Inspection on 08/01/10 for Cheriton

This inspection was carried out on 8th January 2010.

It is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.

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

Cheriton 18/12/07

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 28/03/2010.

Annual service review Name of Service: Cheriton The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Jane Handscombe Date of this annual service review: 1 8 1 1 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: 9 Stubbs Wood Chesham Bois Amersham Bucks HP6 6EY 01494726829 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Name of registered manager (if applicable): Mrs Sushma Nayer,Mr Vipin Parkash Nayar The registered provider is responsible for running the service Conditions of registration: Category(ies) : dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: The maximum number of service users who can be accommodated is: 27. The registered person may provide the following category/ies of service only: Care Home only (PC) to service users of the following gender:Either Whose primary care needs on admission to the home are within the following category/ies Old age- not falling within any other category (OP) Dementia (DE) Mental Disorder- excluding learning disability or dementia (MD) Physical Disability (PD) Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Manager position Vacant Number of places (if applicable): Under 65 Over 65 27 27 0 27 0 0 27 0 Annual Service Review Page 2 of 8 Date of last annual service review (if applicable): Brief description of the service Cheriton home for older people is a detached property located in Chesham Bois. The home is registered for 27 older people. The accommodation consists of all single rooms. There are two large lounges and a separate dining room. One of the lounges allows pleasant views over the grounds. The home is equipped with a passenger lift and grab rails around the home for those who are less physically able. Public transport is easily accessible and is in walking distance from the village and a short drive from Amersham. The home is supported by a local general practitioner (GP) surgery and other health care resources are available through a referral from the general practitioner. There is an established staff team who support the care of residents. The range of fees are #525.00- #625.00 per week. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at information received by the Commission, including that asked for, since the last annual review undertaken in December 2009, this information included: the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection, annual review and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations and what other people have told us about the service have all been considered and fed into this annual service review. Surveys were sent out to the service to distribute to service users, their advocates/relatives, staff members and health and social care professionals prior to writing this review to enable us to gain feedback from those with an interest in the service; the responses provided to us from these surveys have been included within this review. Any that have not yet been received at the time of writing this report will however be considered as part of the Commissions ongoing regulatory responsibilities for registered services. What has this told us about the service? The home sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and generally gave us all the information we asked for, although some sections were left blank or failed to provide us with evidence to support their statements. This shortfall was also highlighted to the service in their previous Annual Service Review and they were reminded that they should be addressed in all future Annual Quality Assurance Assessments as is required. Guidance on how to complete the AQAA is provided on our website at www.cqc.org.uk and is sent to providers with the AQAA, which the registered persons should read prior to completing the document to ensure that they meet with the care homes regulations 2001. We looked at the information in the AQAA and the responses to surveys and our judgment is that the home is still providing an excellent service and that they know what further improvements they need to make. The home continues to let us know about things that have happened since our last key inspection and they show that they have managed issues well. The AQAA showed that people using the service are consulted with and involved in the assessment of their needs and the care planning process. Their opinions are sought and acted upon wherever feasible to ensure that; however diverse their needs may be, they receive a package of care, which meets their needs appropriately. The home inform us that they have made a number of changes as a result of listening to those who use the service which includes improvements made to the environment, improved training opportunities for staff, a new care planning process covering all aspects of individuals health, personal and social care needs, the provision of a regular activities calendar which is accessible to all those using the service and their relatives Annual Service Review Page 4 of 8 and the introduction of a new risk assessment process. Enhancements to the environment have been made over the last 12 months to add to the comfort of those living at the home; these include the installation of a new shower room, the provision of electronic hoists to assist in bathing, the addition of en suite facilities to a number of bedrooms, replacing the hot water system with a new system to ensure a continuous supply of hot water and the redecorating and re-carpeting some bedrooms and one of the communal lounges. Information within the completed AQAA informs us that further extensive refurbishment plans are in place and scheduled to be undertaken over the next 24 months. People using the service, who responded to questionnaires sent to them prior to this review, inform us that staff are available when they need them and that they listen and act upon what they say. All who responded inform us that there is someone available that they can speak to informally if they are not happy but whilst ten know how to make a formal complaint if they need to three tell us they do not know how to make a formal complaint. All tell us that the home makes sure that they get the medical care that they need. There were mixed views on the provision of activities; five tell us that the home always arranges activities in which they can take part in, four answered usually, two said sometimes and one