Inspection on 12/12/06 for Chesham House

This inspection was carried out on 12th December 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chesham House 30/05/07

Chesham House 23/02/06

Chesham House 07/06/05

Chesham House 07/03/05

Chesham House 27/04/04

Similar services:

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

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

CARE HOME ADULTS 18-65 Chesham House 151 Newmarket Road Norwich Norfolk NR4 6SY Lead Inspector Mrs Hilary Richards Unannounced Inspection 12th December 2006 09:00 Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 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 Chesham House DS0000028593.V323935.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 Adults 18-65. 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. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chesham House Address 151 Newmarket Road Norwich Norfolk NR4 6SY 01603 452226 01603 452229 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) Mrs. Penelope Baily Jane Elizabeth Olivier Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 Brief Description of the Service: Chesham House is a care home registered to accommodate a maximum of 6 persons in the category of mental disorder. It is linked to a specialist clinic Baskerville House (a Private Healthcare Facility located next door to the premises), for persons who have experienced eating disorders. Once patients at the clinic are sufficiently progressed in their recovery, they are offered a period of temporary residence at Chesham House. It is anticipated that service users will be supported and enabled to complete their rehabilitation at this care home prior to attaining their independence and moving back into the community. During their stay, service users receive on going psychiatric care, therapy and support as appropriate to their needs. Additional charges made are related to the consultants fees in respect of mental health care services purchased on behalf of the service user. Chesham House is a large period residence located in a mainly residential area to the south of Norwich city centre. The property stands back from a main road, secluded by mature trees and walled gardens, and is approached by a driveway with some private car parking places. Service users accommodation is within single rooms, located on the first and second floors, with access to bathroom facilities alongside. All city amenities are easily accessible, by bus or on foot and service users can if they wish park their own vehicles in the grounds. The home provides detailed information to prospective service users prior to their admission. CSCI Inspection Reports are available in the communal area of the home. The fees charged by the home are £280 per day plus £650 per month. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key Inspection that took place unannounced over one day and lasted for 3.5 hours. The Inspector interviewed the manager, a project worker and one service user. Written comments were also received from three service users. The focus of this Inspection was to assess all the key standards for homes for younger adults and also specifically to follow up the requirements that resulted from the home’s previous Inspection in February 2006. What the service does well: What has improved since the last inspection? What they could do better: • Regulation 26 visits by the provider need to take place at regular monthly intervals Chesham House DS0000028593.V323935.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. The summary of this inspection report can be made available in other formats on request. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 4 Quality in this outcome area is excellent. Individual needs and aspirations are assessed, all residents are appropriately placed and all admissions to the home are planned. EVIDENCE: All residents at Chesham House are referred to the home by Baskerville House, a private healthcare facility adjacent to the unit. The case file that was sampled during this Inspection evidenced a comprehensive needs assessment prior to the individual’s admission to the home. The manager advised that a new format is to be used in future for needs assessments that will provide a better level of information regarding all areas of an individual’s life; an example of the new format was seen during the Inspection. Residents who are moving from Baskerville House to Chesham House have the opportunity to visit the home over an extended period of time, dependent on their individual needs. Two prospective service users were visiting the home on the day of the Inspection. New residents have the opportunity to join the home for meals, stay for up to four or five days between 8.00am and 8.00pm and visit with staff prior to finally moving in. A current resident described their personal experience of the admissions process and how their suggestions for improvement had been accepted and acted upon by the manager of the home. Current residents are included in the process of introducing new service users to the home. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent. The individual needs and choices of residents are fully reflected in their Service User Plans; plans contain clear targets and goals are regularly reviewed. EVIDENCE: As evidenced during previous Inspections, the case file that was sampled on this occasion contained an Individual Therapeutic Plan (ITP) that detailed specific targets and goals and evidenced regular updating and review. The content of the ITP was known to the specific resident who confirmed that they had been fully involved in putting the plan together. The file also held specific risk assessments in relation to known and likely behaviour; these assessments evidenced regular review. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. Service users are actively supported and encouraged to integrate within the local community and access a variety of social situations. EVIDENCE: Discussion with the manager, member of staff, resident and recording on file evidenced that the home continues to offer service users numerous positive opportunities for education and socialisation both within the home and the wider community. Residents are actively encouraged to maintain their links with the local community, friends and family. The staff team are clearly aware of the need to promote service user’s confidence and self-esteem to ensure that they do not become dependent on the service that is offered by the home. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 11 The routine of the home is organised to promote the inclusion of all service users whilst also recognising individual’s need for privacy and freedom of choice within their lifestyle. The staff team continue to provide a sensitive but focused approach to individual’s specific eating disorders and great care is taken to encourage healthy eating plans and opportunities for social meals within the community. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent. Residents receive a high level of personal support from a dedicated staff team that promotes their emotional and physical welfare at all times. EVIDENCE: Written and verbal comments from residents confirmed that staff are always available to support them in how they manage their illness and assist them to develop appropriate coping strategies; numerous positive comments continue to be made regarding all members of staff. The home continues to provide additional specific specialist support via family therapy, psychiatric support, massage etc. The health needs of the residents are closely monitored due to the specific issues relating to eating disorders. All residents in the home keep and administer their own medication, this is held in locked cabinets in their rooms. Case files evidenced a clear risk assessment for each resident regarding their medication and there are agreements in place regarding how often staff monitor stock levels. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Service users are listened to and are protected from abuse, neglect and self-harm. EVIDENCE: The home has an appropriate Complaints Procedure in place that is contained within the service User Guide to the home. The staff team continue to hold regular Community Meetings with residents and the manager remains available to service users and staff on a daily basis as observed during the Inspection. Written and verbal comments made by residents’ evidence their continued confidence that the manager would resolve any issue to their satisfaction. The home has not received any formal complaints since opening. The home has appropriate procedures in place with regard to adult protection and whistle-blowing. The manager has sought advice and taken appropriate action in relation to the protection of a vulnerable resident from the home. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is excellent. Chesham House offers a high standard of accommodation that is maintained, furnished and decorated in good order throughout. EVIDENCE: As part of the Inspection a complete tour of the premises was undertaken, with the exception of two occupied bedrooms. The home continues to present as a welcoming, friendly and relaxed environment that is decorated to a high standard. The home has a number of spacious communal rooms for use by residents, alongside smaller rooms available for therapy. The kitchen is equipped with two cookers and appropriate food storage facilities. Residents have single bedrooms that they are free to personalise during their stay in the home. Bathrooms are shared between residents and the sleep in member of staff; the facilities are sufficient in number to satisfactorily meet the needs of everyone in the home. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 15 Residents at the home are responsible for their own laundry and a domestic washing machine and tumble dryer are available for their use. Staff continue to be responsible for the laundering of communal items such as tea-towels. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. Service users are cared for by an appropriately recruited and trained staff team. EVIDENCE: The home has satisfactorily addressed the outstanding requirement from the previous two Inspections relating to staff recruitment. The personnel files for the two most recently appointed members of staff were sampled during the Inspection; both files evidenced that a satisfactory recruitment process had been followed. The training record within the home continues to evidence that staff undertake comprehensive and relevant training in relation to the specific needs of the service users at this establishment. The member of staff that was spoken to advised that she was completing her induction training, overseen by the manager, and had also enrolled on her NVQ 3 in Health and Social Care. The manager advised that 50 of the staff team hold NVQ 3 or an equivalent qualification. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. The home has an efficient and competent manager and an effective quality assurance system is in place. EVIDENCE: The manager of the home is a qualified nurse and has also recently completed her NVQ 4 in management. She has substantial experience in working with people with eating disorders and provides clear leadership to the staff team. As evidenced during previous Inspections, staff and residents continue to make numerous positive comments regarding the manager’s personal skills and care practice. The home has a good quality assurance and monitoring system in place that is used to inform the development plan for the unit. Resident’s views are sought on a regular basis, alongside the views of families and professionals, and regular audits of records are also undertaken. The home have also conducted a retrospective audit of all residents discharged from Chesham House since it opened in 2002; this is to be commended. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 18 The proprietor undertakes irregular unannounced visits to the home which are mandatory under Regulation 26 of the Care Homes Regulations 2001; visits are not currently taking place at monthly intervals as required. The home has satisfactorily addressed the two previous requirements relating to fire drills and fire doors; the home has purchased two automatic closures for the fire doors that were previously propped open. The Health and Safety records maintained by the home evidence that all appropriate tests and drills are carried out at regular intervals and all equipment is serviced within required timescales. Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 4 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 4 2 X X 3 X Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 20 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 YA39 Regulation 26 Requirement The Registered Provider must ensure that monthly unannounced visits are made to the service and the subsequent report copied to CSCI. Timescale for action 01/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 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 © 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 Chesham House DS0000028593.V323935.R01.S.doc Version 5.2 Page 22 - 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. 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