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Inspection on 20/04/05 for Chestnut Lodge Nursing Home

Also see our care home review for Chestnut Lodge Nursing Home for more information

This inspection was carried out on 20th April 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There are detailed and comprehensive nursing care records in place that reflects the care a resident needs. Assessments clearly identify risks and systems are put into place to protect the resident.

What has improved since the last inspection?

The lounge has been redecorated and some electronic beds have been purchased. The home consistently delivers a high quality service, which the residents and their families have confirmed. There is continual improvement within the environment and new furniture is replaced on a rolling programme.

What the care home could do better:

Relatives should be included in the care planning to increase the awareness to staff about the residents` needs and abilities.

CARE HOMES FOR OLDER PEOPLE Chestnut Lodge Nursing Home 302 Norton Road Norton Stockton-on-Tees TS20 2PU Lead Inspector Lyn Burrell Unannounced 20 April 2005 10:00 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 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 Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chestnut Lodge Nursing Home Address 302 Norton Road Norton Stockton-on-Tees TS20 2PU 01642 551164 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) Mrs Joan Mary Stead Mrs Dawn Anne Brown Care Home 18 Category(ies) of OP Old age (18) registration, with number of places Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: An age variation is in place for a resident who is under the age of 65 years. Date of last inspection 07/10/04 Brief Description of the Service: Chestnut Lodge is a care home providing personal and nursing care for up to 18 service users.The home is owned by Mrs Joan Stead and is situated in Norton on a main bus route into Stockton and has shops and amenities close by.The home has a minibus, which the service users enjoy going out in usually each Monday to places the residents choose.Chestnut Lodge opened in 1989 and is a converted house. There are 3 bedrooms and a lounge/diner on the first floor and 15 bedrooms, 14 single and 2 double rooms are available. On the ground floor that has an extension to the side and rear of the house. There are two spacious lounge/dining rooms on the ground floor and three bathrooms in the house. A stairlift is available to access the first floor. One bedroom as had an en-suite has been fitted in the first floor bedroom.The gardens have been paved for easier access for people who are dependant on wheelchairs and there are potted shrubs and flowers around. The home has successfully achieved the Investors in People Award. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 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 5 hours and there were five residents interviewed. The residents said they were happy and well cared for living at Chestnut Lodge. There is a stable staff team whereby the majority of them have worked in the home for several years. The home was clean and tidy throughout and relatives and friends visited freely. Staff were friendly and hospitable towards the residents and visitors. What the service does well: What has improved since the last inspection? What they could do better: Relatives should be included in the care planning to increase the awareness to staff about the residents’ needs and abilities. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 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 Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 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 standard(s) 3,4,5 The admission process is thorough and it ensures the care residents’ need can be offered. EVIDENCE: A care manager or a registered nurse prior admission to the home completes initial assessments. As Chestnut Lodge is a care home that provides nursing the majority of the residents are very ill and frail. However the home does not admit residents who are suffering with dementia. A detailed admission is again undertaken on admission to the home by a registered nurse to gather information that will enable them to formulate an appropriate care plan. Prior to admission to the home residents and their families are welcome to visit the home to see if it can meet the persons needs and also to allow them to prepare the room with personal effects. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8,10 The health and care needs are well written in an individual plan of care. Evaluation of the care is recorded and demonstrates the appropriate care is given. Residents described the staff as very kind and said that they were treated well and with respect. EVIDENCE: The care plans give an accurate reflection of the resident’s health status and clear instructions for continuing the care. The instructions are detailed and specific for the nursing and care staff to follow. A registered nurse is on duty over a 24 hour period to ensure the residents health care needs are met. Access to the GP service or hospital is available at any time. Residents said that the staff were very kind and they were well looked after. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,15 Resident’s views are sought to discuss recreational interests and life in the home. The meals offered in Chestnut Lodge are good and offer choice and a varied diet. Special dietary needs are also met. EVIDENCE: There are currently 12 residents in the home, the majority being extremely frail. The lifestyle in the home reflects the ability and dexterity of the residents. Some of the residents enjoy playing board games and watching TV. Most of the residents enjoy going out on the minibus to local places of interest. A few residents go to the church that is close to the home and others like to go to the shops with a carer. As mobility is a problem for most residents the carer will push them in a wheelchair. One resident has recently celebrated her 100th birthday and the staff provided a party for the residents and the lady’s family was invited to spend the day with her. A carer took photographs and made her an album with cards and photos to remember the day. The home has it’s own minibus that takes resident’s out every Monday. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 11 The menus show a varied diet and a choice is also available. Many residents have special diets that the home caters for. Residents said the food was very good and were complimentary about the cook. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16,17 The complaints process in the home is good. Residents are adequately protected as the staff have received training in adult protection. EVIDENCE: The complaint procedure needs amending to include all of the requirements listed in the National Minimum Standard and Care Homes Regulations 2001. The policy refers to NCSC instead of the CSCI and should include timescales for managing a complaint. The home has a satisfactory complaints procedure in place but there are a few amendments needed. Residents said if they had an issue they would talk to “Dawn” the manager but none had any matters that they needed sorting. All staff have had training in Adult protection and there is a copy of the “No Secrets” guidelines available for the staff to adhere to. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20,23,24,26 The standard for the environment within Chestnut Lodge is very good providing residents with an attractive and homely place to live. EVIDENCE: The home is clean and tidy throughout and it is in good decorative order. The lounge has been decorated since the last inspection and new electronic hydraulic beds have been purchased. Decoration is undertaken on a rolling programme. The garden areas are paved and suitable for a wheelchair. There are tubs of flowers and shrubs placed around the garden for the spring flowers. The residents said they felt safe in the home and any repairs that needed doing were done by the workman. Bedrooms are personalised with the residents’ personal belongings and photographs. Curtains and bedding are mainly co-ordinated. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 The staffing arrangements in the home are satisfactory as there are registered nurses on duty at all times supported with carers. EVIDENCE: There are currently 12 residents living in the home and a registered nurse is on duty at all times supported by 2 carers during the daytime and evening and 1 on night duty. The staffing of the home remains consistent with a low staff turnover. Carers are encouraged to complete NVQ2 in care and also to participate in other relevant training regarding care practises. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,36 The proprietor and manager runs the home well to ensure the residents are well cared for and their views are listened too. Staff are appropriately supervised and trained to undertake their role and understand the needs of the residents. EVIDENCE: The staff at the home endeavour to run the home smoothly and efficiently. They act in the best interests of the residents at all times. Staff are appropriately supervised by a registered nurse whilst working with the residents. A training plan is in place to ensure all staff receives relevant mandatory training. The manager runs the home admirably with the support from the staff and the homeowner. Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 x 3 x 3 x x 3 x x Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 17 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. Standard 16 Regulation 4,22 Requirement the complaints procedure must include timescales for dealing with a complaint and the policy must amend the name of the regulatory body from NCSC to CSCI Timescale for action 15 June 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. Refer to Standard Good Practice Recommendations Chestnut Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 Page 18 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 Lodge Nursing Home B51-B01 S159 Chestnut Lodge V221896 200405 Stage 4.doc Version 1.30 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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