Inspection on 24/06/05 for Chatham House

This inspection was carried out on 24th June 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 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

Chatham House 28/09/09

Chatham House 08/10/08

Chatham House 29/01/08

Chatham House 31/07/07

Chatham House 13/09/06

Chatham House 15/12/05

Chatham House 01/02/05

Chatham House 06/07/04

Chatham House 11/02/04

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

CARE HOMES FOR OLDER PEOPLE Chatham House 44 / 46 Wembdon Rise Bridgwater Somerset TA6 7QZ Lead Inspector Barbara Ludlow Unannounced 24 June 2005 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. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chatham House Address 44 / 46 Wembdon Rise Bridgwater Somerset TA6 7QZ 01278 427758 01278 427758 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) Mr Raymond Frederick Pope Mrs Jessie Joan Pope Mrs Jessie Joan Pope Care Home - Personal Care Only 26 Category(ies) of Old Age - (26) registration, with number of places Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1 February 2005 Brief Description of the Service: Mr and Mrs Pope own Chatham House. Mrs Pope manages the home on a dayto-day basis. The home is registered to provide personal care for up to 26 elderly service users. Chatham House is situated in the residential area of Wembdon, 2 miles from Bridgwater town centre. Two large victorian houses are linked by a modern annexe. There is car parking at the front of the house. To the rear there are extensive gardens with wheelchair access and handrails with a pleasant patio area. Accommodation is on two floors, comprising of 24 bedrooms, including 2 double rooms. There are 19 rooms with en suite WC facilities, some have a bath (some not in use) / shower facility. TV points are available in each room. There is a passenger lift and two sets of stairs to the first floor, one with stair lifts. The communal rooms comprise of a very large lounge with three distinct seating areas, a smaller lounge and an adequately sized dining room. There are three payphones in different locations in the home, plus the use of a mobile phone for incoming calls. There is a call system fitted to all areas of the home. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over the period 9.30 to 18.30 and the CSCI pharmacist inspector accompanied the lead inspector from 9.30 to 13.30. The inspectors were welcomed into the home. Breakfast was being served at the start of the inspection. Both breakfast and lunchtime meals were observed by the inspectors. The inspectors met and talked with service users and two visitors during the tour of the premises and in the communal areas of the home. The inspectors were shown around the refurbished rooms and building work in progress. Staff were observed interacting with service users and four were spoken with. The manager and her administrator were available throughout the inspection day to assist with the inspection process. A tour of the building was made, looking at the accommodation and standards of hygiene in the home. Staff recruitment and training records were examined, care plans were sampled and the maintenance logs examined. The overall outcome was satisfactory. What the service does well: What has improved since the last inspection? There has been continued upgrading of the homes accommodation with recent redecoration of the upstairs hallways to a high standard. Installation of en-suite walk-in showers has been completed in two bedrooms and is planned for other bedrooms. These showers will replace en suite baths that were previously not used. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 6 The handling of medications is improving although there are still some minor shortfalls. The Fire Risk Assessment has been completed and approved by the local Fire Officer. An increased level of staff supervision of the communal areas was reported by management and staff, it had also been noticed by visitors to the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 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 standard(s) 1, 3 and 4, standard 6 does not apply for this home There is sufficient detail in the home literature for prospective service users and their families/carers to make an informed decision about moving into this care home. Visits to the home are welcomed, it is the managers usual practice to make her assessment of the service user care needs at this time. The home has been sufficiently adapted to meet the needs of elderly people requiring personal care. EVIDENCE: The home has a Statement of Purpose and a Service User Guide. Three care plans for recently admitted service users were examined and found to contain comprehensive information. The involvement of the service users in the assessment was documented. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 9 Adaptations are made within the home to assist those with mobility problems, e.g. passenger lift, stairlift, walk-in showers. The garden has ramps and handrails for access. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Care plans are used to record all relevant information and contacts. Regular entries are made of service users health and condition. Community professionals are involved where care needs required such input as by the district nurse or G.P Medicine storage had the potential to put service users at risk of harm. EVIDENCE: District Nurse treatment was seen to take place privately in the service users own room. Unsecured medicines were found in staff areas of the home. Creams in use did not have the date of opening recorded on them. Risk assessments were not in place for medicines kept in service users rooms. Care plans were seen to have been drawn up from the initial assessment and were seen to be improving. They were seen to be reflecting the needs of the service user and take into account their personal history. