Inspection on 13/03/07 for Chestnut View Care Home

This inspection was carried out on 13th March 2007.

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 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 View Care Home 02/04/09

Chestnut View Care Home 16/07/07

Chestnut View Care Home 15/06/06

Chestnut View Care Home 27/10/05

Chestnut View Care Home 30/08/05

Chestnut View Care Home 06/07/04

Chestnut View Care Home 19/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Chestnut View Care Home Chestnut View Care Home Lion Green Haslemere Surrey GU27 1LD Lead Inspector Pauline Long Unannounced Inspection 13th March 2007 07.45 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 View Care Home DS0000013849.V330017.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 View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chestnut View Care Home Address Chestnut View Care Home Lion Green Haslemere Surrey GU27 1LD 01428 652622 01428 651145 admin@chestnutview.plus.com 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) St Cloud Care Plc Susannah Stanesby Care Home 60 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (48) of places Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE Up to twenty (20) of the sixty (60) service users may be accommodated for nursing care, four (4) of whom may be terminally ill (TI). 15th June 2006 Date of last inspection Brief Description of the Service: Chestnut View is a large detached property set in private gardens. The service currently provides twenty-four (24) hour care for up to sixty (60) older people. The property is close to the local town centre and is within walking distance for those who are able to walk short distances. The home has undergone significant refurbishment including the garden; a separate unit for service users with dementia has been opened. The dementia unit has a separate garden for their use. St Cloud Care plc purchased the property from Surrey County Council, the previous owners in November 2001. Fee levels for 2006-2007 are as follows: levels shown are minimum to maximum fees charged. Residential £540 to £565 Residential respite care £575 Residential with nursing £680 to £715 Residential with nursing respite care £690 Dementia unit £675 Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second site visit of a key inspection and was unannounced. The inspection was carried out by Mrs P Long regulation inspector and lasted for 6.5 hours, commencing at 07.45 and ending at 14.00. Discussions were held with residents, the managers, care staff, other health care professionals and visitors to the home. Service documentation was sampled, and included residents files, care plans, staff records, and service files. Care staff were observed going about their work. A tour of the home took place. Some residents were keen and happy to talk about life in the home. Verbal feedback from other resident’s at home was limited, in view of their communication difficulties. However their body language, facial expressions and observations of their interaction with each other and care staff, evidenced a state of general wellbeing. The CSCI would like to thank the residents, relatives, the managers and staff for their hospitality, assistance and co-operation during the site visit. What the service does well: The manager and care staff demonstrated an open, inclusive approach to the residents care. Some of the staff team have worked in the home for several years and this is reflected in the level of knowledge and understanding of the needs and preferences of the service users. The home promotes and encourages contact with family/friends and the local community. Residents, relatives and visitors spoken with were complimentary about the care and services provided by the home. The residents commented that, they always get the care and help they need, “that the care they received was good” and “that the staff do their best”. One local health care professional commented, that the home now communicates clearly with them, and that staff demonstrate a better understanding of residents needs and take appropriate decisions if needs change. The local General Practitioner commented that, medication is well managed in the home. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Whilst it is noted that the care plan documentation is much improved. There was no evidence to indicate that residents are being encouraged or given the opportunity to agree with and sign their care plans. Staff signatures were also missing on one care plan from the nursing unit. On the whole residents are protected by the homes medication procedures and practices. However one senior member of staff was observed as not adhering to these procedures, this indicated that there was a shortfall in their understanding of the procedures and practices. It was noted that the policies and procedures to safeguard residents from abuse have been revised to reflect the local authority. However the manager has yet to attend the multi agency safeguarding training in this respect. A requirement was made at the previous inspection in respect of the overall environment. Whilst it was noted that some redecoration has been undertaken in the resident’s bedrooms, some of the communal areas require urgent attention. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 7 Staff training in respect of manual handling practices, staff awareness around dignity, respect and communication with residents must be reviewed to ensure that all residents are treated with dignity and respect. Containers of gel sanitizers and liquid toiletries were easily accessible by residents, who may be confused, and this had the potential to pose a considerable risk. Risk assessment must be carried out in order to ensure the risks to residents are minimised. Requirements have been made in respect of these standards. Please refer to pages 27 and of this report. 