Inspection on 17/06/05 for Chestnut House

This inspection was carried out on 17th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Chestnut House 05/02/09

Chestnut House 04/03/08

Chestnut House 01/03/07

Chestnut House 25/01/06

Chestnut House 22/09/04

Chestnut House 05/05/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Chestnut House 141 Acklam Road Thornaby Stockton-on-Tees TS17 7JT Lead Inspector Brenda Grant Unannounced 17 June 2005 09:50 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chestnut House Address 141 Acklam Road Thornaby Stockton-on-Tees TS17 7JT 01642 670581 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) Royal Mencap Society Miss Joanna Elizabeth Lowrie Care Home 6 Category(ies) of Learning Disability (LD) 6 registration, with number of places Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22nd September 2005 Brief Description of the Service: Chestnut House is registered under the Care Standards Act 2000 with the Commission for Social Care Inspection as a care home providing care and accommodation for up to six adults who have a learning disability. The home is operated by the Mencap Homes Foundation for the Royal Mencap Society and is on the busy Acklam to Thornaby main road. The home occupies a large detached house retaining many or the original features, and is in keeping with the surrounding area. The building is indistinguishable from other houses in the neighbourhood. The home has six single bedrooms, none have an en-suite, but all service users have access to the communal bath/shower and toilet facilities. Staff at the home provide support that encourages individual independence and involves service users as much as possible in their own care. Service users are fully engaged in activities within the local community, participating in educational and employment opportunities. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four hours twenty minutes, the inspector looked around the building and the grounds of the home as well as inspecting a number of records. Three service users, a trainee nurse and one staff were spoken to on the day of the inspection. Staff supported service users to be involved with college, day care, work placements and other activities. Staff were observed appropriately speaking to service users. One service user was very comfortable showing the inspector around the home. All three service users said they, ‘like the staff’ and ‘it is a lovely place to live’. Staff training was ongoing with the home providing specialist training for caring of the service user group. The home’s environment, on the day of the inspection, it was observed being kept clean and tidy but there were areas where repairs/replacement and maintenance needed to be carried out. What the service does well: What has improved since the last inspection? Light diffuser, in the kitchen, had been cleaned. The overflow problem had been resolved. A window restrictor had been repaired. 50 of care staff had achieved at least NVQ Level 2, this meets the requirements of the National Minimum Standards. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 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 B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 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 standard(s) 2 & 5 Prospective user’s individual aspirations and needs are assessed. Each service user has an individual written contract with the home stating terms and conditions. EVIDENCE: Most of the service users have been living at the home for many years. The inspector looked at the most recently admitted service user’s Social Work Assessment. The assessment showed the service user and their representative was involved with the assessment process. Information included details of the service user’s needs that were to be provided for by the home. Service users had contracts with the home, stating terms and conditions; they had been signed by a representative of the organisation and service users or their representative. They were dated to indicate when the contracts commenced. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 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 standard(s) 6 & 9 Service users are aware their assessed and changing needs and personal goals are reflected in their individual Plan but the Plans were not reviewed twice yearly. Service users are supported to take risks as part of an independent lifestyle but Risk Assessments are not always updated when there are changes of Care Plans. EVIDENCE: Each service user has a Care Plan that is updated on a yearly basis, after the Care Programme Approach review meetings, but the reviews should be at least every six months. Staff said, where possible, service users signed their Care Plan indicating service users are involved with the Plans. Service users are supported to take risks as part of an independent lifestyle; Risk Assessments were in place for each service user, two Risk Assessments had not been updated to reflect the changes in the Plans. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13 & 15 Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users are supported in having appropriate contacts and relationships. EVIDENCE: Staff said they supported and assisted service users to take part in activities of the service user’s choice of: college, day care and work placements. Service users said they are involved with the local community and walk to the local shopping centre where there is also a leisure centre, pubs, and a health centre. Staff said one service user is supported with going to the local church when s/he wishes to go. One service user said s/he was looking forward to an annual holiday and that staff helped him/her to organise it. Service users were satisfied with the support they received to maintain contacts with families and friends and the assistance with arranging transport when it is needed. Staff said service users were supported in making telephone calls to contact families and friends. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 18 & 19 Service users receive personal support in the way they prefer and require and service users physical and emotional and health needs are met. However, the call alarm system was not regularly checked and some healthcare records had not been updated. EVIDENCE: Staff said service users mainly needed to be prompted and monitored with their personal care needs. Such information was recorded in each service user’s Care Plan. The home provides service users with a portable call alarm system, for use in the home, so that service users can call for assistance from staff when it is needed. One service user demonstrated s/he was fully aware of how the call alarm system is to be used. Staff said there was no record that regular checks of the call alarm system had taken place, to ensure the system is still working satisfactorily. The home had a record of service user’s healthcare requirements but the information regarding chiropodist appointments, for one service user, had not been regularly updated. