Inspection on 16/11/06 for Cheriton House

This inspection was carried out on 16th November 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

Cheriton House 13/10/08

Cheriton House 20/11/07

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Cheriton House 20 Chipstead Avenue Thornton Heath Surrey CR7 7DG Lead Inspector Michael Williams Key Unannounced Inspection 16th November 2006 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 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 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. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cheriton House Address 20 Chipstead Avenue Thornton Heath Surrey CR7 7DG 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) 020 8689 7788 020 8684 6355 London Borough of Croydon Josephine Gbadamosi Care Home 41 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (41) of places Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2006 Brief Description of the Service: 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 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, staffrooms and offices. There is a large well-maintained and enclosed garden to the rear of the property and parking spaces accessible only through security gates. Fees as at November 2006 are £534 per week. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this visit was to monitor progress in meeting requirements and to check the well being and safety of service users. The visit was conducted In November 2006; from midday until tea-time and most service users and staff on duty at the time were given the opportunity to talk to the inspector; several relatives were also visiting on this day and they most helpfully commented on the procedures for admitting new residents. Professional visitors were also observed including Nurses and an Engineer. In Cheriton House diversity is managed in much the same way as it is in many other homes. In this home staff are expected to respect the diversity of all residents - and other staff and visitors. To meet those diverse needs there are staff from a variety of nations; the building is equipped to assist residents with mobility and sensory problems; catering staff will provide meals reflecting a range of choices and nationalities. Where residents choose to make known their sexual orientation the staff will respect their chosen lifestyle. The overall impression is of a well run home and despite some deficiencies the Commission is confident recommendations and requirements will be addressed and so the overall assessment of the service is good. What the service does well: What has improved since the last inspection? What they could do better: A number of recommendations and requirements are made. There remains an excessive reliance upon agency staff; many are employed long-term and know the home but some do not. The décor in the home is rather tired and old, some rooms have not been decorated for several years and are showing signs of wear and tear. Maintenance certificates, such as fire safety checks, could not be readily located. A suggestion is made to change the way information about activities is provided; the current weekly list is unrealistic and not maintained by staff. Evening meals need to be improved and an evening cook is required to provide fresh cooked hot evening snack meals. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 6 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. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 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 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 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): NMS 3: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Needs assessments: admissions of new residents are only made from referrals from local authority care managers who complete a full needs assessment. The needs assessment involves the service user wherever possible and where it is not possible their main carer or legal representative. The needs identified form the basis for each service users care plan. So this means that each service user has had their needs assessed and can be confident these will be met in this care home. EVIDENCE: Residents were interviewed in so far as that was possible without causing them distress; relatives and staff were also interviewed. A sample of case files was checked and care plans were seen for each service user. These care plans include general information about each service user, details of their medical and social histories as well as their wishes and preferences. Risk assessments were seen to be regularly undertaken for the case files sampled. The risk assessments inform revised care plans. Areas of strength are wealth of information provide at the point of admission and as no matters requiring improvement arise this section, about choice, is assessed as good. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 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): NMS 7 8 9 10: Quality in this outcome area is good. This judgement has been made using available 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 plan objectives which are set in order to meet these needs. All residents have access to the full range of health care services including GP services. The home does have in place procedures to ensure the safe management of medicines and medication is administered by trained and qualified staff. Procedures were seen to be followed as required. Staff ensure that service users expressed wishes and rights to privacy and dignity are upheld at all times. EVIDENCE: 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 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 10 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 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. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 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): NMS 12 13 14 15: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As far as is possible service users enjoy a lifestyle that matches their expressed wishes and preferences. The daily activities offered in the home are reasonably flexible and include a range of activities to meet the varied needs of service users. Where ever possible relatives and friends are encouraged to maintain their links with residents. Residents are offered choices wherever possible by staff. Residents are able to make choices from menus for their meals and also in their activities. Service users receive some wholesome, appealing and well balanced meals within the different units that make up the home. Dining rooms are pleasantly decorated in a homely style. EVIDENCE: The Unit’s Activities Officer consults with service users as far as is possible in the planning of daily activities that will meet their needs and wishes. Service users are positively encouraged to participate in these activities and at the time of the visit service users seemed to be content with life in Cheriton House. On the day of inspection there was very little evidence of recreational or any stimulating activities other than the televisions on in each lounge but with residents taking very little notice of them – they provided just a background picture. Some staff were sitting in the same room with residents but again there seemed actual engagement with the residents. Care staff referred me to the ‘activities lady’ who was on duty on the day of inspection. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 12 The inspector was advised the ‘equipment’ is available on the ground floor but it seemed not in each lounge. It is acknowledged that the small groupliving units offer a homely setting for residents, many of whom are very frail. As there is usually just one member of staff in each small unit, and sometimes only one member of staff for the two units on each floor, there is little scope for staff to do anything other than provide for basic care needs, washing, bathing, meals, toileting and then general ‘supervision’ of residents. Residents were frequently seen just sitting and dozing in their chairs. It is suggested that the ‘weekly activity’ list is changed; for example a calendar can be provided to list fixed and regular events such as Sunday worship; then a separate list of available activities (with no fixed days or dates) and thereafter a note on the white-boards as to what will actually be offered on the day. In contrast to the inspector’s observation on the day of his visit, relatives spoke positively about activities available to residents and the choices that are offered in terms of food and clothes. Residents are able to make some choices in the furniture and décor of their bedrooms but bedrooms, especially those on the top floor, are looking a bit old and tired as reported in the section on environment. Some service users are able to and do take part in community activities such as attending day centres and church groups were they have afternoon tea and cakes. Staff also take service users shopping when they are able to. On occasion staff have also taken residents to met their partners at the family home and is commended. On this visit relatives were seen to be together enjoying time with residents. When asked relatives said they were happy with access arrangements and communication with the home. The maintenance of relationships was discussed in some detail under the heading of diversity and meeting individual needs, whether religious, racial, social or sexual in nature. As a number of residents have surviving partners to whom they may have been married for very many years a guest room was suggested to enable private and intimate contact overnight if that is their wish. Information about any special needs or dietary requirements for service users are either made known at the initial assessment or later as needs change and plans are reviewed. Special meals are provided for service users as they require e.g. Halal meat or vegetarian food. The midday meals appeared satisfactory but the planned menu has changed every day this week and clearly needs revising. However, residents appeared to enjoy the lamb casserole and mince and onion pie, whilst the evening meal was rather poor. It was a plate of ravioli followed by jam sandwiches. This was prepared by the morning cooks shortly after 2pm for service to residents after 5pm by which time it would lacking any residual flavour or goodness. A plate of ravioli, without further embellishment is not an adequate meal or even suitable ‘snack’. This is neither appetising, attractive nor appropriate for the residents; an evening cook is required to prepare wholesome and nutritious meals, which look appetising and attractive to eat. It is also to be noted that the national minimum standards recommend that the interval between the evening meal and breakfast is to be no more than twelve hours. It was further noted and is Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 13 reported under the environment section that the kitchen requires a thorough clean and food stores need to be tidy. Areas of strength are the positive attitude of staff despite the uncertain future for Cheriton House and the warm welcome given to all visitors. Matters requiring improvement are meals, especially evening meals and the weekly menus and suggested changes to activity information. Despite shortcomings, this section, about daily life and activities, is assessed as overall good. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 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): NMS 16 18: Quality in this outcome area is good. This judgement has been made using available 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: The unit has a complaints record book in place but in the book shown to the inspector there was no entry after 2003 so this may not have been the latest record. Similarly the Incident record was last dated 2004 and again may not be the latest version. Senior staff in charge of the home must be made familiar will all the statutory records listed in the appendix of the care home regulations (Schedules 1 to 4). The Inspector interviewed a number of staff members who 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 but several ‘suggestions’ were made about poor décor, about over-reliance upon temporary, agency staff and about the availability of hoists on each floor (so they don’t have to be shared between floors). Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 15 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 re-issued with the General Social Care Council’s Code of Conduct and individual staff members told the Inspector that they have read and understood it’s 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 misdemeanours. Staff also have access to all the Council’s 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 home’s positive approach towards matters of concern to residents and relatives. Matters recommended for improvement is the need to ensure all staff know which are the current statutory records. This section, about complaints and protection, is assessed as good. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 16 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): NMS 19 22 23 26: Quality in this outcome area is adequate. This judgement has been made using available 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 poor. The home is generally clean, pleasant and hygienic but the kitchen areas needs cleaning and tidying. Not all staff (agency) know how to correctly use hoists. EVIDENCE: Cheriton House is protected by key coded electronic gates both to the outside area and to the front entrance door of the home, and whilst it is regrettable that this level of security is required, Cheriton House is now a safe and secure environment for the residents. As entry points from the outside are all secured by key coded entry systems a requirement was made that senior management are given access to the home (so that they may make unannounced checks as required by Regulation 26) by making at least one door into the home accessible from the street. The person in charge advised the inspector that this was now the case and unannounced night visits by managers are being made. Within the home the general décor is tidy and decorated to an acceptable Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 17 standard, with some exceptions. The home is furnished to the required standard and whilst bedrooms are all of a similar standard, layout and design they are reasonably maintained and pleasant in most areas but the décor of bedrooms on the top floor is now rather old and tired. The home was clean in most areas and free from unpleasant odours. However the kitchen was not being maintained to a high enough standard, the corners of the floor and some areas of the walls/doors are dirty for example. Food stores are in disarray and food/drinks (potatoes and soft drinks) are being stored on the floor contrary to good hygiene practice – the inspector was advised that the shelves are not strong enough to take the weight of soft drinks; so they need to be strengthened. The cold-milk dispenser is broken and parts are rusty; it must be removed; whether or not is replaced will depend upon whether it is needed by the home. An open drain was noted in the kitchen and advice must be taken as to whether or not this poses a hygiene, cross-infection or infestation hazard; it is not usual to have open drains within kitchen areas. Bedrooms have been fitted with unsuitable deadlocks (but 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 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). Comments were made during the inspection about the use of hoists. In the first instance an engineer was on site to service the mobile hoists and that is commended. However the inspector was informed that some agency staff are not familiar with the hoists and in fumbling with them they disconcert the residents - many of whom don’t like their use anyway. It was also suggested that, as they are in regular use, each floor should have its own hoist suitable for the activities staff are required to undertake most frequently each day. The Commission endorses the good idea. The open sluice, used for washing commodes is in the laundry-room and should not be located here. Areas of strength are homeliness of the small group-living units and matters requiring improvement are décor of bedrooms and improved standards in the kitchen. This section, about the environment, is assessed as only adequate. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 18 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): NMS 27 28 29 30: Quality in this outcome area is adequate. 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 home’s 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: The service user to staff ratio means that there should be two staff working in each unit during day-time shifts and additionally one ‘floating’ member of staff who can be deployed where needed. This was not the case throughout the day when the Commission inspected the home on 16th November. There were occasions (such as ‘handover’ or meal-breaks) when only one member of staff was supervising, or at least expected to supervise, two units set some distance apart on each floor. The Inspector therefore found residents sitting in a small group in their lounge with no staff support or supervision. The Manager of the home confirmed in previous inspections that a careful check is kept and she feels that service user needs are being met at the moment by this level of staffing. But at the time of the inspection not all service users were adequately supported by the number of staff giving care and support to residents. Staff confirmed that they attend a wide range of training courses and this was evidenced by staff training portfolios on their files and noted by the Inspector. It has already been confirmed by the senior management team that all the Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 19 required recruitment checks have been undertaken including the police checks CRBs and other checks that means the service users are supported and protected by the home’s recruitment policy and practices and this was also confirmed by checking a sample of staff files. The Manager has stated in previous inspections that temporary staff employed “always work dual handed with permanent staff and their work is regularly supervised and monitored by senior staff”. However, on the day of inspection there were seven carers of whom five were temporary agency staff and of these five, three were ‘fairly new’ to the home. In the afternoon five of the six carers were temporary agency staff. One of the staff interviewed by the inspector and working alone had worked in the home for four months. The staff-room on the ground floor, which the inspector was advised was the only staff-room - there being no other rest area and no training room, is inadequate and rather poorly maintained, like some other parts of the building this room is need of improvement. Areas of strength are the commitment of the permanent staff some of whom have worked in the home for many years and the professional and helpful manner of all staff interviewed. Matters requiring improvement is the need to reduce the use of temporary, agency staff which visitors note and commented upon; so this section, about staffing, is assessed as adequate. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 20 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): NMS 31 33 35 37 38: Quality in this outcome area is good. This judgement has been made using available 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. Service users and staff are protected by good administration including record keeping and guidance issued to staff and residents. The health, safety and welfare of residents is promoted and protected by the practice and policies in place. EVIDENCE: 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 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 21 and long term staff they had less confidence in short term temporary staff. Ambience 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 were frequently seen dozing without engagement by staff. Service users capable of signalling their contentment indicated that they are happy in this home so far as could be ascertained by their body language and general demeanour. 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. On this inspection visit not all fire exits routes were seen to be clear, equipment is being stored in the ground floor lobby and this area should not be sued for any materials that might compromise escape and might add a fire risk. Final exits were checked in the previous inspection and found to be openable without the use of a key. Areas of strength are the generally well managed home, the positive attitude of senior/managerial staff and the positive feedback from visitors to the home. Matters requiring improvement are use of agency staff; the fire hazard; the need for continued refurbishment – particularly as the closure of this home may be deferred. This section, about management and administration, is assessed as good. Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 3 2 X X 2 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP15 Regulation 16(2)i Requirement Meals: The home must provide suitably, freshly prepared and attractively presented, evening snacks. In order to achieve this the home must review the deployment of catering staff to cover evening meals so that residents do not have an interval greater than twelve hours between meals. Kitchen; the kitchen must be maintained in a clean and tidy state throughout. All surfaces in the whole of the floor, the walls, paintwork must be clean and food stores clean and tidy. Unusable equipment must be removed - and replaced if needed for catering. Fire Safety: All exits including lobbies must be kept clear and not used as storage space. Timescale for action 30/12/07 2. OP15 16(2)j 30/12/06 3. OP38 23(4)c 30/12/07 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 24 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 OP7 Good Practice Recommendations Care Plans: It is recommended that all service user care plans are reviewed internally by staff at monthly intervals and reviewed annually including external professional agencies and representatives. Activities: It is recommended that the information about activities is changed into three separate formats; a master list of fixed events such as Sunday worship; a list of all events available perhaps seasonally adjusted and thirdly the white-boards can be used by staff to indicate what activities will take place on the day. All staff, and not just the activities person, must make use of resources available to occupy residents a meaningful way during the day. Décor: All areas used including bedrooms should be maintained in a reasonable state of repair and decoration. Records: it is strongly recommended that all senior staff who are to be in charge of the home are advised about the location of all the statutory records listed in Schedules 1 to 4. 2. OP12 3. 4. OP23 OP37 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Cheriton House DS0000043301.V314562.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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