Inspection on 09/10/06 for Chestnut Lodge Nursing Home

This inspection was carried out on 9th October 2006.

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 Lodge Nursing Home 11/11/05

Chestnut Lodge Nursing Home 20/04/05

Chestnut Lodge Nursing Home 07/10/04

Chestnut Lodge Nursing Home 16/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Chestnut Lodge Nursing Home 302 Norton Road Norton Stockton-on-Tees TS20 2PU Lead Inspector Neil McKenzie Key Unannounced Inspection 9th October 2006 11:30 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 Nursing Home DS0000000159.V313584.R01.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 Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chestnut Lodge Nursing Home Address 302 Norton Road Norton Stockton-on-Tees TS20 2PU 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) 01642 551164 Mrs Joan Mary Stead Mrs Dawn Anne Brown Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named individuals who are under the age category are allowed to reside in the home, until such a time as the placements are no longer required. 11th November 2005 Date of last inspection 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 stair lift is available to access the first floor. One bedroom as had an en-suite has been fitted with a toilet hand basin and shower 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 DS0000000159.V313584.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspection lasted for 6 hours. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards for Care Homes. During the visits the inspector spoke to 2 residents, 2 relatives and 2 staff to find out what their views were about living and working at Chestnut Lodge. The inspector also spent time speaking to the manager and the owner of the home. The inspector spent some more time watching how staff and residents are with each other. A tour of the home took place and records looked at included staff recruitment, staff levels and staff training records. In addition resident care plans, opportunity for social activity, and how the home handles money and medication were also looked at. There was also questionnaire sent to the home, this was looked at to help decide how good a job the home does in meeting the National Minimum Standards. At the time of the inspection the minimum cost for a bed was £327.00 per week and the maximum cost for a bed £413.00 per week. What the service does well: The home had a relaxed and welcoming atmosphere. Rooms seen at the time of the inspection were very much personalised with resident furniture, televisions, photographs and pictures. Resident and relative comments included: ‘We chose this home because it was more homely and staff appear really nice’. ‘So far so nice, staff very friendly’. ‘A lot better since moving here’. The home seeks views of residents with a satisfaction survey and uses this information to improve the home. The survey is summarised and made available to resident, relatives and other interested parties in the Statement of Purpose. The home is good at ensuring staff receive specialist training to meet the needs of residents living at Chestnut Lodge. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.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 Nursing Home DS0000000159.V313584.R01.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 Nursing Home DS0000000159.V313584.R01.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): 1, 3 and 6 The quality in this outcome area is good as residents’ benefit from a statement of purpose describing the services of the home and a needs assessment before moving into the home. This judgement has been made using available evidence from resident care records and interviews with staff and residents. Intermediate care is not provided at Chestnut Lodge. EVIDENCE: The statement of purpose is provided to prospective residents and gives a description about the persons responsible for the home and the care that is offered. Included in the statement are summarised copies of previous inspection reports, a recent resident satisfaction survey and a leaflet with photographs of the home. One relative stated, ‘ when choosing a home we received a leaflet on this one and we were impressed with the home’. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 9 3 resident records examined, and the 3 residents referred through Care Management arrangements had a copy of their needs assessment completed by a professionally qualified person. The needs assessment provided by external professionals was also complimented by a 48-hour assessment provided by the home to ensure resident needs can be met at arrival. Although intermediate care is not provided at Chestnut Lodge short term or temporary placements can be arranged. An example being a person could be admitted to the home for the management of a wound or pressure sore and then transferred home when the person is well enough. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.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 and 10 The quality in this outcome area is good. This judgement has been made using available evidence from resident files, the pre-inspection questionnaire, and interview with resident, staff and manager. EVIDENCE: In the 3 resident records sampled by the inspector each resident’s had a personal care plan that included daily records documented in their file. These plans and daily records were up to date in their recording and demonstrated involvement of other health specialists such as district nurses and doctors. As one resident stated,’ Doctor visiting to work with me and social worker been in today to see me and talk about things’ New residents have an initial 6-week assessment care plan that is reviewed before the final care plan is agreed. Included in these plans are details on activities, eating and drinking as well as medical and nursing requirements. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 11 Care plans included risk assessments on manual handling, nutrition, pressure sore and falls. These risk assessments involve relatives who have opportunity to sign them if in agreement. One resident stated as a result of his care plan, ‘ A lot better since moving here, I can get up and walk and could not do that before’. It was suggested to the manager that Care plans could be made more personal to the resident with a summary ‘life story and photographs’. During the inspection the home’s policy and procedures and arrangements for receiving, storing, administering, recording and disposing resident’s medication were observed, examined and discussed in depth with the manager. At the time of the inspection visit, medication was seen to be correctly stored with accurate records for administration. Separate records for controlled drugs were also counter signed by 2 qualified members of staff to ensure accurate records. However, the home must ensure they have a waste disposal contract for unused medication and a facility to de-activate controlled drugs no longer required by residents. The home must also ensure policy and procedures are updated to include these new procedures with regard to the disposal of drugs. Individual residents’ medication record sheets did not contain photographs of the person to help ensure that residents receive the correct medication. At the time of the inspection there were no residents who were administering their own medication. The residents’ who spoke to the inspector stated that staff treated them with respect and dignity. Comments made by residents included: ‘So far nice, staff friendly, polite’. ‘Nothing could be better, somebody every day helps me with my medication’. During the inspection it was observed helpful and polite communication and support between staff and residents. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 12 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 and 15 The quality in this outcome area is good. This judgement has been made using evidence from a tour of the home, observation, and interview with residents, staff and relative. EVIDENCE: Relatives interviewed stated they were made to feel welcome, ‘staff appear really nice and friendly’. Residents interviewed confirmed that family members visit them on a regular basis and are involved in their care plans. The manager described the home as having an ‘open door’ policy for visiting relatives. Residents who spoke to the inspector suggested there was enough activity that included trips out. On the day of the inspection a group of residents left for a planned day trip. These trips are planned on a weekly basis. Photographs displayed in the home showed residents enjoying a recent trip out. Other activity available for residents included games, invited entertainers, television and fun days. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 13 On the whole residents receive a wholesome and balanced diet with a choice of menu. On relative commented, ‘ He is eating quiet well which he has not done for some time’. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 14 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 and 18 The quality in this outcome area is good. This judgement has been made using evidence from the pre-inspection questionnaire and documentation of complaints and investigations and interview with staff. Residents are protected by a complaints procedure and a policy and procedure on adult protection and prevention of abuse. EVIDENCE: A complaints procedure is displayed in the home and is written in a plain format for the benefit of residents and visitors. Complaints are logged in a book. There have been no complaints recorded since the last inspection. The residents are protected by an Adult Protection and Prevention of Abuse policy. This was last reviewed in July 2006. Training on the protection of vulnerable adults is regularly organised by the manager and confirmed by the 2 staff interviewed on the day of the inspection. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 15 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, 24 and 26 The quality in this outcome area is good. This judgement has been made using evidence from a tour of the premises, the pre-inspection questionnaire and interview with residents. The residents live in a well maintained home. EVIDENCE: On the whole home provides a homely and clean environment that is well maintained. There was evidence of ongoing refurbishment with new conservatory, corridors and rooms freshly painted, fitted windows and plans to extend and existing bedroom and provide a room for smokers. At the time of the inspection the manager agreed to remove items stored on the top floor landing to improve appearance. Rooms seen at the time of the inspection were personalised with resident furniture, televisions, photographs and pictures. The home was free of unpleasant odours. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 16 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): 17,28,29 and 30 The quality in this outcome area is good. This judgement has been made using evidence from, the pre-inspection questionnaire, rota, staff files and interviews. EVIDENCE: An audit of the duty rota was carried out. At the time of the inspection there were 16 residents living at the home. There was 1 nurse and 2 care assistants during the morning shift. There was 1 nurse and 2 care assistants during the afternoon and evening shift. Included in the day shift and supporting all the residents in the home a chef and 1 domestic. There was 1 nurse and 1 care assistant on the rota for the night shift. The manager has promoted National Vocational Qualification (NVQ) Level 2 and 3 in Care training to staff to offer residents’ safe and competent staff. At the time of the inspection 55 of care staff had an NVQ level 2 or 3 in Care. In addition there was evidence of staff completing training specific to resident needs. For example, training in Dementia awareness and palliative care level 1 and 2. The recruitment files of 3 staff were looked at. All files contained application forms and were backed up by two written references. Evidence was in place to show that Criminal Records Bureau disclosures at Enhanced level had been received for staff members working in the home. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 17 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 and 38 The quality in this outcome area is good. This judgement has been made using evidence from the pre-inspection questionnaire, interview with the manager, staff files, and records. The home is run and managed by a person who is fit to be in charge. EVIDENCE: The manager has been in post for 10 years. The manager is a qualified nurse and has a certificate National Vocational Qualification in management Level 4. The manager conducted the inspection in a friendly and knowledgeable manner. The 3 staff files examined demonstrated that supervision was not happening on a regular basis. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 18 Staff training portfolio demonstrated regular training on health and safety, fire awareness and other mandatory requirements. The home has annual resident and relative surveys to ensure the home is run in the best interests of residents. The results of resident surveys are published and made available to current and prospective residents and other interested parties in the Statement of Purpose. This includes a summary report of the last inspection. A random sample of resident’s personal allowances and records were examined and there were no discrepancies with the balance stated on the transaction sheet and the actual amount contained in the individual money envelope. The transaction is made more robust by ensuring that there are two signatures recorded on the transaction sheet. Details of health and safety were made available through the pre-inspection questionnaire and tour of the premises. These records were recorded as up to date, however, relevant certificates on request for gas and electric testing were not available on the day of the inspection. The health and safety of residents, staff and visitors should be maintained by a record of people in the home in accordance with the requirement of the Fire Officer recommendation. The home must also ensure the kitchen has a lockable facility to make safe when not used by staff. This should include a risk assessment. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 19 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13 (2) Requirement The registered person must make arrangements for the safe disposal of medicines received into the care home. The registered person must ensure that access to the kitchen by residents is free from hazards. Timescale for action 31/10/06 2. OP38 13 (4) 31/10/06 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. Refer to Standard OP38 Good Practice Recommendations The health and safety of residents, staff and visitors should be maintained by a record of people in the home in accordance with the requirement of the Fire Officer recommendation. The manager should ensure residents benefit from staff who have regular supervision on the work they do. 2. OP36 Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 21 3. OP9 Individual residents’ medication record sheets should also contain photographs of the person to help ensure that residents receive the correct medication. Chestnut Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 22 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 Lodge Nursing Home DS0000000159.V313584.R01.S.doc Version 5.2 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!