met. Some case records showed that this was the case, whilst others showed that inconsistencies still remain. In Ford House one care plan, where the service user is a diabetic, stated that the blood sugar level should be tested and recorded daily or weekly. The nurse reported that this is done weekly, but the records showed a very irregular pattern with only two results recorded in both January and April 2005. Where clinical tests are part of a care plan the frequency must be clear, and be followed. This is Requirement 2. In the same file a body chart had been completed on 23/03/05 showing a pressure sore on the right hip, yet the care plan review section for that period stated `skin remains intact continue as planned’. This was discussed with the senior nurse who reported that the bank nurse who had undertaken the review was unaware of the change in condition. This record was amended and initialled by the senior nurse and the inspector during this inspection, so that there is now an accurate record of events. The nurse also explained that the care plan being examined was for the risk of pressure sores, and that once any are identified a new care plan for the treatment of pressures sores is drawn up, but that once the sores have healed this is then taken out of the care plan, as no longer being current. The nurse produced the wound assessment, and treatment plan, and these were comprehensive and appropriate. Whilst the Commission is satisfied that, in this case, the service user received prompt and appropriate care in response to changing need, considerable concern remains that records were inaccurate, and that it was not possible to get a full picture of needs and how these were met over a period of time. This is Requirement 3. In Kennedy House in one care plan, where the service users is fed via a PEG tube, there was evidence of in-put by the specialist nutritional service, and the speech and language service, resulting in a comprehensive care plan, with effective risk assessments. However, the recent introduction of a very small amount of puree food was not consistently recorded in all parts of the care plan, with some relevant pages still stating nil by mouth. In addition the PEG feeding regime is either not being correctly followed or the charts are not always being filled out correctly. This is Requirement 4, which is restated from the previous inspection. A random medication sample was audited from all four units at the last inspection, when several areas of concern were identified. Due to time constraints it was not possible to follow this up comprehensively at this inspection, and a Commission pharmacist inspector has been requested to make an additional visit to the home. On Ford House it had been identified Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 14 that a service user was losing weight, and this had been responded to by weekly weighing, extra fluids, and referral to the dietician. The nutritional plan then included the administration of a food supplement, but this was not referred to in the monthly review. This supplement is also not recorded as prescribed in the Medication Administration (MAR) chart, though the senior nurse did confirm that it is given once a day. The only explanation for this is that this service user is given someone else’s food supplement. This is contrary to medication administration policy and procedure and refers to Requirement 5. As a food supplement was also identified in another person’s care plan, but again not prescribed on the MAR chart the senior nurse and the manager of the home were advised to carry out an audit of the care plans in relation to this aspect of care. This is Requirement 6. Three Requirements were set at the previous inspection in relation to Standard 10; these all related to Ford House and the way that the service could be improved. During this inspection the senior nurse and the manager provided information on how they intend to improve the quality of care, using delegated responsibility, supervision, training and staff meetings. As one part of this plan the senior nurse is undertaking advanced diploma training in order that she can provide further training on the care of people with dementia to all staff working in the house. As this plan has only recently been implemented, and as several areas of concern were identified during this visit in relation to the quality of care in Ford House, a new timescale has been set for Requirement 7. Some of these concerns are commented on in the Environment section of this report. A requirement has been set at the previous two inspections that staff must receive training ad support around bereavement issues. The manager provided written evidence that a programme is now in place, with seven staff having attended to date, and further sessions having been booked. A Requirement was also set at the previous inspection that the wishes of service users at the time of their death should be recorded in the care plans. This has yet to be fully actioned and has been taken forwards as Requirement 8. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 15 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 Service users have a lifestyle that, as far as possible in a group living environment and taking account of level of disability/illness, matches their expectations and preferences. Friends, family and the local community are encouraged to take part in the life of the home. Service users are helped to exercise choice and control over their lives. Some service users’ dietary needs may not be being fully met. EVIDENCE: Examinations of records, discussion with service users and staff, and direct and indirect observation during the visit have been used as evidence in this section. The pre-admission assessments and the care plans clearly state preferences in terms of food, daily routine, and how service users wish to be addressed. The home employs three members of staff with specific responsibility for activities, and also has a volunteer, who runs a gardening club. During the afternoon of the inspection a local church held a service in one of the houses, and this was well attended, and obviously enjoyed. A massage session was also being held. Standard 15 was not fully assessed during this visit, though has been assessed as met at previous inspections. This inspection commenced at 09.20 on Ford house, and some of the service users were still having breakfast. This was observed to be unhurried, with staff assisting people to eat and drink as Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 16 required. The breakfast in this house consisted of tinned spaghetti hoops, porridge or cereal, all accompanied by bread. The nurse reported that spaghetti hoops would normally be accompanied by scrambled eggs, but this dish was not seen in the hot-trolley. On asking service users and staff in the other three houses later in the day it was apparent that a wider breakfast menu had been available to them. Due to time constraints it was not possible, during this visit to thoroughly investigate why the breakfast was different on Ford House than the other three houses. This will be followed up at the next inspection. Requirements 5 and 6 apply to this Standard. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The providers take complaints seriously and where necessary managers external to the home carry out investigation, but the current recording system used within the home may not help in maintaining accurate chronological records. Management have responded appropriately to alleged adult abuse incidents when staff have followed the whistle blowing procedure. There is at least one potential abuse that has not been investigated appropriately. EVIDENCE: This is a large home, and at anyone one time there are usually a number of on-going complaints. The records were examined and discussed with the manager, who confirmed that in two current cases managers external to the home are carrying out the investigations due to the complexity of the complaints. A requirement was set at the previous inspection that the records must indicate whether the complainant was happy with the investigation that the home undertook. From examination of the records during this visit it was possible to see if this was the case or not, but the current system of filing the records of complaints is on a month by month basis, and this can mean that some paperwork is filed under one month, and other paperwork, relating to the same complaint, is filed under another month. In addition some paperwork was found in the complaint records that should have been filled in staff files. The registered person must carry out a audit of the complaint records so as to ensure that they provide an accurate, chorological, account and that, if Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 18 requested, they could be used to provide the Commission with a 12-month summary statement. This is Requirement 9. In one case file in Ford House a body chart had been completed on April 2005 on transfer from Nicholas House, which detailed bruising on the back of both arms. There was then a second body chart, dated 9 May 2005, which detailed bruising on the front of the leg but this was not mentioned in the daily log, nor was there an accident/incident report on file. There was a handwritten note on this body chart to say `couldn’t explain what had happened’. There is therefore no explanation for bruising, and this should have been investigated thoroughly, via referral to the relevant statutory authorities, using the adult protection procedure. This is Requirement 10. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 19 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, 22, 23, 24, 25 & 26 in relation to Requirements and Recommendations set at the previous inspection. The provider and manager have responded to Requirements set at the previous inspection, which have improved the environment for the service users. Staff are not always following infection control guidelines, which could pose a risk to the health of service users. Some bedrooms on Ford House do not have sufficient appropriate furniture. EVIDENCE: The vast majority of the time on this inspection was spent on checking on the quality of direct care to service users. For this reason this set of standards was not fully assessed. The Commission is satisfied that the owners and the manager and staff team have implemented the Requirements and Recommendations set at the previous inspection. A through assessment of these standards will be made at the next inspection. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 20 The design of the home, by being divided into four separate houses, results in there being a more homely atmosphere than one would expect in a 120 place home. All four houses were toured, and the nine Requirements set at the previous inspection were discussed with the manager and the Handyman. The Commission is satisfied that the required action has been taken. Not all bedrooms were visited during the inspection, but in two that were the bed side buffers were on the floor, in one case in the ensuite toilet, and in another in the bedroom. This ignores infection control guidelines, and is Requirement 11. Many of the bedrooms seen had personal possessions, but some on Ford House were extremely sparsely furnished. The senior nurse explained that service users often moved furniture from room to room, and that once all nursing and personal care needs were dealt with that staff would go round each room to put furniture back. However, the morning of the inspection was spent in this house, and no surplus furniture was noted in any of the rooms over an approximate three-hour period. On one of the tours of the house, unaccompanied by staff, it was noted that one service user had gone back to bed, but also that there was no chair in the room should she wish to have sat out. This relates to Requirement 7. All areas seen during the visit were clean and free from odours. