Inspection on 19/08/08 for Chester Court

This inspection was carried out on 19th August 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chester Court 03/08/09

Chester Court 27/07/06

Chester Court 28/11/05

Chester Court 08/08/05

Chester Court 16/11/04

Chester Court 21/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chester Court Choppington Lane Bedlington Northumberland NE22 6LA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Suzanne McKean     Date: 0 3 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Chester Court Choppington Lane Bedlington Northumberland NE22 6LA 01670820111 01670822001 ally.jackson@barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Alyson Jackson Type of registration: Number of places registered: Barchester Healthcare Homes Ltd care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category Additional conditions: Should either of the named service users within the categories LD/LD(E) leave the home, the Commission for Social Care Inspection must be notified immediately. Date of last inspection Brief description of the care home Chester Court is a purpose built care home on one of the main roads in the town of Bedlington. It is situated within easy access of local amenities and services. It is of brick build and apex tiled roof construction of a modern and up to date design. It has an open aspect to the front utilising large windows and glass doors to offer light and air to the building. The home is designed in a cluster of bedrooms and lounge areas. The car parking is to the side and front of the building and landscaped gardens are provided to the front. There is level access to the building and to all areas of the home with the use of the two lifts. Some of the bedrooms have their own door from their Care Homes for Older People Page 4 of 28 Over 65 1 39 1 0 Brief description of the care home rooms directly into the garden area. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Before the visit: We looked at: Information we have received since the last key inspection on 27th July 2006. Information collected for the Annual Service Review on 25 October 2007. Care Homes for Older People Page 6 of 28 How the service dealt with any complaints & concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 19th August 2008 for a period of six hours and starting at nine in the morning. During the visit we: Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager what we found. The fees for the home range between 378 to 573 pounds depending upon the needs of the individual resident. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 28 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All residents admitted into the home have a comprehensive assessment undertaken, so that they can be confident that their needs can be met. Evidence: The care plans examined contained comprehensive pre-admission assessments, which the home calls the Total care assessment. Either the manager or the senior staff carried this out. The records contained the information they need to make the decision as to the ability of the home to meet the persons needs. This is then used following the admission to form the basis of the care planning process. The care plans also contained a care management assessment, which is given to the home on or before the admission of the resident, and from these documents an individual care plan is developed. Care Homes for Older People Page 11 of 28 Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The records are adequate but do not fully show how the health and social care needs are being met. The staff are friendly and respectful when assisting the residents. Evidence: Residents have individual care plans and those examined were of an adequate standard. Relevant risk assessments are completed for, prevention of falls, wound care, moving and assisting, and continence promotion. The care plans are reviewed and updated but some of these had not been carried out at frequent enough intervals. There is not enough evidence of the involvement of residents or their representatives. The new manager has started the introduction of the essence of care which is research based way of focusing on an particular areas of care. They are starting with continence care and have had the initial meetings and the staff are enthusiastic about its introduction. The care plans identified the use of NHS services and facilities. There is a good range Care Homes for Older People Page 13 of 28 Evidence: of pressure relieving mattresses for the prevention of pressure sores. Information was received which shows that there have been periods in the recent past when the staff team did not have the clinical skills to meet the needs of specific complex residents. This has resulted in the need to bring in nursing staff from the community nursing team to assist them in giving the care. It suggests that the staff needed to be given additional training and their competencies ensured. The areas of practice includes the use of syringe drivers to deliver medication to residents who cannot take it orally or otherwise. Records of the nursing action taken for wound care were good with evaluations being dated and signed. Staff seek expert advice for wound management for the individual residents, this suggests their willingness to ensure that they are using best practice in their wound care. The systems for managing medicines in the home were found to be appropriate, the staff record the medicines being ordered. The prescriptions are then checked on receipt from the General Practitioners and are then sent to the Chemist for dispensing. The medicines are then checked against the records when received into the home so that any errors can be picked up. No residents are currently managing their own medication in the home. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents supported to spend their leisure time actively and are well supported to maintain contact with their families and the local community. They receive a nutritious and appetising diet, which is balanced and presented well. Evidence: The home does not have an activities co-ordinator, although steps have been taken to recruit one onto the staff team. The staff are still trying to offer social opportunities to the residents and there is a good resource available of games and activities available. The residents confirmed when spoken to that they are able to make choices about how they spend their day and said they were satisfied with the activities available. Some organised activities are available and staff said that residents are able to choose whether or not they are involved. Staff confirmed this. this should be developed further once the activities co-ordinator is in post. Residents felt that they are encouraged to take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. Care Homes for Older People Page 15 of 28 Evidence: The residents bedrooms were personalised reflecting individual choices and preferences and three residents asked about their bedrooms said they were happy with the decoration. Residents have visitors at any reasonable time and are able to use their own rooms, the small lounges or the larger, busier lounges to receive them. Relatives spoken to on the day and through returned questionnaires from the annual service review confirmed that they are welcomed to the home. Relatives are given information within the residents guide about visiting arrangements. Residents said they were satisfied with the arrangements for visitors and that staff welcome them. The residents were particularly complementary about the food they are offered and the way it is presented. The dining rooms were very well presented and a pleasant place to eat their meals. The menus offer nutritional balance and there are choices for the main meals and breakfast. The food being served was well received by the residents on the visits and they were offered second helpings which some took advantage of. Examples of the comments made were, the food is lovely and they will always find me something else if I don’t fancy the choices. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good policies and procedures in place, which are being followed, these make sure that complaints are dealt with efficiently and that residents are safeguarded from abuse. Evidence: The complaints procedure is available in the service users guide and a copy is available at the front entrance and is displayed in the home. The records of the complaints were examined. There is information to suggest that there have been some issues raised in the past, which were not always recorded as complaints and therefore were not always dealt with formally. This has improved and the new manager records all expressions of concern so she can use the information in the companies quality assurance system. Residents spoken to during the visit knew how to make a complaint, and could describe how this would be dealt with. Relatives who were visiting the home were aware of the complaints procedure but had not needed to use it. Staff are given protection of vulnerable adults training both as part of the Chester Court in-house training package and from Northumberland Care Trust. The Qualified nurses also have more extensive training in this area as they are responsible for being the person in charge of the home when the Manager is not present. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well organised and staff are knowledgeable about how to reduce the risk of cross infection. Improvements are planned to the decoration to bring it back to the high standards usually seen. Evidence: A tour of the home was conducted both with staff and alone; the home is clean and was odour free on the day. The residents who were asked about their bedrooms said they were happy with the decoration and that they were kept clean by the staff. The bathroom and toilet areas were tidy and clean. The laundry was clean, organised and well equipped. The sluices were tidy, clean and odour free and the disinfectors operational. Staff were observed to follow infection control policies throughout the day and appropriate equipment was available. Bathroom areas were generally tidy and they were clean. The kitchen area was clean and there is a detailed cleaning schedule and associated completed records in place to make sure that adequate cleaning had taken place. This identifies all tasks, how often they are completed and who was responsible for undertaking it. Care Homes for Older People Page 19 of 28 Evidence: The light and emergency call cords were all clean and all emergency cords reached skirting level. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient numbers of adequately trained, and recruited staff to make sure that they can provide the care needed. Additional training is necessary to make sure that the staff are applying best practice. Evidence: Staff records examined were completed in line with the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. On the day of the inspection there were sufficient staff on duty according to the needs of the residents in the home. The training records put together the new Manager to allow her to plan for training was examined, it was very clearly maintained and offered a good system. There is evidence of a significant amount of training in both statutory and clinical areas of practice recently. All staff have now either received their training or been scheduled to have it in line with the company policy. However the training in moving and handling and fire training has slipped in the past and are not all are fully up to date. Additional clinical training is required to make sure that all staff follow best practice Care Homes for Older People Page 21 of 28 Evidence: guidance when providing care and they are skilled in the use of any equipment being used for example the use of syringe drivers for the administration of medicines. The manager has started the programme of working with the staff to develop personal development plans to identify individual competencies and produce a training plan for them. This is being carried out along with supervision meetings to support them in developing their practice to ensure they are working in line with best practice. The manager and the Clinical Development Nurse for the company have undertaken additional training in the use of the new syringe drivers they are to extend the training to all of the nurses in the home. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The improved management systems are now working effectively to protect service users and staff and to meet their needs. The home has effective health and safety systems and residents personal finances are managed appropriately. Evidence: The home was has had a recent change of manager. There is now a new manager in place working in the home on a temporary basis who was able to be present during the inspection visit. She is very clear about the improvements she plans to make, and has already achieved a number of these. The company must nominate a manager to be considered by the Commission for Social Care Inspection to become the registered manager. Care Homes for Older People Page 23 of 28 Evidence: The company has the procedures in place to support the manager to take the necessary action to ensure the health and safety of the service users. This is supported by the policies and procedures and by discussion with the Manager and the staff. During the visit the residents and relatives visiting were chatting in a very positive way with the staff. The manager is attempting to make herself available for visitors and residents as much as possible. Formal supervision for care staff has started and a programme is in place to make sure it remains up to date. There is a system in place to review health and safety in the home involving the staff for which records are available. Records were examined of the staff meetings which take place regularly and the contents of these suggest that there a broad spectrum of relevant issues discussed. Those staff unable to attend are given access to the notes from the meetings by them being posted in the staff room to ensure they are up to date with the information they need. The Manager also facilitates meetings with the relatives and residents as appropriate. The management continues to consult the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The care plan must show 01/01/2009 how the service users needs in respect of their health and welfare are to be met. The care plans must give staff enough information so that they can give the care safely and in line with best practice. 2 8 12 The home must make ensure that the residents are given their care in line with best practice. All staff in the home must have the skills and competencies to deliver the care to the residents. 01/01/2009 3 30 18 The home must make sure 01/01/2009 that there is a staff training programme which fulfills the aims of the home and the needs of the residents. Care Homes for Older People Page 26 of 28 The staff must have the skills to meet the complex and changing needs of the residents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 It is recommended that the social activities programme is developed further to give more individualsed opportunities to residents in a person centered way. It is recommended that the plans in place to improve the decoration to bring it up to the usual high standards are implemented. It is recommended that a permanent manager is recruited and that they apply to CSCI to be considered for registration. 2 19 3 31 Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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