Inspection on 03/05/07 for Chater Lodge

This inspection was carried out on 3rd May 2007.

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

The inspector 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

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Chater Lodge High Street Ketton Rutland PE9 3TJ Lead Inspector Mrs Carole Burgess Key Unannounced Inspection 3rd May 2007 10:00 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 Chater Lodge DS0000069215.V335622.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. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chater Lodge Address High Street Ketton Rutland PE9 3TJ 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) 01780 720376 01780 720346 Barchester Healthcare Homes Ltd Jacqueline Law Care Home 45 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (20), Old age, not falling within any other of places category (45), Physical disability over 65 years of age (10) Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Chater Lodge is registered to provide care to male and female service users in the following categories: Dementia (DE) 20, DE(E), 20, Older Persons (OP) 45, PD(E) 10 No person under the age of 55 can be accommodated at Chater Lodge under the DE category. No more than 20 persons under the category or combined categories DE/DE(E) can be accommodated at Chater Lodge No more than 10 persons can be accommodated at Chater Lodge under the PD(E) category The maximum number of persons accommodated at Chater Lodge must not exceed 45. NA Date of last inspection Brief Description of the Service: Chater Lodge is a purpose built residential care home within the attractive village of Ketton. The home was built some three years ago and is set within well-maintained grounds and is bright, clean and modern in design. All areas of the home and gardens are accessible to people who use wheelchairs. All rooms have en-suite facilities and can be personalised with the resident’s own furniture, if so desired. There are attractive communal sitting rooms and dining areas on both the ground and first floor. There are additional assisted bathing and showering facilities for less able residents. There is an ‘in house’ laundry service and all food is freshly prepared and cooked ‘on site’. The Statement of Purpose and Service Users Guide (both give information about the home) are provided for all new residents, and a copy is available in the foyer, with the home’s most recent inspection report. Fees at the time of inspection were: £640 - £799.20 pr week. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. The site visit was unannounced and took place over five and three quarter hours. The Inspector selected four residents and tracked the care they receive through a review of their records, discussion with them (where possible), other residents, their relatives, the care staff, and observation of care practices. The inspector spoke with staff members regarding training and support. The Registered Manager (a person registered with the CSCI), Care Manager and other staff spoken with were positive and helpful during the inspection. Planning for the Inspection included assessing notifications of significant events sent to the CSCI by the home. There have been no complaints received by the CSCI regarding the home since its registration in February 2007. What the service does well: Chater Lodge provides an excellent standard of care within a bright, spacious, modern but homely environment. The home and the attractive gardens are well maintained and provide a safe environment in which residents can be supported to maintain as much independence as possible. The home maintains a very high standard of décor and cleanliness throughout. Food is nutritious and well presented, individual diets and preferences are catered for, and the cook and staff are very flexible to ensure that residents’ requests are accommodated. Visitors are made welcome and are able to dine with their relatives. There is a good activities programme for residents. Good levels of staffing ensure that the residents’ health and welfare needs are met. Residents and relatives confirmed that staff are very caring and respectful to the residents, ensuring their privacy and dignity at all times. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: There are three good practice recommendations: • • Review residents’ care plans at least once a month to ensure that they reflect residents changing needs for health and personal care. Ensure that residents’ new care plans are agreed and signed by the resident or their representative to show that they are involved in the care planning process and agree with the plan of care to be provided. Old care plans are being replaced – these were signed by the resident, or their representative. Update the complaints policy, providing a current contact address and telephone number for the CSCI. • Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Chater Lodge DS0000069215.V335622.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 Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with detailed information about the home, and have their health, welfare and social care needs assessed, so that they can be fully met once they move into the home. EVIDENCE: The home provides prospective residents and their relatives with a detailed Statement of Purpose and Service Users Guide (both give information about the home) to help them decide if the home is the right one for them. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 9 Copies of the residents’ contracts are kept in the home in a separate locked file and residents, or their relatives, are provided with a copy. A visitor confirmed that she had been provided with a contract when her relative moved to the home. The four residents’ care plans reviewed contained a detailed pre-admission assessment to show that the home could meet their specific health, welfare, and social care needs. It included personal details, relative and GP contact numbers, past and present medical history, current health care requirements and medications, personal preferences, social interests and hobbies. The home does not provide intermediate care. Chater Lodge DS0000069215.V335622.