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 22 & 23 Service users feel their views are listened to and acted on but the Complaints Procedure did not include information about the Commission for Social Care Inspection (CSCI). Service users are protected from abuse, neglect and selfharm. EVIDENCE: Service users said if they were unhappy, about anything, they would tell staff about it. The home had a Complaints Procedure stating who to contact and the timescales by when service users would receive a response to a complaint. Service user’s Complaints Procedure did not include the name, address and telephone number of the CSCI. There has been no complaints received during the last twelve months but the home has a satisfactory recording procedure in place. Staff said, and records confirmed, that staff had completed training for No Secrets and Whistle Blowing. Staff said they have an awareness for the need to protect service users from abuse and harm. On the day of the inspection the record of service user’s monies, that is held by the home, was found to be satisfactory. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 24, 27 & 30 The building was not entirely a homely, comfortable and safe environment. two bedrooms were in need of maintenance and/or redecoration, one shower room, was no longer in use, because it was badly in need of repair and the hall carpet was grubby. Service user’s toilets and bathrooms provide sufficient privacy and meet their individual needs. The home was clean and hygienic. EVIDENCE: Since the last inspection repairs and general maintenance had been carried out. The home, on the day of the inspection, was generally homely and comfortable. The rear garden was pleasant with; flowering plants, there is a seating area and a bar-b-que. Further maintenance work that needed to be carried out was for: • Peeling wallpaper in the hallway. • The hot water outlets sometimes flowed cold water instead of hot water. • The stair banister had paint peeling off. • The lounge carpet was wrinkled up along one edge. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 14 Service user’s said their bedrooms were decorated and furnished to their suit their taste. There were two bedrooms that needed maintenance and/or redecoration, that of: • A stained ceiling. • The dampness of the walls and a stained carpet. The home had a satisfactory number and choice of toilet, bath and showering facilities but some were in need of maintenance, those of: • A loose WC seat. • A WC extractor was furred up. • A bathroom did not have a toilet roll holder. • The sealant around a shower was stained. • A shower room had a severe problem of damp. On the day of the inspection, the home was clean and hygienic with the exception of there being: • A grubby hall carpet. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 Service users are supported by competent and qualified staff. EVIDENCE: Staff said, and records confirmed, staff had complete induction and foundation training. Staff said they are then supported to commence training for the National Vocational Training Level 2. Three of the six staff had successfully completed that training. Staff also completed training specifically for the caring of the service user group. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 & 41 Service users benefit from a well run home but the manager has not yet achieved the required qualifications. The home has a quality assurance selfmonitoring system to review and develop services provided to service users but that is mainly by the findings of managers. The home had policies and procedures for keeping records but one insurance document was out of date EVIDENCE: The manager has many years of experience in managing the service but has not yet achieved National Vocational Qualification Level 4, or equivalent, in care and management. Staff said a quality assurance survey had been carried out to gain views from all who were involved with the home but there was no evidence to support that was the case. However there are regular service users meetings and monthly monitoring, by the Regional Manager and the annual audit. There was not an annual development plan showing the planning, action and reviewing of developing the service. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 17 Service users records were kept in a locked facility. They were constructed, maintained and used in accordance with the Data Protection Act 1998. The Employer’s Liability Insurance certificate was dated, to expire, 1st June 2005 and was out of date on the day of the inspection. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x 3 x x Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chestnut House Score 2 2 x x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x 2 x x B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 18 19 Regulation 23 17 Requirement The Call Alarm System must be checked regularly. The home must have a record of service users healthcare checks and include the form of treatment. The Complaints Procedure must include the name, address and telephone number of the CSCI (Previous timescale of 18th November 2004 not met) Maintenace/repairs and redecoration must be carried out: Peeling wallpaper of the hallway must by pasted to the wall. The hot water outlets must flow with hot water and not cold water. The stair banister with peeling paintwork must be redecorated. The wrinkled lounge carpet must be properly fitted. The stained ceiling of a bedroom must be redecorated. The dampness of a bedrooms walls must have the problem addressed and a stained, of the same bedroom, must be cleaned or replaced. The loose seat of a WC must be B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Timescale for action 31st July 2005 31st July 2005 31st July 2005 3. 22 22 4. 24 23 ---------------------------------31st July 2005 Chestnut House Version 1.30 Page 20 5. 39 24 6. 41 17 fixed tighter. The extractor of a WC must be cleaned. A bathroom must have a toilet roll holder. The stained sealant around a shower must be replaced. The shower room with a damp problem must have the problem addressed. The grubby hall carpet must be cleaned. The home must have a quality assurance system, for reviewing the service, that seeks views of all involved with the home. The Employers Liability Insurance must be updated. 31st October 2005 14th July 2005 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. 2. 3. 4. Refer to Standard 6 9 37 39 Good Practice Recommendations Care Plans should be reviewed at least every six months. Risk Assessments should be updated with the Care Plans. The manager should attain qualifications in National Vocational Qualification Level 4, or equivalent, in care and management by 2005. The home should have an annual development plan to plan, action and review the development of the service. Chestnut House B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX 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 B51 B01 SN5 Chestnut House V233811 170605 Stage 4.doc Version 1.30 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. 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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