Inspection on 21/09/06 for Chatsworth

This inspection was carried out on 21st September 2006.

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

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

Other inspections for this house

Chatsworth 21/07/09

Chatsworth 18/07/07

Chatsworth 20/09/05

Chatsworth 19/04/05

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 Devon PL1 5BE Lead Inspector Kim Fowler Unannounced Inspection 21st September 2006 02:10 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 Chatsworth DS0000003474.V302628.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. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chatsworth Address Seymour Road Mannamead Plymouth Devon PL1 5BE 01752 660048 01752 671201 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) Mr Geoffrey Rhodes Mrs Heather Rhodes, Mr Stephen R Davey, Mrs Janet V Davey Mr Geoffrey Rhodes 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 DS0000003474.V302628.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Chatsworth is a large detached 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 DS0000003474.V302628.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 2 days. The registered manager Mr G Rhodes, who is also an owner, and the other registered owners were available during the inspection. The inspector made a tour of the building and spoke to the residents and two visitors visiting at the time of the inspection. Documentation relating to the care planning process and the management of the home were examined. Prior to the inspection, resident comment cards had been sent to the care home to allow residents to comment upon their experiences. Four cards were returned and no issues of concern were raised. Four staff comment cards were also received as well as one GP, one Health and Social Care Professional and one relative feedback card. What the service does well: What has improved since the last inspection? What they could do better: Service users would not be placed at risk if the complaints procedure was carried out as stated. Service users would be better protected if the manager and registered owners, who are responsible for dealing with adult protection issues, correctly report events to appropriate statutory organisations. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 6 Admitting service users for intermediate care may compromise the privacy and dignity of the elderly people who live at the care home. Separate facilities have not been made available in order that this type of care can be given successfully. 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. Chatsworth DS0000003474.V302628.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 Chatsworth DS0000003474.V302628.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3/5/6 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Pre-admission assessments are not routinely undertaken and, therefore, service users cannot be certain that their needs can be fully met at Chatsworth House. EVIDENCE: Of those service user files examined, one held evidence that a pre-admission assessment of the resident’s care needs had not been documented before their admission to Chatsworth House. Other files of service users, who had been at the home for some time, did have pre-admission assessments completed. The manager did confirm that information is obtained verbally prior to a resident’s admission but this may not be documented until they are admitted. Admission is a particularly difficult time for a new service user. If the assessment has not been carried out before admission, the care staff may not Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 9 be fully aware of the new service user’s needs. This information is vital if the new service user is to feel safe and secure in a new environment. During this inspection a new service user was visiting the home which was part of an planned ongoing trial period. The registered providers have admitted service users for short stays, when they will receive rehabilitative care from visiting professionals such as an Occupational Therapist (O.T.), Physiotherapist and any other professional involved in the ongoing care of the service user. The Physiotherapist and O.T. visit daily. This is called intermediate care. The manager stated that one service user was presently receiving intermediate care. They had been admitted from the local hospital after a fall at home. The home uses any vacant room for Intermediate Care admissions. This room is then adapted to meet the need of the service user admitted. Providing intermediate care in this way is contrary to the National Minimum Standards for Care Homes for Older People, which say that there should be dedicated staff providing this care in a separate unit. The reason for this is so that the elderly people who live in the care home do not have their lives disrupted by the many comeings and goings associated with providing intermediate care. Chatsworth DS0000003474.V302628.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The staff and manager provide good personal and health care support to the service users in the home, ensuring the promotion of privacy and dignity at all times. EVIDENCE: Individual care plans were in place containing information about the care needs of service users. The plans also show how the staff would meet these needs. The daily care plans are easy assessable for staff on duty and risk assessments are held on individual files. This included a falls assessment and information about any referral made to the Falls Clinic. A visiting District Nurse confirmed that the homes staff would contact the District Nurse service if there was an emergency. A system is in operation which refers service users to a District Nurse when they visit the home. Messages are left by the homes staff, for the District Nurse, that identify service users that need their attention. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 11 Files examined showed that oral health care requirements are recorded onto care plans. Other services involved with the individual service user had information recorded either on the medical visits form or in the form of appointment letters. This included the Hearing centre and Eye Infirmary. Both the District Nurse and a visiting relative, of a service user, confirmed that they are able to visit service users in private. Some service users have their own telephone situated in individual bedrooms. One service user’s preferred form of address is recorded in the care plan. Privacy is maintained in the homes 2 double bedrooms as screens and curtains are provided. A married couple occupy one double room and the other is occupied by 2 service users who requested a shared room. The home uses the dossett box system for the administration of medication. All medication delivered is checked by 2 staff members to ensure that the correct medication is delivered. A previous requirement from the last inspection stated that all drug cupboards and the controlled drugs box must be kept locked. A check on the medication cupboard found that this requirement had been carried out. Chatsworth DS0000003474.V302628.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The service users at Chatsworth House can be confident that the home offers good wholesome meals. The home welcomes and encourages families and friends to visit. EVIDENCE: A notice was displayed on the homes notice board stating when and what activities are arranged. One service users survey sent to the Commission confirmed that a variety of activities are brought into the home. Several service users confirmed that there are many different activities undertaken. This included one service user who regularly plays tennis. The home keeps a record of service users involvement in activities. This record is used to monitor service users participation in activities. One service user confirmed that they go out for walks in the local area. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 13 A visiting relative confirmed they received information about the home. The information was contained in the Statement of Purpose. They had also received information about the homes complaints procedure. Two other visitors in attendance on the second day were observed making arrangements with the staff team about trips out, a hairdressing appointment and other family and friends visiting times. An inventory is maintained for each service user who has brought personal possessions into the home. Many service users rooms had personal items on display. One service user confirmed that they had a solicitor who manages their money and they have regular access to this solicitor. All service users spoken with were asked about the meals provided by the home. All bar one service user stated that the food was excellent and they were offered an excellent choice and as much as they required. One service user had raised concerns about the amount provided for an evening meal. This service user also stated that they had discussed this with the manager of the home and extra portions were made available. This service user felt the choices were limited after 8.00pm as there were less staff on duty due to change over from day staff to night staff. The manager stated that all staff are required to ask this service user if they would like more to eat. Chatsworth DS0000003474.V302628.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16/18 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Service users may not feel confident that appropriate action will always be taken when allegations are made. EVIDENCE: The home’s complaints procedure is displayed in the main entrance hall. One relative confirmed they were aware of this procedure and had answered a question about the process on a quality assurance survey sent out by the home. This relative was also made aware of how to contact the Commission if needed. The Commission had received no complaints. The home maintains a designated complaints record. The record held information about a complaint made by a service user who had stated that £40 had been stolen. It was evident from this record and discussion with the service user and the manager that this theft had not been investigated. The police, adult protection nor the Commission had been informed. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 15 The manager and approximatly half the staff team have completed Adult Protection training. Chatsworth DS0000003474.V302628.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19/26 Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. Chatsworth House continues to maintain a clean and suitable environment for its stated purpose and the service users can be assured that they will live in an attractive and comfortable home that is regularly maintained. EVIDENCE: The owners of the home carry out regular maintenance work. During the inspection one empty room was being decorated and there was ongoing maintenance work being carried out, which included repairs to the downstairs bathroom. A service user who is going to be moving into this room confirmed that they had chosen the décor. Several other service users confirmed that any issues regarding maintenance were acted upon promptly. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 17 The home is safe and well maintained and suitable for its stated purpose. It is a very comfortable, warm and light home. Several service users confirmed this is usual. The gardens are well maintained by one of the owners. All the grounds are accessible to the service users. A tour of the premises showed the home to be clean, hygienic and free from odours. The staff use a particular cleanser when there are spillages and so the home remains odour free. The laundry facilities are sited separately and a sluice is available. Chatsworth DS0000003474.V302628.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27/28/29/30 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Recruitment practices protect residents. EVIDENCE: The staff files contained information that confirmed the required preemployment checks undertaken on new staff are being carried out. These checks include Criminal Record Bureau Disclosures, ensuring, as far as possible, unsuitable staff are not employed. Service users said that they are assisted promptly indicating that there is sufficient care staff on duty each day to meet the service users needs. The home is currently registered for 26 service users and the home has one empty bedroom that is currently being decorated. On the day of the inspection there were 4 staff on duty. In addition to this, the home’s registered manager and owners were available if needed. All staff interviewed agreed that the home has sufficient staff on duty, the majority of the time. The home employs domestic staff and a cook to assist with the smooth running of the home. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 19 One fairly new staff member stated that their recruitment and selection process was fair and they had completed a CRB check. During her induction she had shadowed other staff members. The staff training files provided further evidence that regular training was carried out. Staff confirmed that they receive regular and updated training. This included First Aid, Manual Handling and Food Hygiene. Pre-inspection information sent to the Commission stated that external training providers are used for specialist training such as Fire Safety training. The pre-inspection questionnaire stated that over 50 of care staff have NVQ training to level 2 or above. Other staff are due to start their NVQ’s in the near future. Chatsworth DS0000003474.V302628.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31/33/35/36/38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users can be confident that the care home is well managed by competent staff. EVIDENCE: The non-registered manager confirmed she has an excellent relationship with the registered owner and lines of communication are good. The owners and registered manager are always available when needed. The non-registered manager has a NVQ 4 in care and the Registered Manager award. All records are kept in the office and the office is secure. Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 21 Files showed that a quality assurance survey was carried out earlier this year. The survey results contained many positive comments. One relative and several service users confirmed the receipt of these surveys. Now the consultation process has been completed a development plan can be produced identifying the plan for service improvement over the forthcoming year. The manager will do this via a newsletter. One service user’s family member confirmed that they manage their relative’s money. Some have their finances looked after by the court of protection. Several service users money and accounts were checked and were accurate and well recorded. The records are secure, updated and the home monitors receipts and expenditure. Staff supervision records showed that this is carried out regularly and on a one to one basis and the manager confirmed that they hold regular staff meetings. Sampling of records indicated equipment is serviced regularly and maintained in good order. Health and Safety is a priority in the home. Records show fire safety training has occurred and fire protection systems are properly maintained. Information about accidents are recorded in an accident record system. Service user daily records also give details of accidents. Cross-referencing these records show that the recorded information is accurate and recorded in sufficient detail. The District Nurse was able to confirm that she is asked to examine a service user if staff have concerns or issues following an accident. The manager confirmed that all water outlets are fitted with pre set valves. These valves maintain water temperature at a safe level and protect service users from the risk of scaulds. Chatsworth DS0000003474.V302628.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 X X 2 X 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 4 X X X X X X 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 3 X 3 X 3 3 X 3 Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 23 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 OP16 Regulation 22 Requirement All complaints made must be investigated using the homes complaints procedure. Action taken and timescales taken must be recorded. Any thefts in the care home must be reported to the police, Adult Protection and the Commission Service users must not be admitted under the Intermediate care provision unless appropriate facilities are provided. Timescale for action 30/11/06 2 OP18 3 OP6 37 30/11/06 16 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chatsworth DS0000003474.V302628.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 DS0000003474.V302628.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!