Inspection on 22/11/05 for Chessington

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Chessington 13/04/07

Chessington 17/10/06

Chessington 19/07/05

Chessington 07/02/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Chessington Chessington 50 Marlpit Lane Seaton Devon EX12 2HN Lead Inspector Belinda Heginworth Unannounced Inspection 22nd November 2005 9:10 Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chessington Address Chessington 50 Marlpit Lane Seaton Devon EX12 2HN 01297 20383 01297 20383 voyagerltd@aol.com www.voyagersltd.co.uk Voyagers Ltd Mr Jonathan Mark Higgins 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) Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The care home may provide accommodation together with personal care for up to three service users with a Learning Disability, between the ages of 18 and 65 The Registered Manager must obtain NVQ level 4 in care and management including the Registered Manager`s Award by 2006. 19th July 2005 Date of last inspection Brief Description of the Service: Chessington care home is part of the company Voyagers LTD. Chessington is registered to provide three residents with support and personal care to people who have a learning disability. The home is situated in a pleasant quiet area of Seaton but is close to the local amenities. The house has three bedrooms, one of which is on the ground floor. There is one bathroom upstairs and a separate toilet down stairs. There is a pleasant lounge adjoined to a conservatory at the front of the house and a large kitchen / dining area to the rear of the property. There is ample parking in the driveway. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1hour and 50 minutes. One resident was consulted and their view of the home discussed. The providers were present throughout the inspection. The inspector looked around parts of the building and some records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Care planning and daily records must take into account residents’ goals, hopes and aspirations. Decisions made on behalf of residents must be discussed and agreed with community professionals. This is particularly important when some decisions infringe on resident’s rights and choices. The home’s policies / risk assessments should reflect any agreements reached. Medication storage and administration must improve to better protect residents’ welfare and safety. The complaint’s procedure should be in a format that can be easily understood by residents with communication difficulties. For example, using pictures or symbols. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 6 The providers and staff should attend training that could help meet the needs of residents. For example training in “challenging behaviour”, catheter care, total communication and so on. The provider should ensure there are very clear systems that monitor the quality of care delivered in the home, with information about what needs to be completed and when. This would ensure that all staff are aware. As part of the home’s quality monitoring the provider should seek the views of residents, relatives, staff and other parties to find out their views on how well the home is run. The home does not have a registered manager but an application has been received by the CSCI and is being processed. 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. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0 Not inspected on this occasion but met during the last inspection. EVIDENCE: Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Care plans and risk assessments provide staff with some information to meet residents’ needs. Improvements are needed to the information and to decisionmaking arrangements. EVIDENCE: The resident said that he felt the home met his needs and he felt safe living there. He was aware of a care plan but did not seem to fully understand its purpose. A care plan completed by a care manager was in place. This provided good information about the resident’s general needs and guidance on how to meet some of these needs. During the last inspection it was highlighted that the care plan did not set out the resident’s hopes and aspirations or be more specific to goals he hoped to achieve. Currently the care plan is mixed in with the assessments of risk. Although there is good information in this document a lot of the important information has been missed out. This means that any new staff working in the home might be unaware of the resident’s needs and what to do to meet them. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 10 The home keeps good daily records and completes a monthly summary of the resident’s progress in all areas. A copy of the monthly summary is send to the resident’s social worker. The home maintains a record of any incidents. During the last inspection it was highlighted that some of the consequences of incidents are managed through the staff restricting the resident’s freedom of movement and choice. The staff said they used this approach to teach the resident rather than punish. It was recommended that decisions made by the staff that could restrict the resident’s freedom of movement, liberty and choice must be agreed with other community professionals. This would protect residents’ rights and interests. The providers have consulted the resident’s social worker about some of these issues. However, some guidelines had not been agreed with the social worker and were restrictive. For example, the guidance in the care plan / risk assessment said that the resident “should be asleep by 11pm”. It was clear that the providers’ intentions are to ensure that the resident sleeps well, but the reasons for restrictions must be documented; and discussed and agreed with the resident’s representatives. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 & 16 Links with the community are good and staff support residents’ social and educational opportunities. EVIDENCE: The resident talked about using the local town and surrounding areas for shopping and walks. The providers also take the resident to places of interest. For example the residents enjoyed a recent trip to watch the trains, which is of particular interest to him. The provider has formed a daily activities chart, using symbols and pictures. The resident said it was useful in helping him understand what was to happen each day. The resident said that the providers and staff help to support him to maintain contact with family and friends. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Personal support and health needs are well met. Improvements are needed to the storage and recording of medicines. EVIDENCE: The resident said that staff are kind and caring. The care plan describes the resident’s likes, dislikes and support needed. Health needs are well met with good records kept. This ensures there is a good method of monitoring the health needs, therefore protecting the resident’s welfare. At the last inspection no medication was held on behalf of the resident. This has now changed. Medication is kept in a kitchen cupboard and is therefore not secure. The recording method of medicines given to the resident is unsuitable. For example, handwritten entries have no signature, the amount of medication received into the home, the dosage and how often it is to be given were not recorded. Staff have received no training on the Safe Administration of Medicines. A list of over the counter medicines has been agreed with the GP but there was no guidance on the dosage to be given and when the GP should be contacted if it is used repeatedly. One medicine being used was not included in the policy. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Residents’ benefit from the home’s complaint’s procedure and are protected from abuse. EVIDENCE: The resident said he would feel happy to raise any concerns or complaints to the providers or his social worker. He also had friends he felt comfortable talking to. The home has a complaint’s procedure. However it was not written in a format that met the communication needs of the resident. For example, using pictures or symbols. It was highlighted during the last inspection that the providers worked in the home with one other member of staff. Neither the providers nor the member of staff have received training on Adult Protection, meaning that residents are not fully protected by suitably trained staff. The staff member has now received Adult Protection training and the home has the local Alertor’s guide on what to do if abuse is suspected. The providers should also attend this training. During the last inspection the inspector was told that the resident’s relative received benefits on his behalf. The relative had set up a bank account in his name for the providers to access on behalf of the resident through using a cash card. Regular monies are paid in by the relative. This system was open to abuse and did not protect the residents’ interests. Discussion took place about finding suitable alternatives. The providers said they would look into this and discuss it with the relative. During this inspection the providers said that the relative has power of attorney and was unwilling to change the system. To ensure the residents’ interests are fully protected the providers are the only people with access to the account. Good financial records are kept and a copy of all receipts are sent to the relative. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Resident’s benefit from a clean and comfortable home. EVIDENCE: On the day of the inspection the home was very cold. The inspector was told they were on their way out and usually the heating would be on. The home is decorated and furnished to a good standard. The resident was happy with his bedroom and said he felt comfortable in the home. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Resident’s benefit from a competent and effective team. Some improvements are needed in staff training to help meet residents’ needs. EVIDENCE: Currently the home has one resident so the providers work as part of the team with one other staff member. The providers or staff member sleep in at night. Recruitment procedures ensure residents are fully protected. Some staff training has taken place. Discussions took place about completing training that helps ensure the resident’s needs are met safely. For example, training in “challenging behaviour” or “catheter care”. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Residents benefit from a well run and safe home with methods that monitor the care given. Some improvements are needed in this area. EVIDENCE: The home is part of a company therefore a person must be employed to manage the home. A requirement was given during the last inspection that said an application to register a manager must be received by the CSCI by the 30/09/05. This has been received and is in the process of being processed. The requirement has therefore been taken away at the moment. The home has varies systems that monitor the quality of services. For example, care plan reviews, health & safety checks, staff training and much more. However, there is no plan that sets out what should be done and when. This would ensure that all staff are aware of what needs to be completed and when. The home should also find a way to seek the views of residents, staff, relatives and other interested parties on how well the home is run. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 17 The providers have recently fitted radiator covers and water safety valves to hot water taps. This ensures that residents’ safety is well protected. Chessington DS0000061472.V264471.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chessington Score 3 3 1 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000061472.V264471.R01.S.doc Version 5.0 Page 19 No 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. 1 Standard YA20 Regulation 13 (2) Timescale for action The registered parson shall make 21/12/05 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. (See narrative under section 18 – 20) 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. Refer to Standard ya6 Good Practice Recommendations Care plans should include residents hopes and aspirations; and day-today goals. Daily records should reflect the care plan goals. (Repeated recommendation) Staff respect residents right to make decisions and that right is limited only through the assessment process, involving the resident, and as recorded in the individual service user plan. (This refers to any restrictions or sanctions in the home. Any decisions that restricts residents freedom of DS0000061472.V264471.R01.S.doc Version 5.0 Page 20 2. ya7 Chessington 3 4 5 YA22 YA35 YA39 movement, liberty or choice should be discussed and agreed with community professionals and the outcomes agreed, recorded and reviewed regularly) (Repeated recommendation) The complaint’s procedure should be in a format suitable to the communication needs of residents. The home should seek training for staff that helps to meet the needs of residents. There should be a quality assurance plan that provides clear guidance on what needs to be done and when. The home should seek the views of residents, staff, relatives and other professionals on how well the home is run. 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