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14 and 15 Chatham House encourages service users to retain a level of independence in their daily living. The range of activities available each day is limited but trips out are offered. Visitors are welcome and family support is encouraged. The meals offer a choice and are nicely served in the communal dining room. EVIDENCE: The home offers a limited range of activities, trips out in the minibus are offered. No activities took place on the day of the inspection. Service users can access large print and other books. More able service users were seen to have unrestricted access around the home and gardens. Service users’ visitors are welcomed and contact with families is supported. The provision of breakfast and lunch were observed on the day of inspection. A varied and appetising selection is offered there was a good selection of Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 12 desserts offered after lunch. Feedback from service users confirmed their satisfaction with the food and catering service offered at Chatham House. The dining room was attractively laid out and mealtimes were observed to be social and unhurried. Service users were seen seated at tables in small groups of four or less. Those requiring assistance were observed to be given one to one attention in a dignified manner. Staff were on hand to assist as required. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 There are policies and procedures in place to protect service users from harm. The management have responded openly and cooperatively to two complaints made to CSCI about the care of a service user, pre 2005. EVIDENCE: There is a complaints policy available in the home with clear guidance of how and who to complain to. Two complaints were made to CSCI; one is currently subject to re-investigation at the request of a family not satisfied with the CSCI response. Staff files were sampled and it was found that staff are employed using a rigorous process. A whistle blowing policy was seen to be in place in the home. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,23,24and 26 Chatham House provides a comfortable environment for service users. The home is clean and well decorated. Staff hand washing facilities must be improved (in service users rooms) to reduce the risk of cross infection. Some individual rooms are having en suites upgraded and refurbished. This is a considerable improvement to these individual rooms. EVIDENCE: An ongoing refurbishment programme was seen with en-suite showers being installed and the redecoration of communal areas. There is a pleasant garden available that has been adapted to make it accessible to all service users. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 15 Bedrooms were personalised with the service users’ own possessions and photographs. Although maintained to a high standard, facilities such as liquid soap, paper towels and foot operated flip top bins, for staff hand washing were not available in all bedrooms where personal care is given. This is required to reduce the risk of cross infection. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,29 and 30 Staff recruitment practice is satisfactory. Staff numbers were adequate on the day of the inspection. EVIDENCE: Sufficient numbers of trained staff were seen to be on duty at the time of the inspection. Staff duty rotas were supplied, these supported sufficient staff numbers rostered to work. The recruitment procedures for the home ensure that all staff are only employed after CRB and POVA checks have been completed and references obtained. The staff are provided with regular and ongoing training to meet the needs of the service users. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 17 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) 36 and 38 Staff supervision at 2 to 3 monthly intervals should be formalised and documented. Manual handling training must be given to all staff to ensure safe practice with updates thereafter. Health and safety was generally well managed. Routine maintenance of the home and equipment was up to date. Risk assessment should be documented for individuals who have caustic substances such as denture cleaning agents in their bathrooms. EVIDENCE: Records were not seen to demonstrate that all staff had received manual handling training, to ensure safe practice, this must be addressed. Records of staff supervision were not available. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 18 Records were seen to show that the fire system, electrical installation and call bell system are regularly checked and maintained. The gas installation was due to be checked. Caustic denture cleansing agents were seen to be stored in service users bathrooms but no risk assessments were seen to be in place. It was suggested that storage within the en suite facilities could be improved. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 19 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 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 x x x x x 2 x 2 Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP 9 Regulation 13(2) Requirement The registered person must ensure that the receipt of all medication is recorded, this is to include the date of receipt and the amount received for both regular and interim medication. The registered person must ensure that a risk assessment is carried out for all service users who have medicines in their own rooms. Staff hand washing facilities must be available to reduce the risk of cross infection where personal care is carried out. Timescale for action From next receipt of medication 01/08/09 01/09/05 2. OP 9 13(2) 3. OP 26 16(2)(j) 01/09/05 4. 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 OP 9 Good Practice Recommendations It is recommended for the safety of service users and staff administering medication that when hand-written entries are made on the Medication Administration Record charts they are signed by the person making the entry and are then signed and dated by a second person. D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 21 Chatham House 2. 3. 4. 5. OP 9 OP 9 OP 24 OP 38 It is recommended that the home have a regular system to monitor the expiry dates of all medicines and dressings stored in the home. It is recommended that the date of opening or the date of discard be written on all tubs and tubes of cream and ointment when opened. En-suite bathroom storage facilities should be reviewed. Individual risk assessments for caustic substances (denture cleansing agents) in service users bathrooms must be carried out. Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier, Taunton TA1 4AL 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 Chatham House D53 - D02 S15985 Chatham House V223774 240605 Stage4.doc Version 1.30 Page 23 - 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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