Inspection on 14/12/05 for Chestnut House

This inspection was carried out on 14th December 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chestnut House 25/07/06

Chestnut House 18/07/05

Chestnut House 25/02/05

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOME ADULTS 18-65 Chestnut House 62 High Street Marton Lincolnshire DN21 5AW Lead Inspector Sue Hayward Unannounced Inspection 14th December 2005 09:30 Chestnut House DS0000061665.V272077.R02.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 Chestnut House DS0000061665.V272077.R02.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. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chestnut House Address 62 High Street Marton Lincolnshire DN21 5AW 01427 718272 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) Prime Life Ltd Mr Brian Charles Ward Care Home 19 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2005 Brief Description of the Service: Prime Life Care Limited owns Chestnut House. It is a detached adapted property set in an extensive plot of land, which is registered to provide care and accommodation for up to nineteen clients with mental health needs. The home is situated in the village of Marton, approximately five miles from Gainsborough town and ten miles north west of the city of Lincoln. The village has a pub and two Churches. Other facilities are available both in Gainsborough and Lincoln. There is a public bus service that stops on the main high street near to Chestnut House. The home has the shared use of a minibus with another home within the area to take clients to day care services, trips or appointments. Bedrooms are located on both floors, with a smoking lounge/dining area, a non-smoking lounge and kitchen being on the ground floor. The providers since they acquired the home have done extensive refurbishment that has involved consultation with clients living in the home. The main lounge/dining area has been made into a bistro type cafe bar. The home does not have a lift and access to the first floor is via stairs. The home has a large parking area to the side of the house and garden to the rear. There is a courtyard, which includes a conservatory, which clients can use for leisure activities such as playing pool. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 4 hours with two inspectors. Residents throughout this report are referred to as ‘clients’ as this is their indicated preference. The main method of inspection used is called ‘case tracking’ which involved selecting three clients and tracking the care they receive through the checking of their records, discussions with them and care staff, and observation of care practices. A tour of the building was conducted with the assistance of a client. Four clients were interviewed along with two staff members. What the service does well: What has improved since the last inspection? The home has maintained it’s high standard of décor and cleanliness. The manager has achieved National Vocational Qualification (NVQ) Level 4 Registered Managers Award and NVQ Level 4 Care Award. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 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. Chestnut House DS0000061665.V272077.R02.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 Chestnut House DS0000061665.V272077.R02.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): EVIDENCE: The core standards were inspected at the inspection of 18/07/05 Chestnut House DS0000061665.V272077.R02.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 and 9 Care plans contain sufficient information to ensure that the care needs of clients are met and clients are consulted and involved in all aspects of their care. Risk assessments are not fully documented to demonstrate that all aspects of a client’s health and safety have been considered. EVIDENCE: Each client has a care programme which contained detailed information related to their care needs including a pre assessment, history, pen picture, professional visits including health care checks, daily living needs including behaviour and communication. Discussion with residents confirmed that they are able to make decisions as to how they lead their lives in the home such as what time they rise and retire, whether they participate in activities and outings and in their choice of key worker. Clients confirmed that they were involved in the writing of their care plan and that a key worker supported them. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 10 The manager confirmed that three clients do not have a named social worker and the home should continue to pursue arrangements on those clients’ behalf. This will be beneficial particularly when clients want additional support/ advice or are ready to move into semi or supported living. Clients undertake a number of activities, which promote their independence and skills, however, there are no risk assessments to support these activities. The manager agreed that these would be developed further. Chestnut House DS0000061665.V272077.R02.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): 13,16 and 17 A wide range of activities and choice are made available to clients to increase their skills and independence. Catering arrangements reflect client’s preferences and choices. EVIDENCE: Clients attend a local social club, which they said they enjoyed particularly the recent Christmas event. There are opportunities to go out in the homes shared minibus for which a charge is made. Some clients are able to go shopping independently using local public transport. One client has a mobility scooter which means that he can go into the village independently. Several clients maintained contact with their relatives by the means of regular visits to their home. Many of the clients access college in Lincoln and Gainsborough for different courses. Two clients are able to attend paid work placements. Clients had their own keys to their bedrooms and were encouraged to maintain their personalised space independently or with help from their key worker. Independence is encouraged in all aspects of daily living including undertaking Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 12 their own laundry and ironing and cooking where appropriate. Care plans show that clients are consulted in all care that is planned. All meals offered a choice of three options, which included a healthy option, usually salad. Five of the clients spoken with confirmed that the meals were of good quality and choice was always offered. The clients put their names against their daily meal choice on the menu board. A kitchen with fridge/freezer, cooker, microwave and kettle was provided for clients who would like to prepare their own meals or make their own drinks. