Inspection on 11/10/05 for Cheney House

This inspection was carried out on 11th October 2005.

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

Cheney House 14/05/09

Cheney House 08/12/08

Cheney House 28/02/08

Cheney House 05/04/07

Cheney House 06/04/06

Cheney House 20/04/05

Cheney House 16/12/04

Cheney House 01/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Cheney House Rectory Lane Middleton Cheney Banbury Oxon OX17 2NZ Lead Inspector Judith Roan Unannounced Inspection 11th October 2005 11:45 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 Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cheney House Address Rectory Lane Middleton Cheney Banbury Oxon OX17 2NZ 01295 710494 01295 712784 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) Regal Care Homes Ltd Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34) of places Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20.04.2005 Brief Description of the Service: Cheney House is a care home providing personal care and accommodation to thirty four older people who may have a dementia related illness. Cheney House has been registered as a care home for a number of years and is now owned by Regal Care Homes Ltd. The home has been registered with Regal Care Homes since January 2004. The Home is situated within its own grounds and located in a village. The building was a former rectory and is a listed building. There are nineteen single bedrooms with nine having en-suite toilet facilities. Of the eight rooms which are shared by two people two have en-suite toilets. The home provides living accomodation for newly appointed overseas workers. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 3 residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The inspection took place during the late morning and afternoon, over a period of 5.75 hours and was carried out on an unannounced basis. What the service does well: What has improved since the last inspection? Assessments and care plans have been developed and demonstrate that they are now being completed. Appropriate activities and stimulation has in part been introduced with an identified staff meber in an afternoon.. The home has been refurbished and now presents with a bright, clean and hygienic home that is fit for purpose. Staffing levels have been increased during identified times in the day to meet the assessed needs of Service Users throughout the twenty four hour period. Movement and handling training has been undertaken by all staff. The manager has commenced the Registered Managers Award course. A comprehensive programme of dementia care training has begun for most permanent staff. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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 Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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 The home does not provide intermediate care therefore standard 6 is not applicable. The admissions process does not fully ensure that service users needs can be safely met. EVIDENCE: Records reviewed of newly admitted residents did contain basic information but failed to have supporting assessments from health & social care professionals involved. Another file did not contain any medical information of a service user whose health was deteriorating. A review of their assessed needs was not evident. However the care they were receiving was meeting their needs. Assessment information does not include life history that would benefit work being carried out with service users with a dementia. This information would aid staff to engage service in conversation in areas about their past or that they have an interest in. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 9 Information about service users is stored in various files and was not easy to access. In discuss with the homes manager it was agreed that she would review how information is stored so that important facts are available to care staff. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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 The shortfalls in planning of care and instruction to staff have the potential to put service users at risk. EVIDENCE: Care plans contain general information to enable carers to provide the support. However there is a need to specify special requirements, personal goals, chosen activities and how care staff workers are to achieve the needs detailed. In observing practice during lunch and afterwards the inspector was concerned that several service users became distressed and a member of staff ignored this. Eventually after intervention the staff member did respond only to escalate the situations. Other care workers were called and resolved the issue for the service users. It was evident that the member of staff did not know how to respond in these situations. (see also standard 30) Records of a service user whose needs have increased where there had been significant weight loss noted did not demonstrate how her nutritional needs would be met. A locum GP had visited the service user and their recommendations were being carried out to reduce the service users fever. The Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 11 manager agreed that she would speck with the service users GP about the weight loss and gain support from the dietician. Medication is administered by trained staff and in looking at records this is managed appropriately. The records are however kept on top of the medication trolley that is stored in the main corridor on the ground floor. The trolley has a good fixing to the wall and would not be able to be removed without security keys. The records however are not stored confidentially and this was brought to the attention of the manager who agreed to review the medication storage. In observation and in discussion with some service users it was evident that they were treated with respect and that care staff maintained their privacy when undertaking personal care. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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 The homes practices are not fully based on the needs of the individual. EVIDENCE: As care plans did not fully detail service users needs in relation to social and personal goals it was not easy to evidence whether needs were being met. A new service user who was admitted the previous weekend was being supported to maintain their daily life skills, yet the care plans did not detail that this was a personal goal. Work to maintain skills and improve service users quality of life is happening but records fail to record verbal agreements. The inspector noted that service users had several visitors to the home who agreed that the home had improved over the past months. They felt comfortable in visiting the home and were always made to feel welcome by staff. The manager was able to evidence good feedback from relatives thanking the care team of the support given to their family member. Service users were seen through observation to be offered choice by care workers and supported to make decisions. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 13 The main lunch time meal was served in the lounge on the day of the inspection as the dining room was being used for training. This did not make for comfortable surrounding for all service users to eat their meal. (see also standard 20) This practice was not in the best interests of service users. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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): 18 Practices within the home ensure that service users are protected. EVIDENCE: The home has a clear policy on action to be taken in the event of an allegation of abuse. Care workers were aware of the types of abuse and would report if they suspected that abuse was occurring. The manager is aware of the local procedures in reporting any incidents to Care Management and that CSCI also needs to be notified. In discussion with the manager it was noted that abuse awareness training was not part of the induction programme and it was agreed that this would be followed up for all care workers. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 15 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): 19,20,23,24,26 The homes environment is fit for purpose providing a bright and comfortable home for service users. The lack of documentation in relation to safety checks does not confirm that management have undertaken the required role in making the home safe. EVIDENCE: The refurbishment programme is almost complete apart from adding personal touches to some communal areas. Carpets and curtains have been replaced providing a safer and homely environment for service users to live in. On the day of the inspection the dining room was being used for staff training. Service users main meal of the day was served using a range of tables some of which were low and made it difficult for service user to eat their food in comfort. The manager was advised that alternative arrangements must be sort for all future training. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 16 The home is clean and free from odour. The domestic and care team, work consistently to make the home comfortable for service users. A care worker was supporting one new service user spoken with during the visit to undertake light domestic duties as part of maintaining her daily living skills. A requirement made at the last inspection regarding an electrical wiring test certificate has not been addressed and again is made a requirement. Service user bedrooms are comfortable and it was noted that they contained items personal to the user. Service users are encouraged to bring personal items from home when the move in. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 17 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 Staff training and recruitment & selection practices do not provide adequate care and fully protect service users. EVIDENCE: Staffing levels at the home have been increased to meet the present number of service users being supported at the home. Consideration will need to be given to the ratio between staff and service users if service user numbers rise above 30. There has been considerable training offered to staff at the home with several now undertaking NVQ training and the manager working towards the Registered Manager Award. There has been a great improvement in this area and more is planned. There is a need required more training in person centred dementia practices to meet the needs of service users. (See NMS 7/8) In discussion with the manager it was established that the member of staff observed as not being competent when supporting a distressed service users was not undertaking the extended dementia training course. They only had access to a one day because they were not eligible for the funded training as an overseas worker available through the local college. A requirement is made for the manager to facilitate comprehensive training for all care workers employed by the home. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33,36,37 Information is not actively sort to gain the view of service users and their representatives to ensure the service is run in their best interests. Supervision of care staff is creating a strong team in providing care to service users but needs to be recorded. EVIDENCE: The deputy manager has been appointed as the manager and has made an application to be registered with CSCI. The manager needs to review how information about satisfaction is sort from the service user group. There is evidence that letters of thanks are kept along with complaints with outcomes. In discussion with the manager it was agreed that views would also be sought from professional visiting the home and how the information could be produced and be accessible for new users or their representatives. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 19 In discussion with care workers it was noted that they are well supported by the manager and have a positive attitude towards supervision. Supervision is generally undertaken on the job and relates to advice about practice or changing bad practice of care workers. Staff confirmed that regular staff meetings are held. In discussion with the manager it was agreed she would review how discussions with staff are recorded to demonstrate issues discussed, appraisal and development needs. The acting manager needs to review how service user records are stored and used to ensure that guidelines under the Data Protection act are maintained. The present office is very busy and there is a need to review how daily working practices impinges on the need to maintain confidentiality of service user and staff information. All staff have now received manual handling training to ensure safe working practices in this area. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 2 X X 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 3 2 3 Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 21 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 OP3 Regulation 12.1 17.1 14. 12 1 a&b Requirement The assessment processes for both new and existing service users need to demonstrate how needs are to be met. Up to date care plans must be in place which contain specific information regarding the individual needs and the required actions of the carer. (Previous timescale of 30.05.05 not fully met) Care plans based on nutritional assessments must be implemented in all cases where weight loss is identified. (Previous timescale of 30.05.05 not fully met) The acting homes manager needs to review how medication records are stored at the home to ensure confidentiality for service user. Appropriate activities and stimulation must be provided based on individual needs and choices. Details of how, what and when activities will be provided must form part of the care plan.(Previous timescale of DS0000012735.V259545.R01.S.doc Timescale for action 30/11/05 2 OP7 30/11/05 3 OP7OP8OP 12 1 a&b 30/11/05 4 OP9 17. 1 (b) 30/11/05 5 OP12 16.2 n. 12.1 a 30/11/05 Cheney House Version 5.0 Page 22 6 OP1515 CH20 OP19OP38 23.2 e&g 7 13.4 a&c 23.2 c 8 OP29 19.1 ab&c 19. 5 d 9 OP30 18.1 a&c 10 OP33 24.1 a&b 2. 3 17.1 b 11 OP37 15.02.05 and 15.06.05 not fully met) The communal areas in the home used by service users should not be used for training of staff An electrical wiring certificate must be in place to confirm that relevant checks have been carried out. Previous timescale of 30.07.05 not met) Document gained as part of the recruitment procedure must be in place at the home prior to staff commencing their duties, which includes obtaining appropriate references, identity and CRB checks. (A previous timescale of 16.12.04 and 30.05.05 has not been fully met) Training opportunities that are essential to meet the needs of the service user group must be available for all staff. The acting manager needs to develop the system by which information of the quality of the service provided is sort. The acting manager needs to review how service user and staff information is handled in accordance with Data protection guidelines records 31/10/05 31/10/05 31/10/05 30/11/05 31/01/06 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations The acting manager needs to develop activities based on information from life histories of individuals. Care workers working in this area need to complete training to ensure DS0000012735.V259545.R01.S.doc Version 5.0 Page 23 Cheney House 2 3 OP30 OP31 that practice is person centred in relation to service users with a dementia. The acting manager must ensure that person centred dementia care practices within the home are maintained at all times. The acting manager needs to receive support in fully understanding their role in relation to the regulations under which the home is registered. Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Cheney House DS0000012735.V259545.R01.S.doc Version 5.0 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. 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