Inspection on 02/02/06 for Chasewood Lodge

This inspection was carried out on 2nd February 2006.

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

Chasewood Lodge 23/03/10

Chasewood Lodge 06/01/10

Chasewood Lodge 17/01/09

Chasewood Lodge 12/12/07

Chasewood Lodge 23/11/06

Chasewood Lodge 13/04/06

Chasewood Lodge 09/06/05

Chasewood Lodge 04/10/04

Chasewood Lodge 18/05/04

Similar services:

Coton Hill House

Doddington Lodge

Far Croft

Churchill House Nursing and Residential Home

Field Farm House

Church Terrace Nursing & Residential Home

Fountain Court

The Forbury

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

CARE HOMES FOR OLDER PEOPLE Chasewood Lodge Mcdonnell Drive Exhall Coventry West Midlands CV7 9GE Lead Inspector Patricia Flanaghan Unannounced Inspection 2nd February 2006 11:45 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 Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chasewood Lodge Address Mcdonnell Drive Exhall Coventry West Midlands CV7 9GE 02476 644320 02476 644320 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) Chasewood Care Ltd Ms Maria Christine Edwards Care Home 107 Category(ies) of Dementia (12), Dementia - over 65 years of age registration, with number (95) of places Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The initial number of residents accommodated will be limited to 10 on the blue unit. All building work and furnishing is completed in the blue unit prior to service users being placed and documentation showing evidence of completion is provided to the Commission All further increases in occupancy up to a total of 107 must be staged and agreed in writing with the Commission and may be subject to further site visits. Service Users admitted to the blue unit must not be subject to any disturbance in respect of the ongoing building work. The drive way and the moat must be risk assessed and be made safe for staff, service users and relatives prior to opening of the new unit. The new laundry must have a sink for hand washing installed before December 31st 2005. 9th June 2005 Date of last inspection Brief Description of the Service: Chasewood Lodge Care Home is registered to provide care to 107 elderly people. And is registered to care for those with dementia. At present the upper floor of the new extension is being completed service users have started living in on the ground floor. Chasewood Lodge is situated in a cul-de-sac and lies next to the M6. The nearest town is Bedworth and can be reached by car. There is no local bus service to the home. As Chasewood Lodge is still completing the work from a large extension there is no suitable garden area at present. Landscaping has been agreed and this will be completed by the end of spring. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection of 2005/06 inspection cycle and was carried out by two inspectors. The inspection visit was unannounced and was undertaken over 5 hours. The service has almost completed the new extension. The ground floor is now open and residents have been admitted. Records related to resident care, staff training, supervision of staff and health and safety were examined. A tour of the home was also undertaken visiting a selection of bedrooms and communal areas. Eight residents were spoken with; two relatives were seen during this visit. Six care staff were also spoken with. The registered manager and registered provider were both available throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: There are a number of areas that the service have still got to improve in: ♦ ♦ ♦ The relationship between assessments, risk assessments and evaluations of care must be reflected in the care plans. Care plans must give clear guidance on the actions to be taken by staff to meet the needs of the residents. Risk assessments associated with falls and skin integrity must be completed and suitable preventative care plans developed where required. DS0000004215.V282143.R01.S.doc Version 5.1 Page 6 Chasewood Lodge ♦ ♦ ♦ ♦ Medication storage and the procedure for administering medication in the new build must be addressed. Cleanliness in the home still needs improving and unpleasant smells dealt with promptly. Residents must be given clear choices concerning what they drink and these must be served appropriately. There was little evidence of suitable activities for all the residents and this must be developed. 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. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 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 Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 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 Residents mostly receive a full assessment prior to moving in to the home and are assured that their needs can be met. EVIDENCE: Three profiles were examined and it was found that in two cases a social service care manager assessment was available describing the care needs of the individual resident. The home had not clarified these and ensured that they could effectively meet their needs. In a newly admitted resident it was found that a full assessment prior to admission had occurred. The home has now implemented a full assessment process. There is a poor organisation of long and short-term care plans for this resident to assist the staffing ensuring that the needs are met appropriately. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 The residents’ health, personal and social care needs are not completely set out in individual care plans which could result in care needs not being completely met. Health care needs are partly met, gaps that exist could result in needs not being met. Procedures and storage of medication in the new unit pose a risk. EVIDENCE: Three profiles were examined; one was from a new admission. In the new admissions profile it was seen that there were risk assessments for nutrition and manual handling. Risk assessments related to skin integrity; mental health and continence were not available. The care planning assessment was not fully completed and there were two care plans; one associated with personal care and the second in relation to the residents mobility and the need to use crutches. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 10 The resident was seen walking around without the crutches. It was determined through discussion that due to failing memory the resident at times forgets the crutches. No care plan was seen concerning this. The other two profiles examined were related to residents who have lived at the home for some time. In one profile there was more than one set of care plans for continence and mobility, both prescribed different care and it was unclear what had generated the completion of new plans. There was evidence in the daily records that this resident had deteriorated physically and may need more intensive care. The care plans did not reflect this and information demonstrating the progress of deterioration was not available. A note in the ‘GP’s’ visits stated that in December the GP had been contacted, as the resident was unwell and increased fluids was prescribed; no corresponding care plans were seen or any follow up statements. The last full assessment of ‘Activities of Daily Living’ that assist staff in determining the care needs of the resident had not been completed since 2003. The monthly report completed by the key worker mainly reported on visits from family and cuddling toys. There was no mention of physical wellbeing or mental health. Information related to this resident’s care needs must be verbally communicated between staff as their needs are mostly met. This form of sharing information must be back by written information to ensure that all care needs are consistently met. The third profile examined had care plans that contained limited information related to the care required. The oral care plan was not appropriate as it stated that the resident should be ‘encouraged too clean teeth’. On discussion it was found that the resident no longer wears their teeth and they had been taken home by the family. Time was spent with this resident and it was determined that the resident is disorientated in person and place. Their hands were dirty and smelled and there was a general unpleasant smell. The staff were informed and took the resident to the bathroom. There were no care plans to guide staff on the care required specific to this resident behaviour that has occurred due to dementia. The weights of the residents are not consistently taken and it was noted in one profile that the resident had gained almost 10 kgs in one month. This was not investigated to determine if this weight was correct or if there was a failure in using the right procedure or the scales were wrong. In another profile the weights for the past year could not be located. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 11 Medication on the new unit was seen. There was no drug trolley and the medication was stored in a locked walk-in cupboard. Some medication was seen in the Multi-Dispensing System and other medication was in a large box. This medication belongs to all the residents on this unit. As there is no trolley the administration of medication is made from this store cupboard, which is time consuming and could result in poor administration practices. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 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 and 14 Residents’ lifestyle experiences in the home does not always satisfy their social, cultural, religious or recreational interests and needs. Residents are able to maintain contact with relatives and friends. Residents are mostly assisted to exercise choice and control over their lives. EVIDENCE: In each residents profile there is an activity sheet. These are completed weekly and the following was recorded: ♦ ♦ ♦ ♦ Visited by the hairdresser Had visit from relative Played with their doll Watched television There was no indication that any organised activities had occurred over the past three months. No organised activities were seen during the inspection. A number of residents were seen wandering around the home and during one period three residents were seen walking down the corridor trying the doors looking for a way to leave. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 13 There is evidence recorded that family and friends are welcomed to the home two relatives spoken with said that they are always welcomed and can visit when they wish. One relative has voiced concerns about the relationship with the home regarding visits to their relative. This has been investigated and referred to the registered manager to deal with. From discussion and observation it was noted that the residents are not always given assistance to make choices. Afternoon tea served in the older part of the home was served in such a way that there was no choice. The carer brought mugs of tea from the kitchen to each resident, no resident was asked what they wanted or would they prefer something different. No biscuits or cakes were offered. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 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): None of these standards were inspected at this visit. Standards 16 and 18 were reviewed at the inspection of 09/09/05 EVIDENCE: Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The environment is varied throughout in relation to safety, maintenance, comfort and cleanliness. This might reduce the experience of quality of life for some residents. EVIDENCE: It was informed that the integral lounge and dining room in the older part of the building had been refurbished. It was noted that two ceiling tiles were coming loose and the large radiator required painting. New chairs had also been purchased, one was seen with faecal matter down the side and a further chair was seen with white staining. The carpet had a large white stain; a carer stated that someone had cleaned the area with bleach as it was stained. In the shower room in the older part of the building it was noted that faeces was smeared on the shower curtain. Faeces were also seen in the corridor. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 16 During the tour of the home, the staff informed that inspectors that a resident was being barrier nursed as they had an infection. Later that day this resident was seen sitting in the communal dining room with other residents. Some bedrooms in the older building require refurbishment and re-decoration and some furniture requires replacement or repair. In the afternoon one carer was left for about 1.5 hours alone in the main lounge-dining area in the older building. This resulted in the carer asking the cook to go and find a member of staff to come and assist. Call bells in this area are not available and in an emergency immediate assistance would not be available this could result in increased risk to the residents and staff. The laundry in the existing building was untidy and disorganised. It was advised that staff would shortly be using the laundry in the new building. Clothes were seen on a wheelchair in the new laundry and the manager acknowledged that this was not a suitable method of transporting clothes owing to the risk of cross contamination. It is acknowledged, however, that this was the first day the new laundry was being used. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 30 A strong commitment to training ensures staff have the knowledge and skills to undertake their duties. EVIDENCE: Training records provided by the home show that staff have attended regular training on the conditions associated with old age. Recent training included Diabetes Awareness and Holistic Dementia Care. Induction training for new staff has been updated by the organisation. This covers all the standards from the National Training Organisation (Skills for Care) workforce training targets. A discussion was held with the manager and the senior staff member responsible for training on how to expand documentation detailing the training. A discussion was held on how a training matrix document could be produced. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 and 38 Resident’s financial interests are safeguarded. Staff are appropriately supervised. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered provider visits the home several times a week, but the requirement for completion of monthly audits of the home including an inspection of the premises and interviewing staff and residents is not been completed regularly. Monies held at the home on behalf of residents are handled in line with the homes policy of handling resident’s money, ensuring their financial interests are safeguarded. A sample was checked and found to be satisfactory. Secure facilities are provided for the safe keeping of monies. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 19 The supervision and appraisal of staff is now being done and evidence was seen of this in staff files reviewed. Individual supervision was being held that covered areas of practice and procedures. A discussion was held on the management could develop a personal development plan for each staff member which identifies training needs and form a basis for ongoing formal supervision. No health and safety hazards were observed. Evidence was seen to confirm that staff receive regular training in moving and handling, fire safety, first aid and food hygiene. Certificates were seen during the inspection for the maintenance and service of major systems. Accident records were examined, the quality system enables the manager to monitor accidents/incidents and the accuracy of recording. Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 2 X X X X X X 1 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 3 X 3 Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 3 Requirement The registered manager must ensure that the care plans reflect the needs of the residents and give clear and concise guidance to the staff. (Outstanding from June 05) 2 OP7 15 The registered manager must ensure that there is clear evidence that the care planned is evaluated monthly and changes are made to reflect changing needs. (Outstanding from June 05) 3 OP8 12 The registered manager must ensure that there are risk assessments for falls, and pressure damage completed for all residents on a monthly basis. Where a risk is determined a care plan must be devised describing the actions to be taken to minimise the risk. (Outstanding from June 05) 30/04/06 30/04/06 Timescale for action 30/04/06 Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 22 4 OP8 14, 17 The registered manager must ensure that all residents are weighed at least monthly and where this is not possible an explanation must be available in the residents records. (Outstanding from June 05) 30/04/06 5 OP9 13 The registered provider and registered manager must ensure that there is a suitable trolley available to store and administer medication on the new units in the home. The registered manager must ensure that activities in the home meet the needs of the residents and reflect their needs and abilities. The registered manager must ensure that staff offer and assist the residents to make choices regarding drinks, meals and other areas of daily living. 30/04/06 6 OP12 4 30/04/06 7 OP14 12(2)(3) 30/04/06 8 OP15 12 13 The registered manager must 30/04/06 ensure that it is clearly recorded in the residents profiles the actions to be taken by staff when a resident refuses a meal. The action taken and outcome must be recorded. (Outstanding from June 05) 9 OP19 39 13 4 23 Areas of the home are poorly 31/05/06 maintained. The registered provider and registered manager must audit the fixtures and fittings in the home and ensure that these are maintained and safe for the residents and staff to use. (Part Met) Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 23 10 OP22 23 The registered provider must ensure that there is a call bell facility in the main lounge of the home to enable residents and staff to summons assistance if required. (Outstanding from June 05) 31/05/06 11 OP24 16, 23 The registered manager must ensure that the furniture in the residents’ bedrooms is in good repair and where required broken furniture is either repaired or replaced. (Outstanding from June 05) 31/05/06 12 OP24 13 OP26 12, 13, 23 The registered manager must ensure that all residents have an individual locked facility for private and personal items. If the resident does not wish to have this facility this must be recorded and signed by the resident and/or their representative. 12 The registered manager must ensure that the unpleasant smells in some resident bedrooms is appropriately dealt with and where necessary the floor covering is replaced. The registered provider must ensure that the laundry area is kept clean and tidy. 31/05/06 30/04/06 14 OP33 26 The Registered Provider must visit the home at least once a month and prepare a written report on the conduct of the care home. A copy of this report must be forwarded to the Commission for Social Care Inspection (CSCI). 31/03/06 Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 24 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 OP35 Good Practice Recommendations It is recommended that two signatures should be recorded on transactions relating to residents monies. These should be the resident/relative depositing or withdrawing money and staff member. Where it is not possible to obtain the first signature two staff should sign Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Chasewood Lodge DS0000004215.V282143.R01.S.doc Version 5.1 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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