Inspection on 06/02/06 for Cheriton House

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Cheriton House 13/10/08

Cheriton House 20/11/07

Cheriton House 16/11/06

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 David Halliwell Unannounced Inspection 6th February 2006 9:30 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.V269983.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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.V269983.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2005 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 garden to the rear of the property and parking spaces accessible only through security gates. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? An improvement has been made in the arrangement of information within the client case files, which facilitates access to the information relating to service users contained within the files. Provision to staff of the General Social Care Council’s Code of Conduct and the Whistle blowing procedures has improved staff awareness and their ability to promote good working practices within the unit. The staffing ratio which had been raised as an issue at the last inspection has been reviewed. This has now improved the delivery of care to the residents. On this inspection visit fire exits and fire routes were seen to be clear and final exits were open-able without the use of a key in the event of a fire. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 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 where ever possible and where it is not possible their main carer. The needs identified form the basis for each service users care plan. This means that each service user has had their needs assessed and met through the delivery of the care plan objectives. EVIDENCE: A sample of case files were 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. These care plans are reviewed regularly however the Inspector found that in some cases review dates had not been met and were now overdue. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 9 Recommendation 1 – It is recommended that all service user care plans are checked and reviewed at the date set and at least annually. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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 Care plan: 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. Health care: 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. Medication: 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. Respect and Dignity: Staff ensure that service users expressed wishes and rights to privacy and dignity are upheld at all times. EVIDENCE: Given the recommendation made at the time of the last inspection visit, care plan documentation was reviewed. Care plans were found within service user files which were listed in a clear and indexed way and which has improved accessibility to the information held for each service user. However review dates were not always met. (see previous section of this report) Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 11 At the time of this inspection no service users were found to be self medicating however as before care staff would support service users if they were able to self medicate. Within the management of medication procedures used, a form has been developed to record instances where medication is refused or not taken for other reasons. In reviewing the procedures the Inspector found that in some cases this form was not fully completed. Recommendation 1 – It is recommended that the medication record is fully completed in all cases where medication has not been administered as prescribed. On this inspection visit the Inspector talked to a number of service users and relatives as well as members of staff. Relatives spoken to felt that their loved ones are treated with respect and dignity. The Inspector from his discussions with staff and his witnessing of how staff were delivering care to residents felt that staff work hard to treat residents with care, respect and dignity. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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 Lifestyle: 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. Community contacts: Where ever possible relatives and friends are encouraged to maintain their links with residents. 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. Meals and choices: 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 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 within Cheriton House. Relatives spoken to by the Inspector at the time of the visit also spoke Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 13 positively about activities available to residents and the choices that are offered in terms of food and clothes. Residents are also able to make some choices in the furniture and décor of their bedrooms. 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 and express a wish to do so. 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. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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): 16 & 18 Complaints: 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. However with regard to minor issues service users and their relatives and friends are more likely to raise issues of concern or complaint informally with staff. Protection: 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. 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. The Manager informed the Inspector that no new complaints had been made since the last inspection visit. A summary of the complaints procedure is now contained in the new 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 Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 15 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. Some problems have arisen recently for staff in being able to attend these courses due to the large numbers of staff across the borough wishing to attend and also as a result of some courses being cancelled. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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): 19 & 26 Environment: Service users live in a safe and well maintained environment. Hygiene: The home is clean, pleasant and hygienic. EVIDENCE: Cheriton House is protected by key coded electronic gates both to the outside area and to the front entrance door of the home, making it a safe and secure environment for the residents. Within the home the general décor is tidy and decorated to an acceptable standard. The home is furnished to the required standard and whilst bedrooms are all of a similar standard, layout and design they are well maintained and pleasant. The home was clean and free from unpleasant odours. No changes have been made yet to bedroom doors as detailed in the recommendation in the last inspection report; however bedroom door locks are not currently used by residents who have not indicated a wish to lock their rooms. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 17 Entry points from the outside are all secured by key coded entry systems and it remains a need and now a requirement that senior management are enabled to access the home so that they may carry out their duties and become able to do unannounced checks. Requirement 1 - That a door is made accessible for managers to gain entry into the building. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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): 27,28,29 & 30 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 are 2 staff on duty at all times for each unit within the home and additionally 1 floating member of staff who can put in extra input where it is needed. The Manager of the home confirmed that a careful check is kept and she feels that service user needs are being met at the moment by this level of staffing. At the time of the inspection service users were adequately supported by the staff group on duty. Staff confirmed that they attend a wide range of training courses and this was evidenced by staff training portfolios on staff files seen by the Inspector. It has already been confirmed by the senior management team that all the 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. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 19 The Manager confirmed that temporary staff employed always work dual handed with permanent staff and their work is regularly supervised and monitored by senior staff. This means that all staff are trained and competent to do their jobs. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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): 31,33,35,& 38 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 the procedural guidance’s and policies that are in place and followed in the home. The health, safety and welfare of residents are 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 interviews – staff impressed the Inspector about their commitment and care to do with the residents; discussions with relatives – relatives confirmed Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 21 with the Inspector that they felt their loved ones were well cared for by staff; Ambience in the home – the Inspector felt that the general atmosphere in the home was positive, friendly and caring; Service users – service users confirmed with the Inspector that they are happy residents of the home. Financial procedures used for residents who wish to purchase items were checked and were found to be satisfactory in that procedures are being followed. The policies and procedures and the care planning and review processes used in the delivery of care to the service users means that the health and safety and welfare of both groups of staff and residents are promoted and protected. However as mentioned earlier in this report review dates need to be kept. On this inspection visit fire exits and fire routes were seen to be clear and final exits were open-able without the use of a key in the event of a fire. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 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 OP 19 Regulation 26(3) Timescale for action Security: It is recommended that 06/06/06 at least one entrance to the building is made accessible to senior managers so they may enter the building unannounced as required by Regulation 26(3). Requirement 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. 2. Refer to Standard OP3 OP9 Good Practice Recommendations That all service user care plans are checked and reviewed at the date set and at least annually. That the medication record is fully completed in all cases where medication has not been administered as prescribed. Cheriton House DS0000043301.V269983.R01.S.doc Version 5.1 Page 24 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.V269983.R01.S.doc Version 5.1 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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