Inspection on 17/10/05 for Chestfield House Nursing Home

This inspection was carried out on 17th October 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Chestfield House Nursing Home 04/12/08

Chestfield House Nursing Home 10/05/07

Chestfield House Nursing Home 05/09/06

Chestfield House Nursing Home 09/01/06

Chestfield House Nursing Home 20/09/04

Chestfield House Nursing Home 20/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Chestfield House Nursing Home The Ridgeway Chestfield Whitstable Kent CT5 3JT Lead Inspector Tina Thomas Announced 17 & 18 October 2005 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 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. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chestfield House Nursing Home Address The Ridgeway, Chestfield, Whitstable, Kent, CT5 3JT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 792281 01227 793046 Unique Help Group Limited Registered Care Home with Nursing 31 Category(ies) of Care Home for Older People registration, with number of places Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) Of the 31 nursing beds 3 are registered for the admission of residential clients 2) PD (Physical Disability) is limited to one (1) person whose date of birth is 19.06.1942 3) DE(E) is limited to one (1) person whose date of birth is 17.10.1913 Date of last inspection 20/09/04 Brief Description of the Service: Chestfield House is a converted property, originally built as a farmhouse in 1751. The House has been extensively renovated and provides accommodation for 31 service users. Accommodation is situated on two floors and comprises of 23 single and four shared bedrooms, 14 of which have en-suite facilities. The Home has a three-person shaft lift, which accesses all rooms on the first floor. Each bedroom has a TV and telephone point and a call-bell system. Some service users have, at their own cost, chosen to have their own direct telephone lines installed. The Day space consists of a main lounge and Dining room on the ground floor and a small “Quiet lounge“ on the first floor. The Home is located near the town of Whitstable and can be easily reached via the Thanet Way. Public transport is available a short distance away from the Home. The Home has car-parking facilities for several vehicles. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of Chestfield House since the purchase of the Unique Help Group, by the Nicholas -James Homes Ltd. The new registered individual is Mr K Rajakanthan. Since the last inspection the registered manager has left her post. The home was without a manager for almost six months. A new manager, Liz Walton has been recruited. Mrs Walton has applied to the Commission to become the registered manager of Chestfield House and this application is currently being processed. The inspector observed that staff have coped well during the time of having no manager, and with the uncertainty that comes with change of ownership. The inspector was pleased to see that the home was clean, staff morale was high and people in the home and their visitors were pleased with the level of service. The inspector acknowledges the work of the deputy manager Liz Springett and the rest of the staff team in ensuring that recent changes did not adversely affect people that live in the home. Liz Walton and the Groups area Manager Mrs Eileen Laherty assisted the inspector during the inspection. The Inspection took place over a two-day period. The Inspector viewed documentation including Service users care plans, staff files, policies and procedures and service user and visitor comment cards. The inspector spoke with management, staff and service users. What the service does well: What has improved since the last inspection? The home is considerably cleaner, particularly the bathrooms than at the last inspection. Doors within the home have been fitted with automatic door closure, so as to increase the safety of the people that live there in the event of a fire. Night staff have increased in number to three. Staff told the inspector that communication between management and staff had improved, together with staff morale. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 6 What they could do better: 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. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 8 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 standard(s) 1,2,3,4,5 People choosing to move to the home have the information they need to make an informed choice. Each person living in the home has a contract. The needs of people who live in the home are carefully assessed prior to them going to live at the home, to ensure that the person moving there and their representatives know that their needs can be met. People who may like to move and their representatives can view the home to assess the suitability. EVIDENCE: The home has an updated Statement of Purpose and Service Users Guide. The Statement of Purpose and Service User guide reflects current changes at the home and fully describes what a person considering moving into the home, or their representatives may expect. The Service User Guide and Statement of Purpose are available in large print. Each person living in the home has a statement of terms and conditions, which is kept in their file. It is signed by the home and the person who has chosen to live there or if they are unable, a representative. All contracts are currently being reviewed. People only move into the home after having a comprehensive, holistic assessment, conducted by the Manager or Area Manager. The assessment Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 9 addresses physical, psychological, social and religious needs. The home does not admit people to the home without first conducting an assessment. People choosing to live at the home are encouraged to spend a day at the home, to see their room, meet other people living at the home and to have a meal. The home does not offer intermediate care as described in Standard 6. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 10 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 standard(s) 7,10,11 Care plans describe people’s health, personal and social care needs. People who live at the home are treated with dignity and their privacy is respected. Staff deal with the death of a service user with respect and sensitivity. EVIDENCE: The inspector viewed a selection of the care plans of people living in the home. The new manager has already identified that there are some deficits in the care plans and has sought some further training for staff from a nurse advisor. The inspector viewed one care plan that did not refer to two areas of a service users physical health. The same care plan did not refer to the serious side effects of one medication. Requirement made regarding this matter. Requirement 1 Part A. The service user had not signed the care plan, which would be good evidence to show that the service users had been involved in the planning of their care. A good practice recommendation has been made regarding this matter. (Recommendation 1 Part A) The inspector viewed daily records belonging to another person in the home. They were written in an inappropriate manner. They reflected the opinion of the author rather than factual information. The area manager and the manager had also noted this prior to inspection and were addressing this issue. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 11 The inspector spoke with people that live in the home. They expressed that carers were all very polite to them, and respected their privacy and dignity. They said that staff always knocked on the door before entering their room. There are two double rooms in the house but they are both currently being used as singles. Service users are given their mail unopened. One visitor has complained that staff opened their relative’s letter. This was an error and has been investigated by the manager. Each room has a lockable drawer where people can put their private things if they chose. There is a communal pay phone in the home that people can use or if they prefer they can have their own phone lines installed. The inspector discussed with the Manager the last death that was experienced in the home. The Manager explained that it was an expected death. When there is no family present, staff will sit with people in the last stages of their lives. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12,13,14,15 Service Users cultural, social, and religious needs are considered and met. Service Users maintain contact with people they chose to. Meals are wholesome and appealing. EVIDENCE: At the time of inspection the home had an activities coordinator. The inspector is aware however, that she was leaving employment later in the week. The inspector was pleased to hear from staff that they felt that they were now staffed appropriately and had time to spend to have a chat or interact properly with the people that they care for. The activities co-ordinator works with people on a 1-1 basis or within groups. Each person has a chart, which identifies the activities they have participated in. Group sessions include gentle movement to music. The home also has a man who comes to the home to work on pottery with the people that live there. The home was going to celebrate the forthcoming Halloween with fancy dress and a special Halloween tea. The Inspector observed from the visitor’s book that people in the Home have visitors at a selection of times. The home operates open visiting. Visitors can if they wish stay for a meal. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 13 People in the home are encouraged to make their own choices. They can make choices such as: when they get up and when they go to bed. The inspector read in one persons notes ‘wanted to stay in bed for breakfast today.’ There are meetings for the people that live in the home, so that they can influence the way in which they live. Meetings are recorded and actioned. People that live in the home have their preferences regarding the way they live recorded in their care plan. People can bring their own possessions into the home, and some furnishings subject to health and safety requirements. The inspector observed items of peoples own furniture and belongings. The inspector viewed the homes menu rota and found it to be appealing. The inspector viewed the homes kitchen and found that it was well organised. Meals consist of breakfast, lunch, tea and supper. The kitchen staff ask people in morning of each day, what they would like for their meals. The home has some special diets to cater for which include low sodium, high potassium diet, diabetic diet, reducing and some soft diets. The home has sought dietary advice from the speech and language therapist for people who have difficulty in swallowing. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16,17,18 The home has the policies and procedures to deal with complaints. This has not always been adhered to. Service users legal rights are protected. Service users are protected from abuse. EVIDENCE: The inspector viewed the homes complaints procedure and complaints book. Complaints are thoroughly investigated; the investigation and actions are recorded. The inspector discussed one complaint with the manager, which occurred prior to her appointment as manager. Although, it was investigated and found to be unfounded, it should have been referred to the adult protection team. The manager acknowledged that this should have happened, and understood the reasoning behind this. All service users have postal votes so as to enable them to remain politically active. All staff complete prevention of adult abuse training. One member of the management team is a trained trainer. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19,20,21,22,23,24,25,26 Service Users live in a safe and well-maintained environment. People have access to safe indoor and outdoor communal facilities. Washing ad toilet facilities are suitable. Specialist equipment to promote independence is in place where necessary. Individual rooms meet people’s needs. The Home is clean pleasant and hygienic. EVIDENCE: The lay out and location of the home is suitable for its stated purpose. The Home is accessible and well maintained; the grounds are accessible to wheelchair users and are kept tidy, attractive and safe. The building complies with the requirements of the local fire service and environmental health department. The home has had new door closures fitted on all doors. The home has a number of communal areas, including two sitting rooms, one upstairs, and a dinning room that are all domestic in nature. Furnishings are Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 16 becoming aged in the sitting rooms. The area manager informed the inspector that all homes within the group would be being refurbished. The inspector observed that all radiators have covered so as to limit the risk of scalds and burns. Emergency lighting is proved throughout the home. Water was randomly tested by the inspector from bath taps and sink taps. The water was of an appropriate temperature. The home has a number of bathrooms and toilets that are in suitable order. They have aids and adaptations such as toilet raisers to assist the people in the home to remain independent. Bathroom and toilets were clean and uncluttered. The inspector noted that bathrooms were cleaner than they had been in the past. Scale had been successfully removed from sinks and baths by the cleaning staff. All bathrooms have suitable locks. All toilets were equipped with liquid soap and paper towels inline with infection control procedures. The home has suitable equipment including mobile hoists to maximise Service Users independence. The home has a shaft lifts that enable people to access all parts of the communal space. All room sizes meet with the requirements of the Standards for pre existing care homes. The Inspector viewed a number of people’s own rooms and found them to be clean and personalised. Some people had bought items of their own furniture to the home and have items such as pressure relieving mattresses to meet their needs. The home throughout was clean and free from offensive odours. Procedure in the laundry has been altered so as to promote best practice and infection control. Hand washing facilities are in all areas where clinical waste or infected material may be handled. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 The home is adequately staffed. The home has a suitable recruitment procedure. EVIDENCE: The inspector spoke with staff that felt that there were now enough staff on duty daily to allow them to have sufficient time to meet peoples care needs and to interact with them more fully. They expressed how this made their role more fulfilling. The inspector also spoke with people who live in the home who expressed that there was adequate staff. Feed back on comment cards from people who live in the home and visitor comment cards did not reflect any concerns regarding shortness of staff. The Manager said that staff levels are determined through a staffing level tool. Also by monitoring the needs of the people living at the home. Staff are: the manager, 7 trained nurses, 1 adaptation nurse, 14 carers and ancillary staff. There is always three staff on duty of a night. The home has a robust recruitment procedure based on equal opportunities and ensuring the protection of service users. Each member of staff has a CRB check and two references in place, prior to confirmation of post. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,38 The home is run in the best interests of the people that live there. The health, safety and welfare of service users is promoted and protected. EVIDENCE: The home is in the process of creating a new quality assurance process. In the meanwhile the manager said that the home has a number of tools to ensure quality assurance. These include: service users meetings, staff meetings, matrons meetings, staff supervision, and C.S.C.I and KCC inspections The manager has adopted an ‘open door’ policy. Staff, the people who live in the home can approach her at any time. The Inspector observed that the Home is kept in a secure manner. The Manager as far as reasonably practicable ensures compliance with relevant legislation to ensure that the health, safety and welfare of Service User and staff is promoted and protected. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 20 Yes 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 7 Regulation 15 Requirement The care needs of service users must be fully described in care plans Timescale for action 18/11/05 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 7 Good Practice Recommendations Service users should sign agreement of their care plans. Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Chestfield House Nursing Home H56-H05 S26087 Chestfield House V245032 171005 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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