Inspection on 13/10/08 for Cheriton House

This inspection was carried out on 13th October 2008.

CSCI found this care home to be providing an Good service.

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 House 20/11/07

Cheriton House 16/11/06

Cheriton House 06/02/06

Cheriton House 28/07/05

Cheriton House 04/01/05

Cheriton House 09/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cheriton House 20 Chipstead Avenue Thornton Heath Surrey CR7 7DG     The quality rating for this care home is:   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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Williams     Date: 1 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Cheriton House 20 Chipstead Avenue Thornton Heath Surrey CR7 7DG 02086897788 02086846355 josephinegbadamosi@croydon.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): London Borough of Croydon Name of registered manager (if applicable) Josephine Gbadamosi Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 41 The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 41) Dementia - Code DE (maximum number of places: 41) Date of last inspection Brief description of the care home Cheriton House is a local authority care home registered to provide residential care for up to forty-one older people with varying degrees of dementia and conditions associated with old age. The home has two respite beds that are regularly used by a designated group of people. Cheriton House is a large purpose built home situated in a residential road leading off the busy Brigstock Road in Thornton Heath. It is close to Care Homes for Older People Page 4 of 23 care home 41 Over 65 0 41 41 0 Brief description of the care home local shops, transport and other amenities. The home is divided into five smaller living units and usually the same group of staff work in each unit. There are baths or showers, wash hand basins and lavatories available throughout the home. The home has the usual facilities including a large kitchen and several small kitchenettes, laundry, staff-rooms and offices. There is a large enclosed garden to the rear of the property and parking spaces accessible only through security gates. Fees as at November 2007 are 540GBP per week. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A visit was conducted in the afternoon of 13th October 2008. We toured the premises, spoke to staff and to residents and we checked documentation. We also took account of information provided to us including feedback from visitors and the homes AQAA form which is the Annual Quality Assurance Audit. Where we have no evidence that there has been any change to our findings in 2007 our report findings are restated. Fees as at November 2007 were 534 pounds per week. We are advised that there have been no changes to the ownership of Cheriton House, it remains the London Borough Croydon. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being appropriately assessed and are being kept well informed about what services are available in this care home. Evidence: We have checked the documentation for admitting residents including the statement of purpose, the service user guide and a sample of resident files and we have found the the home is assessing each resident in a suitable manner so as to test whether admissions would be appropriate or not. We are advised that there have been no substantive changes to the way in which residents are admitted so this section about choice on admission remains assessed as good. Care Homes for Older People Page 9 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users checked in the sampling were all seen to have an individual plan of care setting out their health, personal and social care needs. Service users health care needs are being met by having their needs identified at admission and then by regular monitoring and review of the care plans. Evidence: There have been no adverse changes drawn to our attention in respect of the way in which health and social care is provided so our findings remain as before when a sample of residents case files were read, residents and relatives were interviewed, staff and visiting professionals, a Nurse and a Physiotherapist, offered their opinions and the manager also explained how they aim to met the social and health care needs of all residents. The administration in this home is very good and the case files were in good order despite the range of services on offer, some residents are long stay others admitted for respite or short stay in an emergency, so the case files need to be well managed and they are. The care residents need, and the care plans upon which care needs are based, is not Care Homes for Older People Page 10 of 23 Evidence: being regularly reviewed. The national minimum standards indicate the need for monthly (internal) checks to monitor changes and it is recommended an annual reviews are held that involves all parties, including professional agencies such as care managers or nurses. At the time of this inspection no service users were found to be self medicating however as identified before care staff would support service users if they were able to self medicate. No errors were identified with respect to the procedures for handling medication. Areas of strength are the detailed and methodically maintained case notes for each resident and the attention given to residents health care needs, whilst one matter requiring improvement is the need for regular reviews of the care needs and care plans of each and every resident; so this section, about health and social care, is assessed as good. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health and social care needs are being met by having their needs identified at admission and then by regular monitoring and review of the care plans. Evidence: There have been no adverse changes drawn to our attention in respect of the way in which health and social care is provided so our findings remain as before when a sample of residents case files were read, residents, relatives and staff were interviewed, and the manager also explained how they aim to met the social and health care needs of all residents. We did observe that staff were occupying themselves in the afternoon with administration and domestic tasks whilst residents sat unoccupied in their lounges. Little activity was offered other than the television. The administration in this home is very good and the case files were in good order despite the range of services on offer, some residents are long stay others admitted for respite or short stay in an emergency, so the case files need to be well managed and they are. At the time of this inspection no service users were found to be self medicating however as identified before care staff would support service users if they were able to self medicate. No errors were identified with respect to the procedures for handling Care Homes for Older People Page 12 of 23 Evidence: medication. Areas of strength are the detailed and methodically maintained case notes for each resident and the attention given to residents health care needs, whilst one matter recommended for improvement is the need for regular staff to engage more effectively with residents rather than occupy themselves with domestic tasks that could be undertaken by ancillary workers. This section, about health and social care, is assessed as good. Care Homes for Older People Page 13 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does have a