Inspection on 03/02/06 for Chatterwood Nursing Home

This inspection was carried out on 3rd February 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chatterwood Nursing Home 18/10/07

Chatterwood Nursing Home 21/09/06

Chatterwood Nursing Home 20/07/05

Chatterwood Nursing Home 16/02/05

Chatterwood Nursing Home 13/08/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Chatterwood Nursing Home Huntsbottom Lane Hillbrow Liss Hants GU33 7PA Lead Inspector Marilyn Lewis Unannounced Inspection 3rd February 2006 10:00 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 Chatterwood Nursing Home DS0000038996.V280422.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 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. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chatterwood Nursing Home Address Huntsbottom Lane Hillbrow Liss Hants GU33 7PA 01730 895485 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) Milkwood Care Limited Mrs Joyce Gilfroy Care Home 24 Category(ies) of Dementia - over 65 years of age (10), Physical registration, with number disability (5), Physical disability over 65 years of of places age (24), Terminally ill (5), Terminally ill over 65 years of age (24) Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 5 service users may be admitted between the ages of 55 and 64 years 20th July 2005 Date of last inspection Brief Description of the Service: Chatterwood offers nursing for 24 residents over the ages of 55 years. There are twelve single, six shared bedrooms and the communal rooms are accommodated over two floors. The home has a shaft lift. The garden area is accessible from the front door and conservatory. The home is in a rural area and the local shops in Liss are accessible with assistance. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 3rd February 2006. The inspector toured the home and met with six residents, three visitors, three staff members, the registered manager and one of the providers. Care plans were sampled for three residents and records were seen for medicines, staff recruitment, supervision and training, fire safety checks and fire drills. This was the second unannounced inspection for the year 2005/2006. Information on standards assessed during the first inspection can be found in the inspection report dated the 20th July 2005. What the service does well: What has improved since the last inspection? Residents individual care plans had been reviewed regularly to reflect the current assessed needs of the residents and the actions required to meet those needs. Concerns were raised at the last inspection regarding the management of medication. On this occasion the procedures for dealing with medicines was clear and recording of administered medicines was up to date. Records seen indicated that checks were made to fire safety equipment and emergency lighting and staff received training in fire safety and attended fire drills. The large conservatory that has been built along side the lounge and dining area has improved the communal areas of the home, making them light, Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 6 cheerful and spacious. Residents said that they enjoyed spending time in the lounge and with one saying the ‘lounge was lovely’. 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. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 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 Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed at this inspection. Information from the previous inspection can be found in the inspection report dated the 20th July 2005. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 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 the following standard(s): 7 and 9 There has been an improvement in the reviewing of care plans to reflect the current assessed needs of the residents who are protected by the home’s clear procedures for dealing with medicines. EVIDENCE: At the time of the last inspection care plans sampled did not always identify all the residents’ needs and had not been reviewed as needs changed. On this occasion the three care plans seen showed evidence of regular review and provided sufficient information for staff to follow to support the needs of the residents. The care plans contained risk assessments for mobility, nutrition, pressure areas and falls and these assessments also showed that they had been reviewed. Recording of the residents daily living activities also required more detailed information as many of the entries said ‘washed and dressed, all care given’ but did not provide details such as whether the resident had spent all day in their room, joined in with leisure activities, had eaten their meals in their room or in the company of others in the dining room. The registered manager said Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 10 that this would be discussed during staff supervision and staff meetings. The records will be assessed again during the next inspection. Since the last inspection additional recording systems have been put in place for the recording of the administration of a medicine where a resident was receiving the medication in reducing quantities and for another resident who was receiving Warfarin. Measures were also in place to record the pulse of a resident before administering Digoxin. Where medicines could be administered as one or two tablets as required, the actual amount was recorded on the medication charts. The registered nurse responsible for administering medicines on the day of the inspection knew the residents well and was aware of the medicinal needs. Records seen were up to date. At the last inspection, it was noted that there was an over stock of some medicines. Since then the stock of medicines held has been reduced and appeared to be at the correct level. A system is in place for the disposal of unwanted medicines with two trained nurses signing to confirm the disposal of the medication. The residents’ medication regime is reviewed twice a year by the GPs or more frequently if required. Up to date information on the medicines used in the home was available for staff. At the time of the inspection there were no residents who wished to be responsible for their own medication. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 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 the following standard(s): 15 Residents are offered a choice or well presented, appetising meals served in a friendly relaxed atmosphere. EVIDENCE: Four residents spoken with said that they enjoyed the food provided at the home, which as two commented was ‘always good’. The cook had details of the residents’ likes and dislikes for food items and she said that she based the menus around this information and a choice of meals was always available. This was confirmed during lunch on the day of the inspection when residents’ meals were varied with baked or fried cod or plaice on offer with chips or mashed potatoes and peas and carrots, while one resident was having ham, egg and chips and another had a salad. The main pudding was ice cream with bananas and hot fudge sauce and there was also yoghurts or fresh fruit. The meals were presented well and staff were seen to assist residents who required help in a friendly and respectful manner and there was a relaxed atmosphere. Residents chose whether to eat their meal in the dining area or in their own room. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 12 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): Residents are protected by staff awareness of abuse issues. EVIDENCE: The home has procedures in place for staff to follow should abuse be suspected. The registered manager has attended training in abuse awareness and training records seen indicated that this was being cascaded down to staff. Two staff members spoken with had received training and were aware of the procedures for suspected abuse. Both staff members indicated that they would report any concerns immediately. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 13 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, 20, 21, 22, 23, 24, 25 and 26 Chatterwood provides a safe, clean, cheerful and homely environment for all who live and work there. EVIDENCE: The inspector toured the home that looked clean and well maintained. Visitors to the home are admitted by staff and are required to complete the record book on entering and leaving the property so that staff are aware of who is in the home at any time. Visitors not known to the staff are asked for proof of identity and this was the case for the inspector. The home stands in pleasant gardens in a quiet position on the outskirts of Liss. Residents are accommodated in twelve single and six shared rooms. The registered manager said that prospective residents and their relatives are always asked if a shared room will be acceptable before they take up residency. Residents’ rooms seen looked clean and homely and contained many personal items such as pictures and ornaments. Two residents in their Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 14 rooms at the time said that they liked their rooms and one commented on the pleasure of being able to bring personal belongings to the home. Since the last inspection a very large conservatory has been built to enlarge the communal lounge and dining area. The room looks light and very well decorated and has furniture and fittings of a high standard. Three residents in the lounge said that they found the chairs very comfortable and that they liked the improvements made by the addition of the conservatory. An area has also been provided to one side of the lounge away from the residents for the storing of wheelchairs used to transport some residents from their rooms to the lounge areas. The home has sufficient bathroom and toilet facilities and on the day of the inspection bathrooms and toilets seen looked clean. Specialist equipment such as hoists is available to assist residents with poor mobility and a lift allows residents access to the two floors of the home. The laundry room looked clean in good order. While touring the home it was noted that hazardous substances such as cleaning fluids were stored securely. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 15 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): 28 and 29 Residents are cared for by staff who receive support and encouragement to gain relevant qualifications and are protected by the home’s recruitment procedures. EVIDENCE: All but one of the ten carers employed at the home hold or are in the process of obtaining National Vocational Qualifications (NVQ) level 2 or above. One carer has also completed the Registered Managers Award. Two staff members spoken with said that the registered manager is very supportive and encourages them to attend training sessions and gain qualifications. At the time of the last inspection recruitment records seen for staff did not contain all the information required including Criminal Records Bureau (CRB) checks and two written references. On this occasion records seen for one staff member contained all the information required and indicated that CRB and Protection of Vulnerable Adults (POVA) checks had been completed. Records for another staff member were also complete, although the application form did not provide details of their full employment history. This was however covered during the interview that took place before they were offered a position at the home. The registered manager said that she would ensure the full employment history was provided on the application form in future and during the inspection provided a copy of a form to be used to record the employment history of applicants. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 16 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, 32, 33, 35, 36 and 38 The experienced registered manager operates an open approach to management from which residents and staff benefit and resident’s financial interests are safeguarded by the home’s clear procedures for dealing with residents’ money. Residents are protected by the regular supervision of staff and the safe working practices operated in the home. EVIDENCE: The registered manager is a trained nurse who has many years experience in providing nursing care in a residential setting. Mrs Joyce Gilfroy has worked at the home for fifteen years and has been the manager for five years. She attends training sessions to meet her nursing professional development requirements and has completed the Registered Managers Award. Staff spoken with said that Mrs Gilfroy is very supportive and understanding and residents also said that they felt able to talk with her at any time. During Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 17 the inspection it was noted that there was a good rapport between Mrs Gilfroy and the residents and staff and this gave a relaxed atmosphere to the home. Two visitors also commented on the friendliness of the staff and manager and said that they felt they could discuss any issues with them as they wished. Meetings are held two or three times a year for residents to feedback on the quality of care provided at the home. The minutes of the meetings seen indicated that residents are able to discuss any issues regarding life at the home and the minutes are made available to all residents and their relatives. The registered manager said that the minutes are read and discussed with residents who did not attend the meeting and for those with sight impairment. Staff meetings are also held on a regular basis and the minutes are available for all staff members. The registered manager meets with one of the providers of the home on a monthly basis to discuss the running of the home. The registered manager said that the discussions covered all aspects of the home including staff training and recruitment, equipment required and maintenance of the property. The registered manager said that no money was held at the home for residents. Any costs incurred by the residents such as hairdressing, chiropody and the purchase of newspapers were invoiced by the home to the person responsible for the residents finances. The registered manager undertakes regular formal supervision for all the staff members. A staff member spoken with said that supervision meetings were held at a time agreed by both people. Records were kept of the meetings and those seen indicated that issues discussed included the staff member’s standard of performance, training requirements and opportunities and annual leave. At the time of the last inspection three bedroom doors with fire guards fitted did close properly, with one of the doors obstructed by the bed. The registered manager said that this issue had been rectified and on this occasion the doors were not obstructed and closed appropriately. Records for checks on fire safety equipment and emergency lighting indicated that the required monthly and weekly checks were being completed. Records also showed that staff received training in fire safety and attended fire drills. Staff are often aware of when a fire drill is to occur and the registered manager said that she would arrange for more of the fire drills to take place at a time unannounced to staff. Staff receive training in health and safety issues including moving and handling, food hygiene, infection control and first aid. Health and safety notices are displayed throughout the home. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 18 At the time of the inspection the kitchen looked clean and in good order with food stored appropriately. Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 4 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Chatterwood Nursing Home DS0000038996.V280422.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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