Inspection on 26/09/06 for Chesswood Lodge

This inspection was carried out on 26th September 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

Chesswood Lodge 06/11/08

Chesswood Lodge 16/04/08

Chesswood Lodge 02/11/05

Chesswood Lodge 10/05/05

Chesswood Lodge 02/09/04

Chesswood Lodge 28/05/04

Chesswood Lodge 05/06/03

Similar services:

1 Marten Road

Daubeney House

Three Gables

Deepdene Care Centre

Aldwick House

49 Glendale

Ferndale Residential Care Home

David Gresham House

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

CARE HOMES FOR OLDER PEOPLE Chesswood Lodge 49 Chesswood Road Worthing West Sussex BN11 2AA Lead Inspector Mrs G Davis Key Unannounced Inspection 26th September 2006 14:00 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 Chesswood Lodge DS0000014445.V293345.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. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chesswood Lodge Address 49 Chesswood Road Worthing West Sussex BN11 2AA 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) 01903 230886 Chesswood Lodge Limited Mrs Lorraine Cummins Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (14) Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person in the category Mental Disorder (MD) over the age of 50 years. 2nd November 2005 Date of last inspection Brief Description of the Service: Chesswood Lodge is registered with the Commission for Social Care Inspection to provide care for up to fourteen persons in the registration categories Mental disorder and Dementia over 65 years of age and includes one named person in the category of Mental Disorder over the age of 50 years. The property is situated in Worthing in a residential area close to a wellestablished park, local transport, railway and shops. The sea front, main shopping centre with all its amenities is approximately ½ mile away. The home is a large mature house with plenty of parking to the front and a secluded grassed garden to the rear. The accommodation comprises of 10 single bedrooms - 4 with en-suite facilities and 2 double bedrooms. There is a lift to the first floor but the home is not suitable to accommodate anyone in a wheelchair due to dimensions of the corridors. Chesswood Lodge Limited privately owns the service. Mrs Shoai, a director of the company is the registered responsible individual. Mrs L Cummins has been appointed as the registered manager of Chesswood Lodge. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out the unannounced visit; commencing at 14:00hrs for a period of 4 hours. During the visit the inspector spent time speaking to service users and staff members, examined documents and records and observed interactions between staff members and residents. Feedback from residents was positive “I think it’s very nice here”. A tour of the building was carried out, which covered the communal areas and service users bedrooms and it was considered that despite the inevitable signs of wear and tear the establishment was reasonably comfortable, appropriately furnished and was well maintained. There was a high standard of cleanliness throughout the home and no odours were detected. The pre-admission assessments for three service users were seen and three care plans were tracked. The inspector saw menus and food records and toured the kitchen which was clean and in good order. Due to the time of day the inspector was unable to sit down to a meal with the residents, however they confirmed that they enjoyed the meals provided for them. Records for the management of the service were also seen including, staff recruitment, health and safety, maintenance and fire records. One requirement has been made as a result of this inspection. What the service does well: The residents were able to converse with the inspector and confirmed that they considered that they were well looked after “I love it here”. Observed interaction between staff members and residents confirmed that the support staff were kind and respectful and identified that there was a good understanding of the needs of the residents and of their conditions. The carers Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 6 were observed to be discreet and supportive to residents when carrying out sensitive and intimate tasks Care plans and risk assessments were informative and regularly reviewed. An Occupational Therapist had been employed to provide stimulation for the residents and their enjoyment of the activity provided on the day of the inspection was evident. Attention was paid to find activities that are tailored to the individual and there was evidence that a variety of group activities were also arranged. Attention has been paid to providing the care staff team with training in areas specific to the mental health needs of the residents to enable them to understand how to manage some of the behaviours presented. What has improved since the last inspection? What they could do better: The care home continues to provide a stable and homely life style for the residents. Although the care staff receives guidance from the registered manager this has not been offered in a formal and structured way. The registered person should ensure that all care staff members have regular supervision every two months as detailed in the National Minimum Standards. The metal bedsteads in a number of rooms look very institutional and the look of the home would benefit from them being changed to domestic divan beds. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 7 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. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 8 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 Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 9 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): 2.3.6. Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. Intermediate Care is not provided at the home EVIDENCE: A senior member of staff (Manager or Deputy Manager) will carry out a preadmission assessment on prospective residents. The Care plans of three residents were selected at random and scrutinised. Appropriate information had been obtained and recorded prior to admission and an objective overview as to whether their needs could be met by the home had been made. The potential residents were encouraged to visit to ascertain the suitability of the home but most were unable to do so due to their condition and a representative – either family member or social worker – would do so on their behalf. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 10 Each resident had been given a contract and a copy was found on the person’s personal file. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 11 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. Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Three care plans were selected at random and were examined as part of the case tracking of 3 residents. The pre-admission assessments were generally detailed in identifying the individual needs of the residents. The care plans provided the actions needed by the staff to meet all the resident’s needs as identified by their assessments and were reviewed on a monthly basis. Individual risk assessments had been undertaken, were detailed enough and included in the body of the care plan to allow staff members to access them and use them to inform their practice. A less detailed version of the residents’ plan was found in each individual’s room for the care staffs’ reference to ensure that each person received the personal care that they required. Observation of staff carrying out their duties identified that it was clear that the residents’ needs are understood and are met. One person was observed communicating wordlessly with the staff members assisting her and it was Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 12 obvious that the staff members were very aware of her communication signals and able provide her with what she required. Arrangements are made for the residents to attend any specialist clinics or health services required, and are registered with a local GP. Most of the residents are ambulant – specialist equipment would be supplied as and when needed. The medication administration records were examined and were generally well completed, and no gaps were noted in the recording of medicines. Handwritten entries on the MAR charts were signed and dated. All staff members responsible for administering medication had received training. All residents had a degree of mental incapacity and no one had been assessed as to being able to look after his or her own medicines. Information from previous inspections and observation of the interaction between the staff members and the residents showed that the residents’ privacy and dignity is respected at all times by the staff. Personal care is provided in the privacy of the resident’s bedroom or a bathroom. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 13 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. Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans were noted to contain information regarding the past interests of the residents. An Occupational Therapist has been engaged to act as Activities Co-ordinator who works with each individual and the residents as a group. She also organizes other activities such as individual outings to shop, glass painting and board games. Music for Health and Musical afternoons are also very popular. Residents were able to confirm that they had the opportunity to join in with various activities on a daily basis and on the day of inspection they were enjoying a game of Bingo that had been organised by the Activities Coordinator. Activities undertaken with each individual had been recorded in the care plans. Resident meetings are not well attended possibly due to the degree of incapacity suffered by the residents. Each person is consulted individually on issues such as preferred activities, menu choices and purchases for the home. The home has an open visiting policy and visitors are welcome to sit in the communal areas or in the resident’s own bedrooms if preferred. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 14 The kitchen was visited during the course of the inspection and was found to be clean, well ordered and appropriately equipped. The inspector was not able to eat with the residents due to the time of the inspection (afternoon). The meals are provided by the company’s main kitchen and delivered to the home on a daily basis. Examination of the menus showed a varied and interesting range of well-balanced meals providing a wide choice. All residents spoken to say that they really enjoyed the meals they were given. All required records regarding fridge temperatures etc were available and recorded on a daily basis in a logbook. On observation the staff members were seen to be discreet with any help that was required and appropriately deferential to any wishes that the residents expressed. Residents confirmed that they considered they were well looked after “I love it here”. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 15 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. Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: On checking the complaints log it was noted that there had been no complaints recorded since the last inspection in November 2005. One complaint concerning Company Procedure and involving another home had been fully investigated and successfully resolved. The home has a complaints procedure in place that states that complaints will be responded to within a maximum of 28 days. It was seen that the registered person had responded to any previous complaint made appropriately and actions recorded. Due to their frailty some residents were unable to complain and it was confirmed that information regarding how to complain was given to the representative of the resident on admission. Other confirmed that they knew how to complain and who to. All staff members have attended training on the Protection of Vulnerable Adults. Discussion with staff members identified that all were aware of what to do if they suspected that abuse had taken place. Staff recruitment records were seen to contain all security information required. Chesswood Lodge DS0000014445.V293345.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. Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A tour of the premises was made and was considered generally well maintained with a homely atmosphere. Each person had personalised their room with their own things. A significant number of the beds provided to the residents were metal-framed hospital beds that created an institutional feel to a number of bedrooms. Residents confirmed that they were comfortable to sleep in. Room 10 had been provided with new furniture and curtains and new curtains have been provided for room 4. The standard of décor was satisfactory although shabby in some parts of the home. Bedrooms were being decorated as and when they became vacant. A new floor covering and blinds had been provided for the two bathrooms and ground floor wc. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 17 There were a number of areas for residents to sit in The home was clean and fresh in all areas. Monthly room inspections are undertaken and the company’s maintenance man deals with any hazards or repairs required immediately. There was a small and secluded garden for residents to walk in or sit out in fine weather. A new gazebo had been purchased for the residents to use in the garden. Chesswood Lodge DS0000014445.V293345.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. Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There was a written rota that showed which staff members were on duty at any time of the day or night and that accurately identified those on duty at the time of inspection. On the day of inspection there were three carers on duty in the morning including the Manager and Deputy Manager. Later in the afternoon the carers were reduced to two. Scrutiny of the rotas showed that the number of staff employed was adequate at all times providing that the dependency levels of residents remain the same. An examination of staff files and conversation with the care staff team on duty revealed that there was a good skill mix and level of knowledge of the resident group within that team. It was seen that the registered person operates a thorough and robust recruitment procedure. The files of the staff members that had been recruited since the last key inspection were examined and seen to contain all information required by the National Minimum Standards. New staff members were only confirmed in post following the completion of a satisfactory Police and POVA Check. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 19 Training files were examined for three members of staff and it was seen that a number of in-house training sessions on relevant service related subjects had been undertaken including Moving and Handling, Fire Safety, and POVA. There appeared to be a commitment from the staff team to continue training and learning which was supported by the manager. A satisfactory number of staff (85 ) had NVQ level II and above. The Registered Manager and her Deputy informed that they worked in a collaborative fashion, which offered good support to both. They confirmed that they received help and support from their line Manager and other Care Home Managers working for the company. Currently they offered informal supervision and were waiting to attend a training course on the management of supervision prior to setting up a more formal supervision system. Following discussion with the inspector it was intended to set up formal supervision as soon as possible. Training provided to the staff group in the last year included: Understanding Change and Loss; Adult Protection; Person Centred Approach to the Care of Older People plus all mandatory training such as First Aid and Fire Safety Training. Chesswood Lodge DS0000014445.V293345.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): 31.33.35.36.38. Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. Despite the fact that formal supervision was not carried out it was evidenced through discussion with staff members that appropriate informal supervision was given. All other areas of the management task were satisfactory. EVIDENCE: Since the last inspection a new manager has been registered and was available on the day of inspection. Mrs Cummins has the Registered Manager’s Award and is currently undertaking the NVQ Assessors’ course. Prior to her appointment Mrs Cummins had experience working in a residential care home for people with dementia. Through discussion with the manager it became apparent that the needs of the residents are paramount and that all actions undertaken are intended for their benefit. Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 21 The Deputy Manager Mrs Gillespie spoke very highly of the manager and stated that she was very supportive. The registered provider carries out a regulation 26 visit and report on a monthly basis and these indicate monitoring of the service. The inspector was informed that any complaint feedback would be used constructively to improve the performance of the home. There are quality assurance procedures carried out by the registered provider, which will be used to inform the business plan and the results will be published when completed. Verbal comments from residents indicated a high level of satisfaction with the service provided. “I like this place so much more than the one I was in before, it’s really nice”. The policy of the home is not to manage the financial affairs or handle large sums of money for the residents and the administrator at Head Office manages all financial transactions. Any expenditure on the residents’ behalf is billed to their representative to manage for them. Formal supervision is not in place currently. Staff members confirmed that they found their manager fair and supportive. All systems and equipment had been serviced and maintained at the appropriate intervals. There is a health and safety policy and procedure in place and risk assessments have been undertaken. All accidents, injuries and incidents were recorded and reported to the appropriate authorities as required. Chesswood Lodge DS0000014445.V293345.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Chesswood Lodge DS0000014445.V293345.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 OP36 Regulation 18.2 Requirement The registered person should ensure that the care staff are appropriately supervised Timescale for action 01/01/07 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 Chesswood Lodge DS0000014445.V293345.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton Hampshire SO15 1GW 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 Chesswood Lodge DS0000014445.V293345.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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