Inspection on 25/01/06 for Chestnut House

This inspection was carried out on 25th January 2006.

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 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chestnut House 05/02/09

Chestnut House 04/03/08

Chestnut House 01/03/07

Chestnut House 17/06/05

Chestnut House 22/09/04

Chestnut House 05/05/04

Similar services:

22 Sandown Road

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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 Derek Stow Unannounced Inspection 25th January 2006 10:15 Chestnut House DS0000000005.V263409.R01.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 DS0000000005.V263409.R01.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 DS0000000005.V263409.R01.S.doc Version 5.0 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 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) Royal Mencap (Housing & Support Services) Miss Joanna Elizabeth Lowrie Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons shall not at any one time exceed 6 people with learning disabilities 17th June 2005 Date of last inspection 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 DS0000000005.V263409.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days; four and a quarter hours the first day with a one hour re-visit to examine some confidential documents which were not available at the time of inspection as the manager was not on duty on that day. The inspector looked around the building, examined a number of records and spoke to three residents and three staff members. A tour of the building was carried out and requirements identified at the last inspection were re-visited. There were no visitors during the inspection and the residents who were not seen were either at a day services or at work. This inspection looked at those key standards, which were not examined at the last inspection in June 2005. A detailed list of any issues identified as requiring action is to be found at the back of this report. What the service does well: What has improved since the last inspection? 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 DS0000000005.V263409.R01.S.doc Version 5.0 Page 6 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 DS0000000005.V263409.R01.S.doc Version 5.0 Page 7 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): This section was not looked at during this inspection as the key Standards were examined at the last inspection in June 2005 EVIDENCE: Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 8 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): 7. Service users are supported in making decisions in all aspects of life. EVIDENCE: One resident’s files were looked at in detail. This showed self-advocacy representation in all areas of life’s functions and activities and this was represented in the advice/guidance given to staff as outlined in the care plan. One example from the file stated that resident X liked his girlfriend to visit and that he didn’t like interruptions from staff or other residents when he had visitors. One of the residents was asked if she would like to speak to the inspector and she said that she had a key to the house and to her own room and that she didn’t like to go to day services but had a support worker who went out with her in the community three times a week. The staff on duty confirmed that residents are encouraged and supported to fulfil their rights and wishes and this is the focus of the staffs daily work. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 9 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): 16 & 17 Service users are treated with respect and they are encouraged to take responsibilities and participate in the functioning of the household. Residents are clearly offered and encouraged to have a balanced, varied and nutritional diet with individual needs and likes catered for. EVIDENCE: The staff on duty said that respect for service users rights and privacy are very strongly maintained at Chestnut House and all residents are given keys to their rooms and to the front door. The wishes of individuals was clearly recorded in the files and evidenced in speaking to a resident. The staff said that they encourage residents to participate in household tasks and to be as independent as possible in maintaining their own rooms. One resident was seen coming downstairs carrying her washing and she said that she does her washing but doesn’t like ironing. The menu was examined and staff said that this reflected residents own choice and that each resident was given the opportunity of selecting a main meal of their choice at least one day a week. Residents are helped to choose with the assistance of staff and the use of a coloured picture book of meals. A variety of fresh fruit and vegetables were seen in the larder. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 10 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 Medication policies and procedures are in place and appropriate to ensuring the safe control and administration of medicines. EVIDENCE: Medication was seen to be kept in two locked cabinets in a locked office. The Mencap medication procedure was examined and the staff on duty gave a verbal good practice account of the procedure for the giving of medication as well as the return of any unused medication. The record of returned medication was also examined as well as the blister pack supplied by Boots and these confirmed that medication had that day been given correctly. The training record showed that five of the six staff have undertaken Boots MDS medication training. There are no residents at Chestnut House who have been assessed as being capable of keeping their own medication. Having regard to the health needs and mental capacity of the residents at Chestnut House, the staff should actively encourage each person to have an annual health check. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 11 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): This section was not looked at during this inspection as the key Standards were examined at the last inspection in June 2005. However issues are raised below as a result of an unmet requirement from previous inspections. EVIDENCE: Although not the focus of this inspection the last two inspections have highlighted the need to include in the complaints procedure the information which the regulations require to be given to service users about the right to contact CSCI including contact address and telephone number. This was not evidenced on the day of inspection. The complaints leaflet for service users, which was looked at, also did not contain information about who to contact at the commissioning Social services Department. A clear simple complaints procedure must be made available to service users. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 12 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): This section was not looked at during this inspection as the key Standards were examined at the last inspection in June 2005 EVIDENCE: Although the environment was not the focus of this inspection it was noticed that the toilet seat in the downstairs toilet was badly stained. This must be replaced. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 13 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): 34 & 35 Residents are supported and protected by appropriate numbers of satisfactorily recruited and trained staff, however not all of the records required to be available in the home by regulation 17 Schedule 4 were present. EVIDENCE: The manager explained that staff files held at the home had staff photographs and references and these were examined however the area office held evidence of birth certificate, passport and criminal record bureau checks. Training records were examined and these showed that three of the five care staff (60 ) hold NVQ 2. One member of staff is undertaking NVQ training with the remaining staff member being registered to start the next course. The manager is currently completing the registered managers qualification. Five staff have been trained in the administration of medication. All staff have completed Adult protection training. Training records show when staff have completed induction training and for “essential/statutory “ when this is completed and when refreshers are due. This Training records was not completely up to date and accurate at the time of the inspection. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 14 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 Appropriate policies, procedures and monitoring systems are in place to help to ensure that the health, safety and welfare of service users is promoted. EVIDENCE: A number of health and safety records were examined to confirm that up to date maintenance/checks were in place relating to the gas safety certificate, legionella, hot water temperatures, electrical wiring and fridge temperature records. One hot water outlet was checked and found to be 42.5 degrees. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 15 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 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X x Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 2 2 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 3 X DS0000000005.V263409.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? YES 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. Standard Regulation Requirement The Complaints Procedure must include the name, address and telephone number of the CSCI (Previous timescale not met) A clear simple complaints procedure must be made available to service users. Maintenance/repairs and redecoration must be carried out: The stair banister with peeling paintwork must be redecorated. The wrinkled lounge carpet must be properly fitted /re-placed. The stained ceiling of a bedroom must be redecorated. (Previous timescale not met) A ground floor toilet seat, which is badly stained, must be replaced. Timescale for action 1. YA22 22 31/03/06 2. YA24 23 31/03/06 3 YA24 23 28/02/06 Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 17 4. YA41 (3) The training records must be accurate and up to date. The records relating to persons employed in the home referred to in schedule 4 must be kept in the home and available at all times for inspection. 28/02/06 5. YA41YA34 17(2)& 17(3)& Sched’4 31/03/06 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. 2. 3. 4. 5. Refer to Standard YA6 YA9 YA37 YA39 YA19 Good Practice Recommendations Care Plans should be reviewed at least every six months. Risk Assessments should be updated with care plans. The manager should attain qualifications in National Vocational Qualification Level 4, or equivalent, in care and management. The home should have an annual development plan to plan, action and review the development of the service. Having regard to the health needs and mental capacity of the residents at Chestnut House, the staff should actively encourage each person to have an annual health check. Chestnut House DS0000000005.V263409.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Tees Valley Area Office 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 DS0000000005.V263409.R01.S.doc Version 5.0 Page 19 - 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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