clear, accessible procedure for making complaints and service users or their relatives do feel confident that their concerns will be dealt with effectively. Minor issues are raised informally with staff and this is acceptable to the Commission. To ensure that service users are safeguarded from abuse the home has written policies and procedures to do with the protection of service users from any form of abuse. These policies come within the overarching local authority multi-agency protection policy for LB Croydon. Evidence: No adverse changes noted and the findings in respect of complaints and protect remain extant. The unit has a complaints record book in place. The Inspector interviewed a number of staff when we last visited and they were able to demonstrate that they take any complaints raised seriously and that they know what the procedures are that need to be taken. No complaints arose during this inspection. A summary of the complaints procedure is contained in the service users guide, which is issued to all service users and will assist service users in making complaints appropriately. Staff have all been reissued with the General Social Care Councils Code of Conduct and individual staff members told the Inspector that they have read and understood its contents and that each have their own copy. Staff should therefore now be aware of their responsibilities to protect service users and to report allegations and Care Homes for Older People Page 14 of 23 Evidence: misdemeanors. Staff also have access to all the Councils policies and procedures held within the home and including the Whistle blowing policy which they confirmed with the Inspector they had had a chance to read. All staff are required to attend training to do with the protection of vulnerable adults run by LB Croydon and then to attend update refresher training once every two years. This means that staff should be fully aware of the policy and procedures to protect residents from abuse, how to recognise abuse and what to do if any allegation of abuse arises. Several referrals have been made to the local authority care management team under the procedures for dealing with allegations of abuse and these have been referred appropriately indicating that not only are procedures in place but they are being adhered to. Areas of strength are information provided by the home to residents and the homes positive approach towards matters of concern to residents and relatives. Matters recommended are recommended for improvement. This section, about complaints and protection, is assessed as good. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a safe and generally well maintained environment but some areas such as bedrooms are still poorly decorated. Evidence: There are no fundamental changes to this section of the report, the home is old and due to be replaced within two years. Cheriton House is protected by key coded electronic gates both to the outside area and to the front door of the home, and whilst it is regrettable that this level of security is required, Cheriton House is now a safer and more secure environment for the residents. Within the home the general decor is tidy and decorated to an acceptable standard, with some exceptions. The home is mostly furnished to reasonable but not high standard. Bedrooms are all of a similar standard, layout and design they are reasonably maintained and pleasant in most areas but the decor of bedrooms on the top floor which was particularly old and tired. Has been addressed and the communal areas now look much brighter and smarter. The home was clean and free from unpleasant odours. Bedrooms have been fitted with unsuitable deadlocks and they are not to be used. It was confirmed that these door locks, which are unsafe,as they would delay evacuation in the event of fire, are still not currently used by residents. The Commission has been advised that resident have not indicated a wish to lock their rooms. If they wish to do Care Homes for Older People Page 16 of 23 Evidence: so suitable mechanisms that can be used from the inside without the use of a key must be installed, referred to as hotel standard locks. The open sluice, used for washing commodes is in the laundry room and should not be located here; We note however that these premises are due to be closed and rebuilt. Areas of strength are homeliness of the small group living units and matters requiring improvement are decor of bedrooms and improved standards in the kitchen. This section, about the environment, is assessed as good since it is meeting the current needs of residents albeit in a rather older style building. Care Homes for Older People Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user to staff ratio in the home and the training and skill mix of the present staff team ensures that service users needs can be met. The homes recruitment policy and practices include a number of detailed checks which help to protect service users. Training programmes and access to training helps ensure staff are trained and competent to do their jobs. Evidence: NMS 27 28 29 30: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user to staff ratio in the home and the training and skill mix of the present staff team ensures that service users needs can be met. The homes recruitment policy and practices include a number of detailed checks which help to protect service users. Training programmes and access to training helps ensure staff are trained and competent to do their jobs. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent person and is run in the best interests of service users so as to ensure, so far as is practicable, their safety and well being. Service users financial interests are safeguarded by the policies and procedures in operation within the home. Evidence: No adverse information about the management of this home indicates that management and administration remains god and so findings of previous visits is restated. The caring ethos was evidenced in the home by a number of different aspects; staff impressed the Inspector about their commitment and care of the residents. In discussions with relatives they confirmed that they felt their loved ones were well cared for by staff, but they emphasised this was permanent and long term staff they had less confidence in short term temporary staff. Ambiance in the home, the Inspector felt that the general atmosphere in the home was positive, friendly and caring. Although it was at times a little too quiescent, during the inspection residents Care Homes for Older People Page 19 of 23 Evidence: were frequently seen dozing without engagement by staff. Service users capable of signaling their contentment indicated that they are happy in this home so far as could be ascertained by their body language and general demeanor. Financial procedures used for holding and spending money on behalf of residents who may wish to purchase items such as newspapers and cigarettes, have been checked on several occasions found to be. Money and accounts held in the home are also audited by the local authority, which is itself subject to independent audit of its financial probity. No safety issues were identified during visit in 2008. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 14 Social Activities: it is recommended that staff be deployed in maintaining greater contact with and using their time to occupy residents rather than engage in domestic tasks. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!