Inspection on 20/07/06 for Chestnut Lodge

This inspection was carried out on 20th July 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 but made no statutory requirements on the home.

Other inspections for this house

Chestnut Lodge 01/06/09

Chestnut Lodge 10/07/08

Chestnut Lodge 19/07/07

Chestnut Lodge 30/01/06

Chestnut Lodge 14/09/05

Chestnut Lodge 02/11/04

Chestnut Lodge 18/05/04

Chestnut Lodge 29/01/04

Chestnut Lodge 06/08/03

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

CARE HOMES FOR OLDER PEOPLE Chestnut Lodge 135/137 Church Lane Handsworth Wood Birmingham West Midlands B20 2HJ Lead Inspector Kulwant Ghuman Unannounced Inspection 20th July 2006 09:30 X10015.doc Version 1.40 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 Lodge DS0000016897.V302377.R02.S.doc Version 5.2 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chestnut Lodge Address 135/137 Church Lane Handsworth Wood Birmingham West Midlands B20 2HJ 0121 551 3035 F/P 0121 551 3035 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) Mrs Evelyn McIntosh Mrs Catherine McHugh Mrs Evelyn McIntosh Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Chestnut Lodge is a home providing residential care for up to 15 older people. The premises consist of 2 large houses that are joined, and situated on a busy main road with shops nearby. The home has a well-maintained garden at the rear, with a paved patio area, and furniture for those residents that wish to sit outside in fine weather. There is parking for 2-3 cars at the front of the property. Residents accommodation is on three floors consisting of a mix of single and double rooms. There are ample communal bathing and toilet facilities. The home has two sitting rooms, one at the front of the house and another at the rear overlooking the garden. The atmosphere of the home is very homely. A shaft lift gives access to upstairs rooms. The fees range from £305 to £322. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this key inspection over one day during July 2006. There were 14 residents in the home at the time of the inspection with one resident in hospital. The inspector was able to speak with 8 residents, the manager and one two staff as well as sample 5 residents files, 3 staff files, some health and safety records and tour the building. The inspector had not received the completed pre-inspection questionnaire at the time of the inspection. The majority of the residents were unable to offer their comments regarding the home and how they felt to the inspector due to their level of confusion and the inspector relied on observations of the way they looked. Those that were able to comment on the home stated: “It was a very good home”. “Don’t have to do anything”. “There’s always someone to take you to have a bath”. What the service does well: The home provides care in a homely environment with a stable staff team that provides continuity of care for the residents. There are good relationships with relatives and other professionals who visit the home. Contact with friends, relatives and the community are encouraged. The health care needs of the residents are well managed. The nutritional needs of the residents are met and residents stated ‘the food is good’. Staff are recruited appropriately with all the required checks being undertaken before they begin work at the home. Activities are provided for those residents wanting to take part. Residents were able to choose where they sat in the home and no areas of the home were out of bounds. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 6 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 Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, 5 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. There was no evidence available that the home had received information about the assessed needs of the residents or that the resident had visited the home prior to admission to ensure that the home was able to meet the residents’ needs. EVIDENCE: The inspector sampled the files of two residents newly admitted to the home. The inspector was unable to evidence the process by which the admissions had been made. There was no pre-admission assessments on the files sampled carried out either by placing social workers or staff at the home that would tell the care staff what the residents needs were and how they were to be met and whether the residents were suitable to be admitted to the home. The manager told the inspector that the residents visited the home prior to admission and did not know why the assessment they had carried out was not on the file. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 9 One of the care plans provided by the social workers was sent to the home after the resident had been placed there. There was evidence of a third party funding agreement for the two residents but there was no contract for the residents between the home and the residents. Residents needed to be provided with a contract that informed them of the fees to be paid, by whom they would be paid and the room the resident was to occupy at the time of moving into the home. There were contracts in place for the other residents however the fees and room numbers were not identified. These contracts identified that there was a 28-day trial period to ensure that the home was suitable for the resident and that the home could meet the residents needs. For the two most recent admissions there had been no 28day review undertaken. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The care planning and risk assessment processes were not detailed enough to enable residents’ needs to be met. Health care needs of the residents were being appropriately met. The management of medicines in the home was good ensuring that residents received their medicines in a timely manner. EVIDENCE: The care plans for three residents who had been at the home for over a year were sampled as were the care plans for the two newest admissions to the home. The home had begun to use the Assessment for Good Care Planning booklets. These documents were very good for helping the home to carry out the assessments and prompt for monthly and six monthly reviews of the residents. There was a section for Care/Action Plans however the detail recorded in these did not enable a new member of staff to be able to pick up the care plan and identify all the residents needs and how they were to be met. For example, Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 11 the plans stated that residents needed to be assisted with their