Inspection on 19/04/05 for Chatsworth

This inspection was carried out on 19th April 2005.

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

Other inspections for this house

Chatsworth 21/07/09

Chatsworth 18/07/07

Chatsworth 21/09/06

Chatsworth 20/09/05

Chatsworth 31/08/04

Chatsworth 20/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Chatsworth Seymour Road Mannamead Plymouth PL1 5BE Lead Inspector Tina Maddison Announced 19/04/05 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. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Chatsworth Address Seymour Road, Mannamead, Plymouth, Devon, PL1 5BE 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) 01752 660048 01752 671201 Mr Geoffrey RhodesMrs Heather Rhodes, Mr Stephen R Davey, Mrs Janet V Davey Sally Colwill Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26), of places Physical disability over 65 years of age (26) Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2004 Brief Description of the Service: Chatsworth is a large detatched property situated in the Mannamead area of Plymouth. The home is registered to provide residential accommodation and personal care for a maximum of 26 people over the age of 65 years who may also have dementia or a physical disability. Accommodation is provided over three floors, and offers 22 single bedrooms, 7 of which have en suite toilet facilities, and two double rooms, one of which has an en suite toilet facility. Stair lifts provide access to all floors. On the ground floor there is a large lounge that has patio doors opening on to the garden, and a large dining room. There is a call bell system in operation in the home. The home has a chair lift to all floors. Various activities and trips are regularly offered at the home. The garden is attractive and accessible to the service users. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection began at 9.30am and ended at 4.15pm. During the inspection a meal was sampled, a pre inspection questionnaire was received from the Provider prior to the inspection. Care records were inspected and a tour of the building was conducted. Comment cards were received from service users and relatives, and during the inspection five residents were interviewed. What the service does well: What has improved since the last inspection? What they could do better: Water temperature regulator valves must be installed to minimise the risk of scalds. Plans were in place to install these two days after the inspection. Risk Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 6 assessments for residents that self medicate should be updated. There was discussion during the inspection with the Manager and owners about expanding the quality assurance system in the future. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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 Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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, 2,3,4,5 Prospective residents are able to use a comprehensive service users guide and statement of purpose to influence their choice of care home and they can be confident that Chatsworth will be able to meet their care needs. EVIDENCE: Individual records are kept for each of the residents, and records evidenced that the manager had completed a pre admission assessment for the two most recently admitted residents, in order to be sure that the home is able to meet their assessed care needs. The Manager had also gathered additional information from GPs, District Nurses and the residents care manager. A resident confirmed that they were offered the opportunity to visit the home prior to their admission. In order to ensure that staff have the skills to enable them to meet residents care needs, records and discussion with care staff and the Manager evidenced that they have received training in first aid, food handling, moving and handling, and in the care of people who have dementia. Contracts contain all necessary information and were signed by the resident or their representative. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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 standard(s) 7,8,9,10 Residents can be assured that staff will treat them with respect and they will be in no doubt that their health care needs will be met. EVIDENCE: Individual care plans were in place for all service users, and contained detailed information regarding how all care needs would be met. There was evidence that these plans are reviewed at least monthly or when needs change. Service users confirmed that they were involved in reviewing their care plans, and were aware of where the plans were kept and that they could see them if they wanted to. From discussion with residents, management and from information seen on care plans and documents. Chatsworth is able to evidence that it meets the health needs of the residents. All are registered with a GP of their choice. A district nurse visits the home on a regular basis, and the home has links with the continence advisory service, the falls prevention service, dentist, opticians and chiropody services. All residents have moving and handling plans on files, and their preferences regarding their care needs are noted. Privacy is respected at all times, and residents confirmed that this is the case. Medication is dispensed only by care staff that have received medication training. The Pharmacist visited the home in February of this year and had no recommendations. Two residents self medicate, and do not have a risk Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 10 assessment in place. Controlled drugs are appropriately stored. Exercise is encouraged to aid mobility, and gentle exercise and armchair aerobics are offered at the home. During the inspection the Inspector observed that staff, the Manager and owners were respectful in their dealings with residents at all times and appeared to have a positive and enabling relationship with all of the residents. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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) 12,13,14,15. Social activities and meals are both well managed, creative, and provide daily variation and interest for people living in the home. EVIDENCE: A number of people living in the home were spoken with, and everyone who commented on the food said how good it was, and the menus evidenced that choices were varied. During the inspection, a meal was sampled and evidenced that good quality ingredients are used, and the menus also evidenced a good variety of wholesome and nutritious meals. Mealtimes were observed to be a relaxed and unhurried time, and residents who need assistance with eating were assisted in a discreet and respectful manner. All bedrooms are lockable and all residents are offered keys to ensure privacy. Some residents have their own telephones, and a cordless phone is available if required to facilitate private calls. Residents confirmed that daily living routines are flexible. The home offers a daily activity programme, and during the inspection, residents were observed playing bingo. There are also quizzes, armchair aerobics, skittles, dominoes and movie days on offer. A relative of a resident was spoken with during the inspection and they confirmed that visitors are always made welcome, and are able to visit at any reasonable time. Residents confirmed they are able to visit church with staff to assist them if they wish, and a vicar visits the home on a regular basis. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 12 Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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) 16,18. Residents can be confident that their concerns will be listened to, taken seriously and acted upon. The homes vulnerable adults procedure is robust which will ensure the protection of residents. EVIDENCE: The home has a complaint policy and procedure, and a record of complaints and concerns was examined, and a record of action taken to remedy any complaints was also seen during the inspection. No complaints have been received by CSCI in the last six months. Residents stated that they felt that any concerns were taken seriously by the manager and owners, and all residents spoken to were aware of whom they should speak to in the event of a complaint. A complaints procedure is displayed in the home. There is an adult protection policy and procedure, and there is a staff whistle blowing policy. Staff have attended adult protection training. The staff spoken to during the inspection were aware of the homes procedures regarding verbal and physical aggression toward staff. The home operates a no restraint policy. Records showed that service users money is kept securely, and records were accurate and well kept. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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) 19,20,21,22,23,24,25,26. Chatsworth is decorated and furnished to a high standard. It is very clean, warm and well lit. Gardens are pleasant and accessible, and this creates a comfortable and safe environment for residents. EVIDENCE: A tour of the home including all bedrooms evidenced that the exterior and interior of the home are in a good state of repair, and are well maintained. All bedrooms are pleasantly decorated and have been personalised by the residents. Furnishings are of a good quality. The home has 22 bedrooms, 8 of which have en suite toilet facilities. There are two double bedrooms that have screens to ensure privacy. There are adequate and well equipped bathroom facilities in the home. All bathrooms and toilets were equipped with soap and clean towels to facilitate infection control. The home has a large lounge and dining room. These were well lit, were warm on the day of the inspection and are well decorated and furnished. The gardens are attractive and provide seating, and are reached through doors from the lounge. Smoking is currently permitted in the entrance lobby of the home, but following concerns from Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 15 residents and visitors, the owners intend to review this policy. The home does not have a passenger lift, but does have a chair lift to all three floors. The home was extremely clean and was free from offensive odours on the day of the inspection. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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) 27,28,29,30. Care staff numbers are adequate to meet the care needs of the current residents. The home has a robust recruitment procedure, and this offers protection to the residents in the home. There is a consistent staff team who are committed, caring and appropriately skilled to provide care to the residents in the home. EVIDENCE: Staff rotas showed that the home has an adequate number of staff on duty at all times, and training records and discussion with staff evidenced that staff are well trained, experienced and have the skills to meet the needs of the residents. Turnover of staff is low. The home has a robust recruitment procedure. All staff have a CRB check in place, and two references are obtained prior to employment at the home. Residents confirmed that they thought that there were enough staff on duty at the home at all times, and staff came quickly if they pushed their call button. During the inspection the call alarm was tested, and staff reached the room in three minutes. Staffing at the home is as follows: Mornings – 5 care staff plus the Manager Afternoons –3 or 4 care staff plus the manager Evenings – 4 care staff Nights – 2 waking night staff The home employs 3 cooks and 2 domestic staff. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 17 The Manager has devised a training programme for staff that includes moving and handling, first aid, dementia care and the home is committed to providing NVQ training for staff. Staff receive at least three paid training days per year. Staff stated that they believed the home was a happy place to work and felt that they were valued and well trained. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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 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) 31,32,33,37,38 The home is managed by a competent manager who has respect from the staff team and is highly thought of by the residents. There is a management structure operating in the home that is clearly effective. EVIDENCE: The Manager and registered owners maintain a good system of recording. It is clear and easy to access. The Manager has a written policy relating to access to files, and residents knew that they could see their records at any time. All records are securely stored in the home. The Manager is qualified to NVQ level 4 in care and has completed the registered managers award. Residents spoke very highly of the care and kindness shown to them by the Manger, owners and staff. The Manager and owners operate a quality assurance system by asking residents and relatives to complete questionnaires regarding the quality of care in the home. The Manager is planning to expand on this system by recording outcomes of the responses to the questionnaires and will action these results. Staff are Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 19 supervised by the Manager every six weeks, and supervision records were seen by the Inspector. The Manager is supervised by one of the registered owners of the home. Health and safety is a priority in the home, and records evidenced that fire safety training and fire precautions are in place and up to date. The accident book was accurately and comprehensively completed, and information had been transferred to residents care plans. Records also evidenced that gas and electrical systems in the home are regularly serviced, and portable appliance tests are completed on an annual basis. Risk assessments are in place for the building and all staff working practices. At the time of the inspection, temperature regulation valves on hot water outlets had not been fitted, however, the owners confirmed that arrangements had been made for the valves to be fitted that week. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 3 3 N/A 3 3 3 3 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 3 2 Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 21 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 OP25 Regulation 13 Requirement Design solutions must be put in place on all hot water outlets accessible to service users, to ensure that water is stored at a temperature of at least 60c, distributed at 50c, and provided at close to 43c. Timescale for action 31/8/05 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 OP9 Good Practice Recommendations Risk assessments should be updated for the residents that self medicate. Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Chatsworth D52-D04 S3474 Chatsworth V214034 190405 Stage 4.doc Version 1.20 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. 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!