Inspection on 18/07/05 for Chestnut House

This inspection was carried out on 18th July 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 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 25/07/06

Chestnut House 14/12/05

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 18 July 2005 10:45 th 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 C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Peter Van Herrewege Prime Life Ltd Mr Brian Ward Care Home 19 Category(ies) of MD Mental Disorder Both 18 registration, with number MD (E) Mental Disorder (over 65) Both 1 of places Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22/02/05 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 the home and the home has the shared use of a minibus with another home within the area to take them to day care services, trips or appointments. Bedrooms are located on both floors, with lounges/dining areas and kitchen being on the ground floor. The providers have since they acquired the home 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 making the home generally unsuitable for wheelchair users. The home has a large parking area to the side of the house and garden to the rear. There is a courtyard conservatory which clients can use. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced starting at 10:45 and took place over 4 ¾ hours. It was carried out by one inspector as the first of two statutory inspections for 2005/6. The main method of inspection used was “case tracking”. This involved selecting two residents’ records and tracking the care they receive through their records, discussion with one of them and two care staff on duty. It also included discussion with three other residents. A sample of other regulatory records and policies and procedures were also checked. A pre-inspection questionnaire had been completed prior to this inspection. 13 completed comment cards from clients and 2 from relatives/visitors were received prior to the inspection. The manager was present throughout. What the service does well: What has improved since the last inspection? What they could do better: The staff recruitment procedure must be reviewed to ensure that staff do not start work at the home until all checks necessary have been completed to ensure that service users are not put at risk. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 6 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 C53 C04 S61665 Chestnut House V232706 180705 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 C53 C04 S61665 Chestnut House V232706 180705 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) 1, 2 and 5 The systems in place for the introduction and assessment of resident’s to the home ensure care needs are identified and met. Written information about the home is made available to residents and their representatives. EVIDENCE: Two residents records were viewed and demonstrated that an assessment of need had been done prior to a decision being made to admit the client to the home. Letters are then sent to residents confirming whether the home can meet their needs. A resident said that she had visited the home prior to coming and was aware of the care records that the home kept about her. The homes statement of purpose and service users guide known as “Bespoke Services to Adult Clients” was noticed to be readily available for anyone to refer to as it was on display in the hallway along with previous inspection reports. Both records checked contained details about terms and conditions of residency and contractual information. The manager confirmed that he and his senior care worker assess residents and this usually includes a visit to them and obtaining as much information as possible from other professionals who may be involved. Records confirmed this. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 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, 7 and 9 Residents are involved in their care planning and are able to make decisions and choices as to how they lead their lives at this home. EVIDENCE: Discussion with residents confirmed that they had been involved in the completion of their care plans and that these were discussed with their “key workers”. “Key workers” are staff that have specific responsibilities for specific residents. A staff member confirmed that care plans are reviewed on a monthly basis and more formally involving residents 3-6 monthly or as needed. 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. Risk assessments are in place where risks have been identified in relation to residents. Comments from residents spoken to on the day and written comments received prior to the inspection demonstrated that they felt safe at the home. Residents spoken to on the day also commented that they felt that staff gave them the support they needed. Some residents spoken to Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 10 also gave examples of ways in which their independence is promoted, for example, using public transport, initially with the support of staff. Residents can make their views known to staff individually or through the residents meetings that are held. Minutes are kept of these and it was confirmed by the manager that the last meeting had been held in June 2005. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 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 standard(s) 11, 12 and 15. The home assists residents to pursue a range of activities and leisure interests both within the home and community. These are based on the preferences of service users who are encouraged to make choices about their preferred lifestyles and routines. Visitors are welcomed at the home. EVIDENCE: Information provided through the checking of records and discussion with residents and staff demonstrated that residents have opportunities to pursue various educational, training, work and social interests. Some residents attend college and are doing computer or art courses. Residents also have opportunities to increase their independent living skills with support from staff and participate in the cleaning of their rooms, laundry and the preparation of meals. One resident said that he was hoping to be able to do a catering course. Within the home residents said that they are able to take part in social events such as quizzes and bingo and birthday parties are organised. A pool table was seen, as was some outdoor games equipment for residents to use if they Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 12 wished. Some residents attend day services. A holiday has been arranged for residents for the summer and this was discussed at a residents meeting. Discussion with residents demonstrated that they are able to invite relatives or friends to visit. In addition it was noted that a resident said that he was being taken by the home to visit his relatives. Comment cards were received from two relatives/visitors to the home. They both confirmed they were made welcome at the home, were given privacy when they visited and that they were consulted about their relatives/friends care. Staff gave a good account of the homes visiting procedure, which included checking the identity of unknown visitors and checking with residents as to whether they wished to see visitors. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 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 standard(s) 18 and 19 Residents at this home receive the support and care they need to be as independent as possible and to promote their physical and emotional wellbeing. EVIDENCE: Records checked demonstrated that resident’s healthcare needs are addressed as needed. For example discussion indicated that some residents have visits from community nurses. Resident’s comments indicated that when they have hospital or G.P appointments they are able to have consultations in private or if they prefer with staff to support them. One resident said that if you needed to see a doctor or dentist you need only mention it to staff and they would arrange it. It was also observed that on the day of the visit a resident returned from attending a hospital appointment and had been accompanied to do so by a staff member. A staff member demonstrated that she had a good knowledge of the healthcare needs of a resident asked about. Staff were noted to treat residents in a respectful and courteous manner. Resident’s records, which were detailed, included information of other health and care professionals’ involvement. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 14 Comments from residents seen at the time of the inspection were positive about the care and support that the staff provide. A resident said, “Staff are wonderful they have really helped me”. Overall, questionnaires received from residents prior to the inspection indicated that they felt they were well cared for and treated at the home. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 15 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 and 23 Residents are protected by the procedures in place for handling complaints and allegations of abuse. EVIDENCE: There have been no complaints or adult protection issues raised with the home or the CSCI in the last twelve months. There is a recording system in place should any be received. Discussion with residents indicated that they were aware of whom to raise a complaint with. One comment made was that staff would help them to do so. Residents spoken to on the day were satisfied with the care provided and had no complaints. Information about how to make a complaint is on display in the home on notice boards and in the brochure of information in the hallway. The organisation has policies and procedures relating to complaints and adult abuse and a copy of the revised Lincolnshire County Council Adult Abuse procedure was on display in the office a was the document “No Secrets”. A staff member spoken to said that she had had training in relation to adult abuse. The homes booklet “Bespoke Services to Adult Clients” which is given to residents on their admission to the home also includes information about how to complain. The organisation also has other policies that are designed to protect residents, such as physical intervention/restraint and the management of client’s monies and financial affairs. The record keeping systems in place for any resident’s money held in safekeeping were satisfactory. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 16 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 The home provides a comfortable and safe environment for residents. EVIDENCE: The following areas of the home were seen on this occasion, two bedrooms, lounge and dining areas, bathrooms, resident’s kitchen, laundry and staff accommodation. The home was generally clean and tidy and generally well maintained. Residents said they clean their rooms with staff support and some also do their own laundry. Resident’s comments also confirmed that they are able to make themselves drinks and snacks whenever they wish in the kitchenette. Residents said that their rooms were comfortable and those seen were lockable and both rooms had been provided with a lockable piece of furniture. An upstairs bath was showing signs of wear and tear but discussion with the manager confirmed that this had been reported to the organisations estates department for attention. Reports were seen in relation to visits by the fire brigade and environmental health officers for their routine inspections. The fire brigade last visited on 21.07.04 and the report was satisfactory. The Environmental Health officers report in relation to the kitchen inspection was also satisfactory. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 17 There is a rolling programme of redecoration and refurbishment and comments from residents confirmed that they are consulted about this. The preinspection questionnaire identified that since the last inspection some bedrooms had been redecorated as had hallways and a lounge area. Discussion at the time of the inspection indicated that other areas of the home were due to be redecorated. The environment is suitable for service users who are generally independent with personal care and mobility. Radiators have not been guarded however risk assessments were in place and the manager confirmed that they did not pose a risk to current residents. Radiator temperatures can be regulated. Risk assessments had been documented in relation to the environment and a fire risk assessment of the home had been completed on 15/02/05. Records were in place to demonstrate checks and services in relation for example to electrical items, water temperatures and central heating systems. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 18 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) 34 and 35 Staff have training to ensure that they have the necessary skills and knowledge to care for residents safely. The process to recruit staff must be reviewed in order to ensure as far as possible residents are protected. EVIDENCE: There is a staff training and development programme in place, which consists of statutory as well as more specific training to meet the needs of residents. For example records indicated that staff attend induction training, foundation, fire, manual handling, COSHH, First Aid, mental health and challenging behaviour and basic food hygiene training. The manager confirmed that there are now 4 staff who have obtained National Vocational Qualification Level (NVQ) II award and 1 who has attained Level III. There are 2 staff who have commenced NVQ Level II and 1 who has commenced a registered managers award. Staff comments confirmed the training programme in place. Resident’s comments about the staff were positive and said they were able to talk to them if they had a problem and felt they would be listened to. One matter, which must be addressed, is in relation to the staff recruitment procedure. It was discussed with the manager that since 26th July 2004 staff must not be employed unless a satisfactory CRB check or PovaFirst in exceptional circumstances pending a CRB check had been received by the Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 19 organisation. On this occasion it could not be demonstrated that this had been obtained for a newly employed staff member although it was noted that the staff member and manager confirmed that it had been applied for. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 20 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 and 39 The home is being well managed. Service users are consulted and feel their views are listened to. EVIDENCE: The manager has been registered by the CSCI. He has completed the registered managers award. Staff and residents made positive comments about the management of the home indicating that they could make their views known or raise concerns on an individual basis or via staff and residents meetings and they felt comfortable to do so. Staff members confirmed that there is a supervision and appraisal system in place and they had training, which had “helped a lot”. A staff member’s comment confirmed that she felt supported by the management systems in place and felt comfortable to raise any issues. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 21 It was noticed that there is a suggestion book kept in the hallway for anyone to make comments about the service or how it might be improved. One had been recorded which was complimentary about the service. There are monthly visits to the home by a representative of the organisation and records were available to demonstrate these. The manager confirmed that he had sent out CSCI’s relative/visitors comment cards to other professional who visit the home however none had been returned to the CSCI. Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 22 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 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 3 3 x x 3 x x Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chestnut House Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 23 None 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 34 Regulation 19(1) Requirement Staff must not be employed to work in the home unless a satisfactory CRB or POVAFirst check pending a satisfactory CRB check has been received by the employer. Timescale for action 31/08/05 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 Good Practice Recommendations Chestnut House C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 C53 C04 S61665 Chestnut House V232706 180705 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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