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 There are safe systems in place for the storage and administration of medication, which will help keep clients safe; however, there are no risk assessments in place for clients who self medicate. EVIDENCE: The storage and recording of clients’ medication was appropriate. The prescribing General Practitioner dispenses medication. Staff comments and records indicated that they have received training to dispense medication. 5 members of staff have undergone a 12 week accredited medication course. New staff members do not give out medication until they have completed their foundation training and accredited medication training. One client self-administered his own inhalers but a risk assessment has not been documented to support this. (See comments and requirement made at standard 7). Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 14 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 and 23 Clients know how to make a complaint and feel comfortable in talking to the manager of the home. EVIDENCE: Clients spoken with said that they felt comfortable telling the manager or deputy of any concerns or problems that they have and that things are sorted out as quickly as possible. There has been one complaint received by the home since the last inspection and records demonstrated that this matter was dealt with appropriately. Staff spoken to are aware of policies and procedures for the protection of clients. There was ongoing training for the protection of vulnerable adults. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 15 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): 30 The home is clean, tidy and organised making for a comfortable environment for clients to live in. EVIDENCE: The cleanliness of the home is of a high standard. A cleaner is employed for 25 hours per week. Clients are encouraged to maintain the cleanliness of their own bedrooms either independently or with assistance from staff where required. A laundry room is provided for clients to undertake their own personal laundry and ironing where appropriate, risk assessments should be in place in individual plans of care. (See also comments made at standard 7). The main kitchen is clean and has documentation to support safe food practices such as maintenance of cleaning rotas, fridge/freezer temperatures and probe recordings of cooked foods. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 16 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): 35 There is sufficient numbers of staff on duty who are appropriately trained to meet client’s needs. The staff recruitment procedure is not sufficiently robust to ensure that clients are protected. EVIDENCE: Clients felt that there is enough staff on duty to look after their needs. Staff rota shows that there are two staff including the manager on duty from 8am to 5pm and then from 5pm to 10pm and one waking and one sleeping staff for night duty. Additional staff are on duty for one to one care of named clients. There are also additional support staff employed such as the cleaner and cook. The manager had been awarded National Vocational Qualification (NVQ) Managers award and NVQ level 4 Care Award. Staff training records demonstrates a comprehensive training package including induction, foundation, fire, mental health, COSHH, adult protection. Five staff have completed NVQ level 2 award and the training is ongoing for the remaining staff in the home. The requirement made at the last inspection in relation to ensuring staff are not employed at the home unless a satisfactory Criminal Records Bureau (CRB) Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 17 check has been obtained or a POVAFirst check pending a CRB has been addressed. However it was noted that a staff member who had a POVAFirst check but had not yet received CRB clearance was working in an unsupervised capacity with clients. It was agreed with the manager that this staff member must be supervised until satisfactory clearance has been received. Staff were noted to have a good rapport with clients who also made positive comments about staff. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The environment is safe for clients and staff. EVIDENCE: Cleaning materials were kept within a locked cupboard to ensure clients safety. Radiators were hot to touch and had not been protected or of low surface temperature type; a risk assessment was in place but needs to take in to account clients who are at risk of fitting due to epilepsy. All but one of the homes clients smoked and the home should ascertain the views of the non smoker (who is aware of the dangers of passive smoking) in relation to the smoking lounge being open plan with the dining area. Fire extinguishers were requiring maintaintence at the end of December; the manager said that new ones were going to be purchased instead of maintaining the present ones. The manager will confirm in writing to the Commission when this has been completed. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 19 Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 x 16 4 17 Standard No 31 32 33 34 35 36 Score x x x 2 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chestnut House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x 3 DS0000061665.V272077.R02.S.doc Version 5.0 Page 21 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 YA9 Regulation 13 (4) (c) Requirement Risk assessments to be in place where appropriate for clients relating to independent living skills including cooking, ironing, accessing public transport, self medication and unprotected radiators. Staff must not be employed to work in the home unsupervised with clients unless a satisfactory CRB check has been received by the employer Timescale for action 28/02/06 2 YA34 19 (1) 31/01/06 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 Views of the non-smoking client should be obtained to ensure that they do not feel that they are unnecessarily exposed to the effects of passive smoking. Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Chestnut House DS0000061665.V272077.R02.S.doc Version 5.0 Page 23 - 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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