CARE HOME ADULTS 18-65
Chatterton Hey House Exchange Street Edenfield Ramsbottom Lancashire BL0 0QH Lead Inspector
Mrs Susan Hargreaves Key Unannounced Inspection 30th August 2006 10:30 Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 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 Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Chatterton Hey House Address Exchange Street Edenfield Ramsbottom Lancashire BL0 0QH 01706 824554 01706 824554 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) The Langley House Trust Care Home 14 Category(ies) of Past or present drug dependence (14) registration, with number of places Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Chatterton Hey is a large detached property in its own grounds and is situated in Edenfield on the outskirts of Rawtenstall. The home provides a programme of rehabilitation and accommodation for up to 14 men recovering from substance misuse. This rehabilitation programme usually lasts for 12 months. The house is comfortable with domestic style furnishings and fittings. The accommodation reflects normal living as far as possible and both single and twin-bedded rooms are available. Communal rooms are spacious and a television, music centre and snooker table are available for residents to use in their free time. Residents and staff liaise with local educational services to provide for residents educational needs. The current fees charged at Chatterton Hey are £450 per week. Additional charges are payable for personal items. A copy of the statement of purpose and service user guide is available to prospective service users and their relatives on request. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over nine hours. At the time of this inspection seven residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty and residents were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection?
Following the last inspection a permanent manager has been appointed. The manager provided strong leadership for both residents and staff. One resident said, “ The manager is firm but fair, she will explain the reasons for any decision.” Members of staff said the manager was helpful and supportive. The problem of residents using alcohol at the last inspection has been resolved by adopting a zero tolerance approach. A procedure for staff to follow in the event of resident reported missing or absconding has been developed. Fire alarms and emergency lighting are tested regularly. Improvements to the premises since the last inspection include; providing a water cooler in the dining room, redecoration of the TV lounge, refurbishment of one shower room and the purchase of sports equipment for badminton, basket ball and cricket. The snooker table has also been re-covered and rebedded. Residents were provided with tee shirts and jeans to wear for decorating and gardening. Residents were allowed free use of the telephone for all landline calls. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 6 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. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures were thorough. EVIDENCE: Prospective residents were referred to the home by the probation service, social services or the prison drugs worker. A detailed pre-admission assessment was carried out prior to admission. This included information of the drug abuse and any related health problems. Prospective residents were required to complete an application form and if possible visit the home for an interview and to meet other residents. If necessary the manager would visit a prospective resident or conduct a telephone interview. Following this process a decision is taken about the suitability of a prospective resident for the rehabilitation programme provided at the home. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were detailed and addressed the identified needs of the residents. Appropriate risk assessments were in place. EVIDENCE: The care plans of two residents were inspected. These contained detailed information about their care needs. An action plan had been completed with their key worker and goals agreed. This plan was reviewed every three months. The resident met regularly with their key worker to discuss care issues and review progress within the rehabilitation programme. Records of these meetings were seen in the care plans. The care records also included appropriate risk assessments and strategies to address any identified risks. On admission to the home residents agreed to keep the house rules and the restrictions these imposed. However, residents were encouraged and supported by their key worker to make decisions about lifestyle changes. Residents were required to attend the daily morning planning meeting and group therapy sessions. Advocacy services would be contacted for residents if required.
Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 10 Risk assessments were carried out for group activities. A procedure for staff to follow if a resident was missing or absconded was in place. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The rehabilitation programme ensured residents had structured routines, which included educational and recreational activities. Meals were wholesome and appetising. EVIDENCE: Residents were encouraged and supported to attend appropriate educational classes. These included courses at the local colleges and learn direct. Literacy and numeracy classes were held at Chatterton Hey and residents without these skills were required to attend. It was not appropriate for residents to seek employment during the rehabilitation programme. However, voluntary work locally was encouraged. A variety of leisure activities were available in the home including; snooker, TV and DVD’s. In order to increase the range of activities available sports equipment for, badminton, cricket, basketball and fishing was purchased recently. In addition to this residents regularly had day trips, went for walks, visited the local shops, cinema and sports centre. Several residents regularly attended a local church.
Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 12 Visiting was by prior arrangement to fit in with the rehabilitation programme. Visitors were only allowed in communal areas of the home. The daily routine was structured as part of the rehabilitation programme. This included education, counselling, household tasks and leisure activities. House rules did not permit residents to lock bedroom doors. Mail had to be opened in front of a member of staff. Residents understood the reasons for these rules and accepted them as part of the rehabilitation programme. On the day of the inspection the meal served at lunchtime was wholesome and appetising and appropriate for the lifestyle of the residents. Lunch was unhurried allowing time for residents and staff to chat and enjoy their meal. Members of staff ate their meals in the dining room with the residents. Menus were varied and offered choice. Residents were responsible for preparing and cooking the meals and clearing up afterwards. Snacks and drinks were available on request. All the residents asked said the meals were good. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were treated with respect. Healthcare needs were identified and met. Medication was generally well managed. EVIDENCE: Each resident had a designated key worker. The role of the key worker was to support the resident through the rehabilitation programme. Although residents had to live within the house rules they were treated with respect. Members of staff did not enter resident’s rooms without first knocking and waiting to be told to enter. Care plans contained detailed information about the healthcare needs of residents. Residents were registered with a local GP and had access to other healthcare professionals. Policies and procedures for the management of medication were in place. Medication was stored correctly in locked cupboards in the office. The temperature of these cupboards was checked and recorded daily. Residents were responsible for asking for their medication at the correct time. Records of the receipt of prescribed medication were available. However, records of the receipt of medication bought over the counter were not kept. Records of medication returned to the chemist were seen. The manager was advised to ensure that all hand written instructions on the medication administration
Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 14 records were signed and witnessed. Training for all members of staff in the management of medication was booked for 20 October. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints would be taken seriously and investigated. Appropriate policies and procedures were in place to ensure the protection of residents and staff at the home EVIDENCE: A copy of the complaints procedure was included in the service user guide and displayed in the home. No complaints have been made to the home or the commission since the last inspection. Policies and procedures relating to the protection of vulnerable adults, ‘whistle blowing’ and bullying and harassment were in place. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a clean and comfortable environment. Laundry facilities were appropriate for the size of the home. EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. Residents were responsible for all household tasks, decorating, small maintenance jobs and gardening. A maintenance record was kept. The extensive grounds and gardens were well kept. Furnishings and fittings were domestic in style and met the needs of individual residents. The laundry facilities were appropriate for the size of the home. Residents were responsible for doing their own laundry. An infection control policy was available. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels were appropriate for Staffing levels were appropriate for the needs of the residents. Recruitment procedures were thorough. Training opportunities were available for all members of staff. EVIDENCE: Discussion with members of staff and the manager confirmed that training was encouraged. This included first aid, basic food hygiene, diversity and equality, basic food hygiene, fire safety and drug awareness. A comprehensive induction programme was in place for all new employees. The manager was responsible for supervising this training, which took up to six months to complete. Two members of staff were working towards NVQ level 3. The manager explained that changes to the rehabilitation programme were due to be introduced later in the year. Langley House Trust was in the process of recruiting of a therapeutic manager and two counsellors to facilitate the new programme. There were currently vacancies for 1.5 residential drugs workers. This meant that agency staff were covering some shifts. To ensure continuity of care the agency had, where possible, arranged for the same carers to work at the home. Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts in order to meet the assessed needs of the residents. During the night when one carer was on duty a senior member of staff was on call for emergencies.
Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 18 The files of two project workers appointed since the last inspection were inspected. These indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed. Residents were encouraged to express their views about the rehabilitation programme. Procedures to safeguard the health, safety and welfare of residents require further development including staff training. EVIDENCE: The deputy manager has recently been promoted to the manager. She has management experience and is working towards NVQ level 4. This NVQ also involves completing four units from the ‘drug and alcohol national operating standards. Members of staff said the manager was helpful and supportive. One resident said the manager was firm but fair. The manager explained that following alcohol related problems with some residents there was a policy of zero tolerance in place. Any resident who tested positive for alcohol would be evicted. All residents had been informed of this rule. Residents and staff met daily to discuss activities for that day. Residents were encouraged to express any concerns at these meetings. Residents held weekly
Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 20 meetings, which were not attended by any members of staff although the minutes were available for staff to read. The Langley House Trust had a resident’s forum to which resident’s representatives from Chatterton Hey were invited. These meetings took place every three months. Langley House Trust had recently distributed satisfaction questionnaires to the residents. Policies and procedures relating to safe working practices were available. A member of staff was responsible for completing a weekly health and safety check of the premises. Fire alarms and emergency lighting were tested regularly. Records of fire drills were seen. However, a fire risk assessment was not in place. A member of staff qualified to administer first aid was not on duty for all shifts. The electrical installation certificate had not been renewed after five years in line with Health and Safety Executive guidelines. The testing of small electrical appliances had not been carried out since April 2005. Records of fridge, freezer and food temperatures were not kept. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 2 X Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 22 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 YA20 Regulation 13(2) Requirement Timescale for action 30/08/06 2. YA32 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. A record of all medication received into the home must be kept. 02/03/07 18(1)(c)(i)(ii) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (c) ensure that the persons employed by the registered person to work at the care home receive – (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. 50 of care staff must have an NVQ level 2 or 3 or be working towards this by the date given. Timescale of 30/06/06 not met
DS0000009512.V289133.R01.S.doc Version 5.1 Chatterton Hey House Page 23 3. YA42 13(4)(a) 4. YA42 13(3) 5. YA42 13(4)(c) The registered person shall 27/10/06 ensure that (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their health and safety. An electrical installation certificate must be obtained. Timescale of 28/10/05 and 28/04/06 not met. PAT testing must be carried out annually. The registered person shall 30/08/06 make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. Fridge, freezer and food temperatures must be checked and recorded daily. Timescale of 07/03/06 not met The registered person shall 22/12/06 ensure that – (c) unnecessary risks to the health and safety of service users are identified and so far as possible eliminated and shall make suitable arrangements for the training of staff in first aid. 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. Refer to Standard YA20 YA42 Good Practice Recommendations Hand written instructions on the medicines administration records should be signed and witnessed. A fire risk assessment should be carried out. Chatterton Hey House DS0000009512.V289133.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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