said never. One service user said that whilst they had only been at the home for a short while he/she felt that the home could do better in providing more activities and motivation - there is too much TV and not enough interaction with residents and staff. Similarly surveys received from relatives/carers/advocates contained comments about the provision of activities which included I would like them to have more activities throughout the day, another said the service could provide more stimulus for people with dementia and one told us there is too much reliance on television. One service user suggested that a visiting shop would enable him/her to purchase personal items. The home inform us that they have plans over the next 12 months to extend their activities programme to include more outings for those using the service and plan to also provide people with visits to the local shops and local walks on a regular basis. There was many positive comments received about the service which included; I left my home to come here and after a year here I find Ive settled very well, we have an excellent chef who does good balanced meals and caters for our likes and dislikes, they look after me well and help me with most of my needs Staff who responded to questionnaires tell us that they receive enough support in meeting the needs of those living in the home. Two said that there was always enough staff to meet the service users needs and six answered usually to this question. All told us that their induction covered everything they needed to know to do their job when they started and are provided with ongoing training that is relevant to their role, enables them to meet the individual needs of those using the service and keeps them up to date with new ways of working. The majority of staff tell us that the training gives them enough knowledge about health care and medication although one respondent did not feel this to be the case. In terms of what the home does well staff responses included; creates a happy environment for both residents and staff, three commented on the provision of training and informed that they receive regular training and two commented on the high standards and level of care. Feedback from relatives/carers/advocates was generally very positive. All who responded inform us that they feel the home meets the needs of their relative/friend, Annual Service Review Page 5 of 8 that the staff have the right skills and experience to look after them. All told us that the service supports people to live the life they choose and all were aware of how to make a complaint should the need arise. one added if there is any concern about an individual residents health, knocks, bruises etc (however small/minor) the staff always call the doctor/district nurse to check it out i.e. the staff take action rather than wait for a third party to instruct them. Further comments included; they look after my mother well and understand her needs...., friendly caring attitude to my mother and an open and friendly attitude to myself and my wife, staff are always patient and kind and the atmosphere is cheerful, the manager and majority of the staff are to be commended, on the whole the standards are very good and the atmosphere is relaxed and welcoming, my mother was nursed by the staff at Cheriton with great love and kindness during her last weeks. Renovation work on the home was postponed so that my mother had a peaceful environment in her last days. I cannot commend Cheriton enough - they were first class! There were some areas of concern which the service need to address to ensure peoples individual needs are being met appropriately; in response to the question what could the service do better one said informing me when they have a senior nurse to the patient and the follow up another stated that they felt during the non busy periods, such as the afternoons and weekends the less able residents should be checked upon more frequently as they are unable to call or ring for help this person also told us that some of the less able residents are rushed during mealtimes an example being given of some staff filling their drinks to the brim and hurrying them to drink their drink before they have managed to swallow their food. Another responded by saying Immediate action should be given to some personal needs of residents like toiletries, pads etc for carers to have ready use for the residents One GP completed a questionnaire and gave positive feedback on the care and support provided at Cheriton. He/she informed us that the manager and staff have the right skills and experience to support the residents social and health care needs which are always monitored and reviewed properly, that the home seeks advice and acts upon it to improve peoples well being and always responds appropriately if he/she has raised any concerns. There has not been a need to notify us of any serious issues affecting people using the service and information provided to us in the completed AQAA informs us that the service have not received any complaints about the service or any safeguarding concerns during the period under review. The Commission have not been alerted to any safeguarding issues either. There has been a change to the management of the home since the last review of the service undertaken in December 2008. The commission was informed in January 2009 that the service was without a registered manager in place and they were actively recruiting to fill the position. Management arrangements were put into place during the interim and until a suitable person was appointed. At the time of writing this report, we are informed that a manger has been appointed and will be registering with the Commission in due course. It is recommended that an application for registration be submitted to the Commission without delay, to ensure the continuity of care for those using the service. The home continues to let us know about things that have happened since our last annual review and they have shown us that they manage issues well. Annual Service Review Page 6 of 8 Overall, the balance of responses from the questionnaires were positive, we have no doubt that the home will take note of the less positive ones. What are we going to do as a result of this annual service review? We are not going to change our inspection plan and will do a key inspection by 29th October 2010. However we can inspect the service at any time if we have concerns about the quality of service or the safety of the people using the service Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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