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 21 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 in relation to Requirements and Recommendations set at the previous inspection. If care records were fully accurate, and all procedures fully followed, then service users’ needs could be fully met by the numbers and skill mix of the staff, and they would be in safe hands and protected. EVIDENCE: The vast majority of the time on this inspection was spent on checking on the quality of direct care to service users. For this reason this set of standards was not fully assessed. The Commission is satisfied that the owners and the manager and staff team have implemented the Requirements and Recommendations set at the previous inspection. A through assessment of these standards will be made at the next inspection. Three Requirements and one Recommendation set at the previous inspection were checked, and the Commission are satisfied that the home has taken action to meet these. The number of care staff has been increased on the nursing units since the last inspection. The manager has applied for registration and is due to have her fit persons interview in mid June. Some staff are still working long hours some weeks, but this is balanced by more time off in preceding or following weeks. Staff files were not inspected during this visit, but will be at the next inspection. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 22 Staff were observed carrying out their jobs, and where possible service users were asked their views. Some staff were asked about the way that they meet the needs of service users. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 23 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, 34, 36 & 38 only as they apply to Requirements and Recommendations set at the previous inspection. Five Requirements and two Recommendations set at the previous inspection have been actioned, resulting in greater safety for the people who live in the home. EVIDENCE: The vast majority of the time on this inspection was spent on checking on the quality of direct care to service users. For this reason this set of standards was not fully assessed. The Commission is satisfied that the owners and the manager and staff team have implemented the Requirements and Recommendations set at the previous inspection. A through assessment of these standards will be made at the next inspection. Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 2 3 1 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x 3 x x x x Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 25 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3, 7 & 8 Regulation 14 & 15 Requirement The registered person must ensure that a care plan is in place for all needs identified by pre-admission assessment. Where clinical tests, such as blood sugar monitoring, are part of the care plan, the frequency must be clearly stated and adhered to. Diabetic monitoring must be carried out in line with the care plan. Previous timescale of 30/03/05 not met. All service user records must be accurate, and reflect changing needs and how these are met. Enteral feeding must be provided in line with the dieticians feeding regime. Accurate records must always be kept of all feeds. Previous timescale of 30/03/05 not met. The registered person must ensure that where nutritional needs are idetified they are met within the medication administration policies and procedures of the home. Food supplements prescribed for one service user must not be used for another. Version 1.30 Timescale for action 31/08/05 2. 7&8 12 & 15 31/08/05 3. 4. 7&8 7&8 12 & 15 12 & 15 31/08/05 31/08/05 5. 7, 8, 9 & 15 12, 13 (2), 15 & 16 (i) 31/08/05 Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Page 26 6. 7, 8, 9 & 15 12, 13 (2), 16 & 16 (i) 7. 10 & 24 8. 11 9. 10. 16 18 11. 26 The registered person must carry out an audit of the care plans and medication prescriptions to ensure that where food supplements are included in care plans they are correctly prescribed for each service user. 12, 15, 16 The home must improve the (2) c & 24 quality of care provided in Ford House, including the provision of appropriate furniture in each bedroom. 15 (1) The wishes of service users at the time of death must be recorded in the care plan. Previous timescale of 30/04/05 not met. 22 The registered person must review the system used to record the investigation of complaintst 13 (6) All bruising, or other signs of potential abuse, must be thoroughly investigated, using the adult protection procedure, and records must be retained on file. 13 (3) The registered person must ensure that all nursing and care practices assist in the prevention and spread of infection within the home. 31/08/05 31/08/05 31/08/05 30/09/05 31/08/05 31/08/05 12. 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 Good Practice Recommendations Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Chaseview Care Centre G55_S0000015586_Chaseview_V228857_260505_Stage 4.doc Version 1.30 Page 28 - 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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