personal hygiene but gave no details on how this was to be done by the care staff. One resident’s assessment indicated that exercises were to be carried out but there was no detail of what exercises these were or how often they were to be undertaken. Several risk assessments were carried out including general risk assessments, nutrition and pressure area care but there were no strategies in place to manage the risks. It was determined that some of the residents had pressure mattresses and cushions in use and that bed rails were in place. This was not obvious from the documents on the files and there were no risk assessments in place for their use. There was insufficient detail in the moving and handling assessments to show how the residents were to be assisted to mobilise. The inspector observed one resident being moved from a wheel chair to a taxi by one resident without any aids. Instructions on how this manoeuvre was to be carried out by the staff needed to be written down. The manager told the inspector that a moving belt should have been used. Staff were aware of this however this had not been used during the transfer observed by the inspector. Care plans were being reviewed on a monthly and six monthly basis however the information was not always correct, for example, a recent review stated that the residents eye sight was good and glasses were not used however, the file showed that six months earlier glasses had been provided for the resident. Daily records of the care being provided to residents were being maintained however these were repetitive in some cases but good in others. The daily recordings however did not reflect how the identified needs of the residents were being met, for example, the daily records of one resident did not indicate that the resident was undertaking any exercises or that the resident was stood up several times during the day to relieve the pressure on pressure areas. Handovers were being undertaken from day staff to night staff and there was a written record of any issues to be taken into consideration by the following shift. The health care needs of the residents were met by referral to the GP, district nurses, CPN, hospital, dentist and opticians. Records of these visits were made in the assessment books. Also recorded in these books were records of residents’ weights. One of the residents was taken across to the doctors’ surgery for blood sugar monitoring. The management of medicines was found to be good. There was only one minor issue to be addressed where there was a choice of one or two tablets to Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 12 be given. The number of tablets given was not recorded on the MAR chart so that an audit could not be carried out. The home used a monthly monitored dosage system for the majority of medicines. Privacy was generally well catered for in the home. There were privacy screens in shared bedrooms, toilets and bathrooms had appropriate locks on the doors, and there was a lockable piece of furniture in the bedrooms. A district nurse was seen to come into the home and the resident was taken to the bedroom for treatment. The bedroom doors did not have appropriate locks on as they were the lever type generally used in bathrooms. There were two bedrooms where a fire exit route through them meant that another resident could access their bedrooms. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There were no rigid rules or routines in the home and residents could spend their time as they chose. There were some organised activities for those residents who wished to take part. The residents were satisfied with the catering arrangements at the home. EVIDENCE: Several visitors were seen to come and go during the day and were made welcome. The visitors were able to spend time in the bedrooms with them. Visitors could visit the home at all reasonable times but were asked to avoid mealtimes. There was evidence in the daily recordings for residents indicating that there were some activities within the home including reading newspapers, watching television, chatting with staff and residents, sitting in the garden and going out with friends and relatives. There were regular movement to music sessions and games such as skittles. There were regular visits to the church and from the church to the home. Relatives were encouraged to take residents out with them. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 14 Residents were seen to wander around the home freely. The residents’ nutritional and dietary needs were met however, the home was advised to have a rolling programme of meals and introduce seasonal fruits and vegetables to ensure a variety of foods and nutrients were provided. At the time of the inspection the meals were repeated on a weekly basis. There were choices available and records were kept of the meals prepared however, the records did not identify what each resident had eaten. Diabetic and culturally sensitive meals were provided but again these were not always identified on the records. Plate guards and other equipment were in use to enable the residents to eat independently. One member of staff was observed to be assisting a resident to eat. It would be more dignified for the resident if the member of staff was seated next to the resident whilst giving assistance. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents were safeguarded by the policies and procedures in the home. EVIDENCE: There was a complaints procedure in place that needed a small amendment to be made to it as it stated that all complaints needed to be made to the Commission for Social Care Inspection (CSCI). The procedure should make clear that the home would try to resolve any concerns or complaints raised with them and given details regarding who could be contacted within the home and how this contact would be made and the timescales within which the issue would be resolved, but that a complaint could be referred to the CSCI if the complainant did not feel able to raise the issue at the home. The inspector was told that no complaints had been raised directly with the home and there had been no complaints lodged with the CSCI regarding the service since the last inspection. There were adult protection procedures in place and the staff had undertaken training in adult protection. The recruitment procedures in the home raised no concerns about the protection of the residents and the home did not handle any monies on behalf of the residents. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Care was being provided in a homely environment. Bedrooms varied in size and the state of décor in the home was variable. The environment was generally safe although some requirements meant that the comfort and safety of some residents could not be ensured. EVIDENCE: The home consisted of two adjoining houses joined together and therefore maintained a homely atmosphere. The home was accessible throughout for residents and visitors with additional mobility needs by the use of ramps into the home and into the garden. Some fire doors in communal areas were wedged open and could pose a potential risk in the event of a fire. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 17 There was an emergency call system in all areas of the home. The inspector called for assistance in one of the toilets however, the response was slow due to the fact that one member of staff was in another toilet assisting a resident and the other member of staff was in the garden. The panel was located in the lounge and could not be heard by the staff. The manager needed to ensure that the buzzer could be heard by staff in all areas of the home including the upper floors to alert them to the need for assistance. The rear garden was very well maintained with a patio area accessible to all residents that had garden furniture available to the residents to enable them to sit in the warm weather. The lawned area was accessible only to those residents who were mobile as there were a number of steps up to the lawn. There was an ample communal space for the residents in two lounges and a dining room. The furniture in these rooms was homely. In addition there was a comfortable sitting area between the two lounges that some of the residents used. There were a number of shared and single bedrooms that varied in size but that appeared to meet the needs of the residents. The bedrooms included the required furniture and one item of furniture was lockable. The majority of the bedrooms were personalised with some personal belongings brought in by the residents and their families. Several areas of the home, including the bedrooms, needed to be re-decorated and several carpets throughout the home needed to be stretched to remove the wrinkles from them to prevent them causing any tripping hazards and some of the carpets were quite dirty and needed to be deep cleaned or replaced. There was central heating throughout the home and all radiators were guarded. Windows in bedrooms and lounge areas could be opened to help to relieve the current high temperatures, however, in two bedrooms the temperatures were too high due to the boilers being located in cupboards in the bedrooms. The manager needed to ensure that fans etc were available to the residents, following risk assessment, to ensure that the rooms could be kept at comfortable temperatures. There were bathing and toilet facilities on all floors. There were hot water temperature regulators in place on baths and wash hand basins. The shower in the bathroom on the first floor was regulated and the hot water was very hot posing a scalding risk to the residents. There was one bedroom where odour control was an issue and the manager needed to look into what could be done. In general the home was clean and odour free. The kitchen was clean and well maintained. Infection control procedures were in place including netting on doors and windows to prevent Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 18 flies entering the kitchen, colour coded cleaning equipment and liquid soap and paper towels available in the bathrooms and toilets. There were however some nail brushes in the bathrooms and some meat in the freezers that had not been dated on freezing. The underside of the bath chair needed to be thoroughly cleaned. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Adequate staffing levels were being maintained with a well-trained staff group who could meet the needs of the residents. There were robust recruitment procedures in place ensuring the right people were employed and safeguarding the residents. EVIDENCE: The staffing levels met the needs of the residents with the manager and two care assistants on duty during the day. In addition there was a cook to prepare the meals. The inspector was told that there were two waking night staff on duty. The inspector was concerned at the number of hours worked by some of the staff. For example, the manager was on the rota for 12 hours seven days a week. Many of the other staff worked 11 or 12 hour shifts for 4 or 5 days a week. The inspector was informed that staff had signed opt-out of the working hours directive and were able to work these hours. The manager had a duty to ensure the health and safety of the staff and showing that they were having the required breaks in their shifts. There were 10 care staff employed in the home of which 9 had achieved NVQ level 2 and of these 4 had achieved NVQ level 3. Staff had undertaken mandatory training and were taking further refresher courses in first aid and Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 20 moving and handling. Staff needed to be mindful that they put into practice all that had been taught for example as discussed in Standard 7 the transfer of a resident into a taxi without using the appropriate equipment. The inspector saw the recruitment files of three staff and all the required documentation was in place. The manager was advised to keep a record of the questions asked at interviews, the responses of the interviewees and the querying of any gaps in employment identified on the application forms. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The manager ensured the smooth running of the home in a competent manner. Some of the health and safety issues raised needed prompt attention to ensure the safety of staff and residents. The home needed a formal quality monitoring system in place based on seeking the views of the residents to ensure there was a system in place for continuous improvement. EVIDENCE: The manager had been a nurse and had managed the home for several years and had in intimate knowledge of the residents needs. The manager had started to undertake the Registered Managers Award however due to personal problems was restarting the award in September 2006. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 22 The home appeared to be run in an open way and staff said they thought of the home as a ‘second home’ and several residents commented that ‘it was a good home’ and ‘that the staff were good’. The residents’ needs were priority for the staff and manager who involved families and professionals as required. The inspector was told that the home did not handle any monies on behalf of the residents. Any items purchased for the residents were then claimed back by the home by invoicing the appropriate authority. The home had purchased a quality assurance system but had not yet put it into practice. Some supervision sessions had taken place but the required levels had not been achieved. The minutes of staff and resident meetings were not available in the home for inspection. The majority of the documents in the home were well organises and accessible. The health and safety of the staff, visitors and residents was well managed and equipment was regularly serviced and maintained. There was some improvement required to the care planning and risk assessments in the home in particular, the home needed to ensure that there was a documented, valid reason for the use of bed rails for residents, that the bedrails were safe and suitable and that a joint decision had been made that they were required. The inspector was concerned that the bed rails in use at the home had not been appropriately risk assessed and there was a risk of joints being caught under the rails as there was a gap between them and the mattress on the bed. The emergency call buzzer was not audible in all areas of the home and could leave residents in need of attention. Fire doors must not be wedged open. Steradent tablets must not be left in bedrooms where confused residents could enter and mistake them for sweets. Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 1 2 2 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 2 2 X 3 2 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 2 1 Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 24 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. 1. Standard OP2 Regulation 5(1) Requirement All residents must be issued with a contract/terms and conditions of residence at the point of moving into the home. Timescale for action 21/08/06 2. OP3 3. OP4 4. OP5 5. OP7 The contract must show the fees to be paid, who is responsible for paying them and the room to be occupied. 14(1)(a,b) The home must receive a comprehensive assessment carried out by the placing authority before the resident is admitted to the home. 14(1)(c) No resident must be admitted to the home before a full assessment has been carried out to ensure that the home can meet the resident’s needs. 12(1)(a) There must be documented evidence that the resident, or their representative, has been able to visit the home prior to admission to assess its suitability for them. 15(1) Care plans must contain details of how staff are to care for residents and manage all areas of need including any risks. DS0000016897.V302377.R02.S.doc 14/08/06 14/08/06 14/08/06 21/08/06 Chestnut Lodge Version 5.2 Page 25 Previous timescales of 31 October 2005 and 31 March 2006 not met. Care plans must be updated as and when changes in needs are identified. The home must ensure that more detail is recorded on moving and handling assessments of individual residents to ensure safe transfers. Previous timescale of 31 March 2006 not met. There must be strategies in place for the minimising of all risks identified including aggression, falling, pressure areas, nutrition and smoking. Where medicines are given as and when required and there is a choice of one or two tablets the number of tablets given must be identified to ensure an audit trail can be carried out. The home needed to develop a rolling programme of menus to increase variety of meals and nutrition. Individual food records must indicate what is eaten by each of the residents. The records must indicate where special diets have been met e.g. diabetic and culturally sensitive diets. Staff assisting residents to eat should be appropriately seated next to them. The complaints procedure should make clear that the home will attempt to resolve concerns locally and the arrangements for making the concerns known with DS0000016897.V302377.R02.S.doc 6. OP8 13(5) 21/08/06 7. OP8 13(4)(c) 21/08/06 8. OP9 13(2) 14/08/06 9. OP15 17(2) Sch 4(13) 21/08/06 10. OP16 22(1) 21/09/06 Chestnut Lodge Version 5.2 Page 26 11. OP19 23(2)(b) 12. OP21 13(4)(c) 13. 14. 15. 16. OP22 OP25 OP25 OP26 13(4)(c) 23(2)(p) 23(2)(p) 13(3) timescales, but that concerns can be raised with the CSCI by the complainant at any time. Several areas of the home needed to be redecorated, carpets needed stretching and cleaning. A programme for refurbishment needed to be identified and a copy forwarded to the CSCI. The hot water being delivered by the shower on the first floor must be restricted to 43 degrees. The buzzer on the emergency call panel must be audible in all areas of the home. The boilers located in two bedrooms must be insulated so as not to overheat the bedroom. The bedroom temperatures must be maintained at a satisfactory level. Infection control procedures must be maintained in the home by removing nailbrushes from communal bathrooms. The underside of the bath chair on the first floor must be cleaned. Meats must be dated when frozen. 31/08/06 24/08/06 31/08/06 14/08/06 26/07/06 24/07/06 17. 18. OP29 OP31 19. OP33 The odour control in one bedroom must be addressed. 12(1)(a) A record must be kept of the interview questions and responses. 9(2)(b)(i) The registered manager must attain the Registered Managers Award. Previous timescale of 30 October 2006 not expired but extended. 24(1)(a,b) A formal quality assurance programme is implemented in the home. DS0000016897.V302377.R02.S.doc 01/09/06 30/03/07 31/12/06 Chestnut Lodge Version 5.2 Page 27 20. OP36 18(2) 21. 22. 23. OP38 OP38 OP38 23(4)(c,i) 13(4)(c) 13(4)(c) It is recommended that areas of audit are implemented month by month to complete all areas by 12 months. Previous timescales of 28 February 2005 and 31 March 2006 not met. Formal documented supervision must be provided for every member of the care staff at least 6 times a year. Previous timescales of 28 February 2005 and 31 March 2006 not met. Fire doors must not be wedged open. Steradent tablets must be kept out of sight in a drawer in the bedrooms. Risk assessments for the use of bed rails must be in place for each resident using them. 31/12/06 21/07/06 20/07/06 14/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chestnut Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Lodge DS0000016897.V302377.R02.S.doc Version 5.2 Page 29 - 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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