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health, personal and social care needs. EVIDENCE: The Registered Manager and Care Manger are in the process of introducing new care plans for all of the residents in line with Barchester Healthcare Homes Limited. The new care plans are detailed and give carers detailed information about the health, personal and social care needs of the residents. The recently completed care plans have yet to be agreed and signed by the residents and/or their representatives. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 11 However, a family member said that she had detailed discussions with the Care Manager, and had reviewed and signed a care plan on behalf of her relative when he first moved to the home. The home is recommended to make sure that all new care plans are seen, agreed and signed by the resident or their representative, and that the plan is reviewed at least monthly by the care staff so that residents’ care needs continue to be met. Contact with healthcare professionals such as GP’s, District Nurses, hospitals, and Chiropodists were recorded in the care plans to ensure that healthcare needs and treatments were addressed. Medication policies and procedures were sound. Residents are able to continue to self medicate following a risk assessment to ensure that they are safe to do so. Medications is only administered by senior carers who receive annually updated training to safeguard the residents, and ensure to that they receive their medication as prescribed. Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity. Staff spoke to residents in a respectful, friendly, quiet and supportive way. Three residents, spoken with during the inspection, said that they were very well looked after and that staff were kind, caring and respectful. A visiting relative said that the home provided an excellent standard of care and they were happy that their relative was so well cared for. Chater Lodge DS0000069215.V335622.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff work hard to ensure that residents experience a safe, stimulating and homely life style. EVIDENCE: The home has an information board in the foyer detailing forthcoming activities. On the day of the site visit residents were listening to music, walking in the gardens and generally enjoying the warm weather. There is a television, piano, large print books, and videos in the sitting room and the mobile library visits the home. The home employs an activities organiser who arranges special monthly entertainments – during May they were being visited by ‘Exotic Pets’. Daily activities such as skittles, videos, and reading group are also provided. Residents have regular meetings and their visitors are able to take meals with them. Birthdays and festive days are celebrated. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 13 Residents are able to have their own television and telephone in their room should they choose to do so. Residents said that they are able to have visitors at any time and a number of people came to visit during the course of the site visit. Staff support residents with making choices in their everyday life. All residents spoken with said they got up and went to bed when they wished, were able to choose what they wanted for their meals and were well supported by very caring staff. All meals are prepared in the home’s kitchen by the cook. A cooked breakfast is available every day and there are choices at all main meal times. Coffee, tea and biscuits are provided in the morning and afternoon and residents have a bedtime drink. Sandwiches and additional drinks are provided throughout the day as requested. Special diets such as diabetic and soft diets are catered for. Residents have a nutritional assessment in their care plan to ensure that their dietary needs are being met. One resident said that she enjoyed her meals but there was ‘too much’ food ‘which seemed a waste’. Residents and a relative said that food was very good and that there were always choices. Chater Lodge DS0000069215.V335622.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. 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. Arrangements for receiving and responding to complaints are sound resulting in satisfactory protection of residents’ rights. EVIDENCE: Residents and staff comments showed that people feel at ease discussing any concerns with the staff. Information regarding advocacy services is available in the foyer. The CSCI has not received any complaints regarding the home. The home has received one complaint from a relative since the last inspection, but prior to the new provider registering the home. The Registered Manager is dealing with this with in a professional and sympathetic manner. The home’s complaints process reflects the Safeguarding Adults policies and procedures and staff are being provided with appropriate training and were Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 15 able to demonstrate the correct procedures for safeguarding the residents from abuse. The home’s complaints policy requires updating to reflect current information for residents and their relatives relating to the CSCI. Chater Lodge DS0000069215.V335622.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A comfortable, clean, safe and high standard of accommodation is provided for the residents. EVIDENCE: The home is clean, safe and well maintained with many adaptations to suit residents’ specific needs. It is decorated and furnished to a high standard that creates a comfortable, light, spacious but homely environment. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 17 Residents have access to attractive safe gardens and all areas of the home are fully accessible for wheelchair users. Residents’ rooms have en-suite facilities and ‘nurse call’, and were clean and well decorated. Residents are able to bring items of their own furniture and possessions with them to personalise their rooms. All residents’ rooms were highly personalised, some with all of the resident’s home furnishings. There are sufficient toilets, bathing and assisted bathing facilities. Residents and a relative praised the staff for the high standards of cleanliness and décor in the home. The home’s health and safety arrangements such as regular maintenance and servicing of equipment, regular fire drills and monitoring heat control valves on hot water taps throughout the home show that the providers are mindful of their responsibilities to make sure that residents live in a safe environment. Chater Lodge DS0000069215.V335622.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are sufficient in numbers to meet the residents’ needs EVIDENCE: Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 19 There were forty-two residents at the time of the site visit. Staffing levels, at the point of inspection, were in line with those suggested by the Department of Health Residential Forum Guidelines and were sufficient to meet the residents’ needs. During the early shift there are six carers; between 2pm and 5pm there are four carers; between 5pm and 10pm there are five carers and three carers at night. In addition, during the day, there are cooks, cleaners, kitchen and laundry staff and a maintenance person. Four relatives in the ‘Have Your Say About ’ surveys, returned to the CSCI, said that staffing at weekends seemed to be less at weekends. However, residents and a relative said that there always seemed sufficient staff on duty and the Registered Manager said that the providers (Barchester Healthcare Homes Limited) were responsive to staffing in order to meet the care needs of the residents. Four staff files were checked during the inspection and showed that there is a satisfactory recruitment process. All staff had had Criminal Records Bureau (CRB) checks and references. However, one staff file contained two ‘old’ references from being employed previously at the home some twelve months before, and one recent reference from this employment. Two recent references would ensure that the home has up to date information on which to base their decision to employ the carer, thereby fully protecting the residents. The home has a training matrix. Staff undertake training in specific areas such as fire training, first aid, moving and handling and safeguarding adults. The Care Manager said that about 50 of staff had completed National Vocational Qualification (NVQ) in Care and that she had completed Level 4 and the Registered Managers Award. This provides staff the necessary skills to give safe care for the residents. Chater Lodge DS0000069215.V335622.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager provides strong and supportive leadership to staff, ensuring that residents receive a high standard of care. EVIDENCE: The Registered Manager is an experienced nurse and works in a supervisory and management role in addition to the care staff numbers. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 21 Excellent interaction between staff and residents ensures that there is a culture of openness and friendliness in the home. A visitor said that she can ‘relax’ knowing that the staff are very caring and will inform her day or night if her relative was unwell or needs her. The home conducts a yearly quality audit (satisfaction survey) for residents to complete. The results are published in the Statement of Purpose and Service User Guide information pack to provide residents and prospective residents with additional information about the home, both good practice and where there needs to be improvements. The Registered Manager said that she welcomed comments from residents and visitors to help them improve their service. The home keeps small amounts of money on behalf of residents. This is kept in a safe and records were accurate at the time of inspection. Staff are well supervised by the Care Manager in performing their care tasks. Staff do not currently receive regular recorded supervision (regular review of staff’s personal and training needs in relation to their work) and appraisals, although this is to be implemented by the Registered Manager. This would be considered to be good practice and to ensure that staff maintain the standards of care expected at Chater Lodge although it is recognised that staff do receive appropriate, updated training to enable them to care for the residents. The staff monitor accidents, such as residents’ falls. It is suggested that these are audited to look for any patterns so that preventative steps can be taken to minimise falls and improve safety for residents. Health and Safety Policy and Procedures, such as regular recorded fire drills and fire alarm tests are completed, to ensure the health and safety of the residents and staff. Chater Lodge DS0000069215.V335622.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 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 X 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 3 3 Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 OP7 3 OP16 Refer to Standard OP7 Good Practice Recommendations Care staff should review residents’ care plans at least once a month to make sure that they have up-to-date information about the residents care needs. Residents’ new care plans should be agreed and signed by the resident or their representative to make sure that all of their needs have been identified. The complaints policy requires updating to provide a current contact address and telephone number for the CSCI for prospective residents, residents and their representatives. Chater Lodge DS0000069215.V335622.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chater Lodge DS0000069215.V335622.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!