CARE HOME ADULTS 18-65
Chatterton Hey House Exchange Street Edenfield Ramsbottom Lancashire. BL0 0QH Lead Inspector
Susan Hargreaves Unannounced 06 September 2005 10:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 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 Mrs Susan Dorothy Heaton Care Home Onley Personal Care (PC) 14 Category(ies) of Past or present drug dependene (D) 14 Male registration, with number of places Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 01 December 2004 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. Comunal rooms are spacious and a television and music centre are available for residnets to use in their free time. Additional recreational facilities include a snooker table and well equiped gymnasium. Residents and staff liaise with local educational services to provide for residents educational needs. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over seven hours. No additional visits have been made since the last announced inspection. A tour of the premises took place and staff files and care records were inspected. At the time of this inspection 10 residents were living at the home. Members of staff on duty and residents were spoken to. Several residents and their relatives had completed comment cards expressing their satisfaction with the rehabilitation programme. 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 a recommendation given at the last inspection a fire risk assessment has been carried out. To maintain and improve the environment appropriate gardening tools had been purchased. This enabled the residents to complete all the necessary work in the grounds and gardens to a high standard. Space had also been made in the barn for essential maintaintenance of the equipment. The manager explained that he was making the rehabilitation programme more individually focused by introducing flexible timescales on any restrictions. To help residents with financial planning they were made aware of the need to keep to a budget when preparing the menus. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 standard(s) 2 Admission procedures were thorough and ensured the rehabilitation programme was appropriate for the needs of each resident. 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 F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 standard(s) 6 and 7 Care plans were detailed, clearly written and addressed the identified needs of the residents. 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 or earlier if requested by the resident. 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. Resident’s rights to make decisions were restricted in accordance with the house rules as part of the rehabilitation programme. These were discussed and agreed with residents on admission. Residents were required to attend the daily morning planning meeting and the evening therapeutic meeting. Information about how to contact an advocacy service was displayed in the home. Resident’s money was kept securely and available on request. Detailed up to date records relating to service users money were seen. Resident’s signed these records when they received their money.
Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 10 Residents were encouraged to make decisions on day-to-day issues about household tasks, shopping, maintenance, gardening etc. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 standard(s) 12, 14, 15 and 17 Educational opportunities were provided for the residents. Visiting was restricted as part of the rehabilitation programme. A variety of leisure activities were available. Residents planned and prepared nutritious, wholesome meals. EVIDENCE: Residents were encouraged and supported to attend appropriate educational classes. Educational needs were recorded in resident’s individual care plans. It was not appropriate for residents to seek employment during the rehabilitation programme. However, voluntary work locally was encouraged. Residents had access to a variety of leisure activities. A fully equipped gym, snooker, table tennis and TV lounge were available in the home. A field outside the home was used for outdoor games. In addition to the facilities provided at the home residents went for walks, visited the local shops, cinema and sports centre. Day trips were organised monthly and residents decided where to go. Visiting was restricted for the first few months of the rehabilitation programme. Subsequently residents were permitted to receive visitors at the weekends. After 5 or 6 months residents were allowed to visit relatives. Visiting was
Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 12 planned at team meetings and residents were supported to rebuild relationships with their families if necessary. On the day of the inspection the meal served at lunchtime was wholesome and nutritious 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 planned weekly by the residents and checked by staff to ensure balanced nutritious meals were served. Residents were also responsible for shopping, preparing and cooking the meals and clearing up after meals. Residents were also made aware of the need to keep to a budget when planning the meals. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 standard(s) 19 and 20 Residents were registered with a GP and had access to other healthcare professionals. Residents were not reminded to take their medication potentially putting their health at risk. EVIDENCE: 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. Medication was stored correctly in a locked metal cupboard in the office. The manager was advised to check and record the temperature of this area daily to prevent any deterioration of the medication. Although the residents had given written consent for their medication to kept in this cupboard they were responsible for asking for their medication at the correct time. However, members of staff did not remind residents if they forgot. It was evident from the medication administration records inspected that one resident had missed a significant number of doses of his medication. This issue was discussed with the manager in relation to the duty of care members of staff have in ensuring residents receive prescribed medication. Residents were responsible for purchasing their own homely remedies e.g. paracetamol. These were locked in the cupboard and given to residents on request. Policies and procedures for the management of medication were available but did not include how medication was supplied to a resident on leave from the home. Written
Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 14 instructions should be provided for individual residents stating when medication prescribed ‘when required’ should be given. The manager was advised to obtain an up to date copy of the ‘British National Formulary’ for reference. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 standard(s) 22 and 23 Complaints were 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 displayed in the home. One complaint had been made to the home since the last inspection. Records of the complaint and the action taken were available. Policies and procedures relating to the protection of vulnerable adults, ‘whistle blowing’ and bullying and harassment were in place. Members of staff had received appropriate training, which included how to deal with challenging behaviour. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 standard(s) 24 and 30 Residents were happy with their accommodation at the home and 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. One resident was responsible monitoring the standard of cleanliness in the home. The extensive grounds and gardens were very well kept. The resident responsible for this explained that he had asked the manager for some new tools and these had been provided for him. Furnishings and fittings were of a good quality and met the needs of individual residents. The laundry facilities were domestic and appropriate for the size of the home. Residents were responsible for doing their own laundry. Arrangements for this were co-ordinated by one of the residents. An infection control policy was available. This included information about HIV, hepatitis B and C. Local amenities were within easy reach of the home. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35 Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were thorough. Training for all members of staff was actively encouraged. EVIDENCE: 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. At the time of the inspection the manager explained that due to holidays and staff vacancies agency staff were covering the night shifts. To ensure continuity of care the agency arranged for the same carers to regularly work these shifts. The file of a recently appointed project worker and a volunteer were inspected. These indicated that all the required pre-employment checks to ensure protection of the residents had been completed. It was evident from discussions with the manager and members of staff that training was actively encouraged. This included, induction training for new employees, drug and alcohol abuse awareness, health and safety, moving and handling, challenging behaviour, basic counselling, medication, fire safety and first aid. Further training in the management of medication was planned for October.
Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 18 The manager explained that the recently developed ‘Drug and Alcohol National Occupational Standards’ would enable members of staff to achieve appropriate NVQ’s. Although a training and development plan was available the manager was advised to carry out a training needs assessment for the staff team. This will assist in planning training to ensure the needs of the residents are fully met. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Appropriate procedures were in place to safeguard the health, safety and welfare of residents. EVIDENCE: Policies and procedures relating to safe working practices were in place. A member of staff was responsible for completing a weekly health and safety check of the premises. To ensure the safety of residents fire alarms and emergency lighting was tested weekly. A detailed fire risk assessment had been carried out. Although fire drills were held regularly attendance records of members of staff present were not kept. Records of the routine servicing of equipment were seen. The gym equipment was checked weekly by the member of staff responsible for health and safety and every six months by a qualified engineer. Testing of electrical appliances was completed in April. However, the electrical installation certificate was out of date. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 20 The standard of cleanliness in the kitchen was commendable. Records kept by the resident responsible for preparing and cooking the meals included fridge, freezer and food temperatures. Health and safety was discussed with residents on admission and safety notices were displayed in the home. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 4 3 x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 4 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Chatterton Hey House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 22 NO 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 20 Regulation 12(1)(a) (b) Requirement The registered manager shall ensure that the care home is conducted so as (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. Members of staff must ensure that residents are reminded to take their prescribed medication. The registered person shall 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 for action 6 Sept 2005 2. 42 13(4)(a) 28 Oct 2005 Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 23 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. 3. 4. 5. 6. Refer to Standard 20 20 20 23 35 42 Good Practice Recommendations The temperature of the cupboard where medication is stored should be checked and recorded daily. Policies and procedures relating to the supply of medication for residents on leave from the home. Written instructions should be in place for individual residents advising when medication prescribed when required should be given. A whistle blowing policy should be developed. A training needs assessment should be carried out for the staff team. Attendance records should be kept of members of staff present at each fire drill. Chatterton Hey House F57 F07 S9512 Chatterton Hey V237397 060905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington Lancashire. BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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