Inspection on 30/05/07 for Chesham House

This inspection was carried out on 30th May 2007.

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 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

Chesham House 12/12/06

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 Marilyn Fellingham Unannounced Inspection 30th May 2007 09:10 Chesham House DS0000028593.V341870.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.V341870.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.V341870.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.V341870.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 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 offers a service exclusively for people recovering from an eating disorder. It is linked to a specialist clinic Baskerville House - a private healthcare facility located next door 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.V341870.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. This service enjoys an excellent record of care and the Commission, therefore only looked at the key standards. During the inspection all six residents were chatted with and two staff members. Discussion with the Manager also took place and care and staff records were examined. A tour of the premises also took place. This home remains an excellent environment for caring for those persons requiring specialised intervention in care related to their eating disorders. What the service does well: What has improved since the last inspection? What they could do better: It is difficult to assess what this home could do better although the home is always putting in place systems where they think they could improve. Chesham House DS0000028593.V341870.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.V341870.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.V341870.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual needs and aspirations are fully assessed and all residents are therefore appropriately placed. EVIDENCE: New admission paperwork has been put in place since the last inspection; this allows for an even better approach to the admission process and gives very clear guidelines to the assessment of needs for each individual. Three admission records were examined by the Inspector, these were very informative and gave useful information regarding all areas of the prospective clients life so that the home has full knowledge of the residents and can fully prepare therapeutic plans of care. Chesham House DS0000028593.V341870.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care plans reflected the individual needs and choices and there was evidence of continual review and service user involvement. EVIDENCE: Three care plans were examined and they were all found to contain individual therapeutic plans for care and also the resident’s involvement in the plan. The plans also contained evidence of frequent reviews and this was also confirmed by those residents spoken to; they stated that from the moment they were admitted to Chesham House they were completely involved in the care planning and were always supported to take responsible risks in relation to their move to being more independent. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 10 The care notes also contained risk assessments in relation to behaviour that might jeopardise their care, these risk assessments evidenced regular review. The residents were full of praise for the staff saying that they felt very secure and that they were well supported to take risks in order to move forward and that they really felt that since they had been at the home they had certainly moved forward. This was also expressed by a resident who had only been at the home for a short period of time. Another resident said that the staff were always working alongside them and always on the end of the phone if they go out and feel suddenly that they need support. One resident commented that what they liked was that the home addressed their individual needs and that Chesham House was the missing link that they really needed. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to participate in a variety social and leisure activities and also integrate within the local community. EVIDENCE: Discussion with the residents, staff members and examination of care records confirmed that the residents were given many opportunities to socialise inside and outside the home, maintain links with their families and other important persons in their lives. For some, part of their care is to go out to lunch or join organised exercise groups or travel on local transport. This clearly promotes the resident’s confidence and forms part of their supported therapeutic care. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 12 On the day of inspection some residents were going out to visit their families another went to the local garden centre whilst another was being supported to go out to lunch. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An holistic approach to care is given from a most dedicated staff team. EVIDENCE: Discussion with the service users confirmed that the staff were most supportive and always available to support them in their move to a more independent lifestyle. The staff are very conversant with the specialised needs of the residents and ably assist them in the way that they wish and prefer. Many positive comments were made to the Inspector, some have already been mentioned in other parts of this report: one resident commented that they loved being at the home and had so much support, another said that they received excellent care and that the staff were very approachable and always listened. Additional support is also provided by other professional agencies, such as, massage, family therapy and psychiatric intervention. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 14 Due to the nature of the client group and in part their needs in relation to eating disorders, the physical health of the residents is closely monitored. All the residents in the home self medicate and their medication is kept in locked cabinets in their rooms; they are also responsible for obtaining their own medication. Risk assessments are in place for this activity and reviewed on a regular basis. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are listened to. Staff have the knowledge to deal with matters of abuse. EVIDENCE: Neither the Commission nor the home have received any complaints since it opened. There is a complaints procedure in place that all the residents are aware of. The staff and residents continue to meet on a regular basis and as already mentioned the staff and the manager are always available to the residents on a daily basis. The Inspector witnessed the residents accessing all members of the staff team during the inspection. The residents spoken to felt that if they had any issues they were always resolved very quickly because the staff are so committed to ensuring that the residents move forward. The staff are aware of all issues relating to the protection of vulnerable adults and have received training in this area. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Chesham House offers excellent and well-maintained accommodation for the residents. EVIDENCE: A tour of the premises took place in which many of the rooms were seen except those that were occupied. All the residents have single rooms that are very pleasantly decorated and well maintained. The rooms had evidence that they had been personalised by the occupant. Chesham House is decorated to a very high standard throughout and is very homely and extremely comfortable. The kitchen is very large with and well equipped, is used continually throughout the day by all the staff and residents and a lot of communication takes place in this environment. The residents are responsible for their own laundry arrangements and there are sufficient facilities to allow them to do this. The garden is most pleasant with seating arrangements and shady areas. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a detailed training programme in place; this ensures that this specialised client group receive the care that meet their assessed needs. EVIDENCE: Recruitment records were examined of the one new staff member and were found to be robust. A training programme is in place, this includes a new induction programme relating to the Common Induction Standards. The records for training evidenced updating in many areas and courses that have been undertaken by the staff, many of the courses are relevant to the client group. One staff member commented that there were many opportunities to do plenty of training. NVQ training is on going. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents and staff benefit from an extremely well managed home. EVIDENCE: The Manager continues to give clear leadership to the staff and ensures that the resident’s health, safety and welfare is promoted at all levels. One member of staff commented that the Manager always looks after them and that they have regular meetings where they plan the way forward for the residents; all the staff have an input and they really feel that they are listened to. This was reflected in the staff surveys that have recently been carried out. The service users and staff certainly benefit from the ethos and leadership of the manager who ensures that the home meets the National Minimum Standards and introduces systems for continual improvements. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 19 The staff and residents feel that they are very well managed. A number of new policies have been introduced including one for a major incident. Case notes have been audited and carers meetings. The management needs to be commended for its continual review of its practices and the action taken in relation to this. The health safety and welfare of the service users is addressed and records were seen for the maintenance of all equipment. Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 20 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 4 3 x 4 x 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 4 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 4 33 4 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 4 15 4 16 4 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 4 4 x x 4 4 Chesham House DS0000028593.V341870.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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.V341870.R01.S.doc Version 5.2 Page 22 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. 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