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. The summary of this inspection report can be made available in other formats on request. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 8 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 View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are only admitted to the home following a comprehensive assessment of their needs. The home does not provide an intermediate care service. EVIDENCE: Referrals to the service come from privately funded and social services clients. The manager described the procedure and process for admitting a prospective resident. Following a referral from a private individual or social services care management team, one of the managers would visit the prospective resident at their home or hospital to carry out a care needs assessment. The prospective resident would then be encouraged to spend time at the home prior to making a decision as to whether the home could meet their needs. One resident commented that, the manager came to visit her at her home before she came to live at the home and asked her questions about her health and the things she likes to do. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 10 Improvements have been made in the homes pre admission care needs assessment process. A new format has been developed to include all daily living activities, religious and cultural needs. Four of the residents care needs assessments were sampled and were found to provide a holistic view of the residents care needs, for example, health, social care and spiritual needs likes and dislikes were recorded. The home does not provide an intermediate care service. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans are good and resident’s health care needs are well met. Residents are not responsible for their own medication and are protected by the homes medication policies and procedures. However improvements are required to ensure that all staff adhere to the homes medication policies and procedures. On the whole staff were observed to treat residents respectfully and their right to privacy was upheld. Improvements are required in respect of staff awareness around promoting a resident’s dignity and in safe moving and handling practises. EVIDENCE: Four of the residents care plans were sampled, two from the residential unit, one from the reminiscence unit and one from the nursing unit. The residents care plans were good, well documented and had been reviewed. The documentation contained information regarding all activities of daily living, Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 12 changes in healthcare needs, various visits from health care professionals and social and cultural needs being met. Three out of the four care plans had been signed and dated by a representative from the home. One had not been signed or dated. None of the care plans sampled had been signed by the resident or their representative. Residents commented “that the care they received at the home was good” and “that the staff do their best”. One local health care professional commented, that in the past there were concerns around some aspects of care practice in the home. However things were much improved. They commented that the home now communicates clearly, and that staff demonstrate a better understanding of residents needs and take appropriate decisions if needs change. A Discussion was had with a local General Practitioner. She commented that, all aspects of medication were well managed in the home. On the day of the visit, medication administration was not observed. However one member of staff was observed dispensing a resident’s medication. Discussions were had with this member of staff as to the timing of this. He commented that the resident refused their medication on the morning round and now wished to take it. The medication record sheets were sampled and it was evidenced that the member of staff had signed the record during the morning medication round. Medication procedures were discussed with him at the time and he agreed that they had not followed the homes procedures. The storage of all medication was found to be good, including controlled medication. Medication record sheets were sampled, and were found to be well kept, with no gaps in signatures. The home has implemented an audit on the procedures and practices around medication and good records were kept in this respect. Discussions were had with the care staff about the homes medication policies and procedures. It was evident through discussions, that staff had a good understanding of these policies and procedures. The care staff commented, that only those staff, who have undergone training in administration of medication and who are assessed as competent are permitted to administer medications. The managers commented that the staff undertake regular updates and training on medication administration. Training records evidenced this. Through out the inspection process, staff were observed carrying out various aspects of personal care for the residents, on the whole support was offered in a respectful and dignified manner. Staff were observed knocking on doors and waiting to be invited in, before entering rooms. Residents commented that they were treated with respect. One member of staff was observed as being somewhat brusque in her approach to one of the residents on the nursing unit. This was brought to the manager’s attention at the time. A member of staff on the ground floor was attending to a resident who had fallen. He appeared Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 13 not to have an understanding of safe moving and handling procedures. He was observed to reach under the resident’s arms in order to lift them up from the floor. One of the managers intervened and the resident was supported from the floor in appropriate and safe way. Requirements were made in respect of these standards. Please refer to pages 27 and 28 of this report. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are encouraged to make choices and enabled to maintain fulfilling lifestyles in and outside the home. The home promotes contact with family, friends and the local community. Meal times in the home were observed as being a mostly positive and pleasant experience for the residents and the food looked appetizing. Improvements are required in respect of staff awareness at meal times. EVIDENCE: The home is committed to ensuring that the residents maintain their relationships with their family and friends. Residents commented that they receive regular visitors and some were visiting the home on the day. There were various flyers posted on notice boards, relating to future outings/activities. Care plans evidenced that residents have an activities schedule, some of the schedules sampled evidenced that residents are encouraged to undertake various activities during the day. Examples of activities included home and social skills for example: knitting, sewing and bingo. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 15 Some residents were enjoying watching the television in their bedroom. On the day of the visit several residents were taking part in a quiz and several went out on a trip in the afternoon. One resident commented that “the staff were always trying to get tem involved in doing things, but they just liked to watch what was going on out on the road. Another resident commented that she attends the church service every Friday at the home, and that if she wished to go out to the local church the home would arrange this for her. One relative commented that her relative found staff “friendly and welcoming and she enjoyed the activities organised”. Throughout the visit, residents were observed moving freely around the home, making choices as to where they would sit and what activities they would take part in. One member of staff was observed handing a resident a biscuit, they did not offer the resident a choice in this respect. This was discussed with the manager following the site visit. The meals are freshly cooked in the home and it was positive to note, the choice, quality and quantity of food on offer. The food was served up from a hot trolley to the dining room tables. One resident commented that the food was not always warm enough. Other resident’s commented that, the food was nice, and it was hot enough. They appeared to be enjoying their meal. Care staff, were observed encouraging the residents to eat their food and assisting those residents who required help. It was noted that one member of staff was standing up whilst supporting a resident to eat their meal. This lack of staff awareness was discussed with the manager. Discussions were had with the manager in respect of the chef spending time with the residents to seek their views about the food. The manager stated that the chef speaks with the residents on a regular basis and that the comments are recorded. These records were not sampled. One resident commented that the chef asks them about what food they like and dislike. A requirement has been made in respect of these standards. Please refer to pages 27 and 28 of this report. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected by the homes policies and procedures around concerns, complaints and the protection of the residents. EVIDENCE: The CSCI have received one complaint about this service since the last inspection. The complaint was investigated by the service and has been satisfactorily resolved. Residents commented that they were aware of the complaints procedures and if they had to make a complaint they were confident that it would be dealt with in a timely manner. The homes complaints records were sampled, and evidenced that any complaints received had been responded to according to the homes procedures. Three referrals have been made under the local authority multi agency Safeguarding Adults procedures. Meetings have been held in this respect and the issues have been resolved. Discussions were had with some of the staff on duty, and scenarios put to them in respect of the home’s Safeguarding Adults procedures. Staff interviewed demonstrated a good understanding of the policies and procedures. The staff stated that adult abuse was covered in the homes induction training and refresher updates were held, this was evidenced in the homes training records. The manager has not undertaken the local authority multi agency Safeguarding Adults training as yet. A requirement has been made in respect of these standards. Please refer to pages 27 and 28 of this report. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst overall the standard of the environment within this home is good and meets the needs of the residents, improvements are required in respect of the hygiene standards and decoration in some of the communal areas. EVIDENCE: Overall the environment was found to be satisfactory, and provides a reasonable standard of accommodation. Some of the resident’s bedrooms were sampled, and were found to be nicely personalised, there were photographs of family members and other personal items. The main sitting and living areas were comfortable, and had ample armchairs. It was noted that in the absence of a footstool, one resident legs had been elevated in a wheelchair. This was brought to the manager’s attention and was addressed immediately. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 18 A requirement was made at the last inspection in respect of the general decoration in some areas of the home. Whilst it was noted that some of the resident’s bedrooms have been redecorated, communal areas now require urgent attention. The dining room on the ground floor requires particular attention, the walls stained as a result of liquid spillages and marks from wheelchairs and trolleys. The skirting boards and the general paintwork were dirty and chipped. The kitchenette area in the reminiscence unit was dirty. Wheelchairs sitting around the home were also observed as being soiled with food debris. Requirements have been made in respect of these areas. Please refer to pages 27 and 28 of this report. Chestnut View Care Home DS0000013849.V330017.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing levels were adequate for the resident’s dependency levels/numbers. Residents are protected by the homes recruitment practices and staff training. Improvements must be made in respect of staff training around medication procedures, safe moving and handling practice and staff awareness in respect of their approach to residents needs. EVIDENCE: The home employs a diverse staff group. On the day staffing levels were adequate for the dependency level of the residents, and consisted of 11 care staff, one registered nurse, the manager and the deputy manager. The homes recruitment practices were sampled and were found to be good. Three staff files were sampled and all had the required documentation in place. Good records were kept in respect of the interview process. It should be noted that, since the last inspection, the homes administrator has worked hard to ensure that all of the required documentations was in place. Discussions were had with staff, who, talked about their job roles and responsibilities. There was clarity and an awareness of the different roles and responsibilities within the home. Work based observations evidenced confident staff carrying out their various tasks. Staff also discussed the training opportunities in the home and commented that the manager had given training a high priority. Training records demonstrated that statutory Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 20 and various current good practice training had been undertaken since the last inspection for example, health and safety, food hygiene, first aid, medication, challenging behaviours, dementia care, care planning and infection control. The home is proactive in promoting NVQ (National Vocation Qualifications). Several members of care staff are undertaking NVQ level 2 and some of the senior staff are undertaking NVQ level 3. The deputy is undertaking NVQ 3 and the manager is undertaking the Registered Managers Award. The manager commented that the home does not provide a specific training course in equality and diversity, but stated that the training and development programme would be amended to include this. She also commented that, the staff undertaking an NVQ would cover equality and diversity during this training. Training sessions are offered at different times of the day to meet the needs of the staff who may have carer responsibilities at home, or who work antisocial hours. As discussed earlier in this report, some of staff must undertake further training in manual handling, safe handling of medications and awareness around communication with and approach to the residents. Requirements have been made in respect of these standards. Please refer to pages 27 and 28 of this report. Chestnut View Care Home DS0000013849.V330017.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced, qualified and competent to run the home. The residents and staff benefit from her management approach. Resident’s financial interests are safeguarded by the homes financial procedures and practices. Staff are appropriately supervised. Improvements are required in respect of some health and safety procedures and practices, to ensure the continued health, safety and welfare of residents. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager is a qualified registered nurse, she is experienced and competent. She is undertaking the registered managers award. Care staff commented that the manager had a “hands on” approach and was “firm but fair”. Health care professionals visiting the home, commented, that the home was much improved since the current manager started working there. The home has implemented a service user questionnaire. These were sent to the resident’s families. The response was positive, with many of the questionnaires being returned. Comments included “ very high standards in all areas” “some of the staff are very cheerful and helpful, others could be better” “ couldn’t have better care” “found staff friendly and welcoming” “ my relative enjoyed the activities organised” However there was no evidence that to indicate that the residents had received a questionnaire. The manager stated that the residents had not been included in the service user questionnaire, but she would ensure that in the future this would be addressed. One resident commented, that “she was invited to a residents meeting”. She had been provided with a copy of the minutes of this meeting and was keen to show the minutes to the inspector. Discussions with the care staff indicated that a formal one to one staff supervision programme had been implemented in the home. Records were sampled, and evidenced that staff had received a formal one to one supervision meeting with either the manager or deputy. Staff commented that they are also expected to attend regular team meetings. Minutes are kept of all of the meetings held at the home. The minutes of team meetings were not sampled on this occasion. Discussions were had with the homes administrator in respect of resident’s personal monies. She stated that resident’s families/representatives had overall responsibility for resident’s monies and that the home would only hold small amounts of money, in the case of an emergency. Records in this respect were sampled and were found to be good. One minor discrepancy was noted however this was addressed immediately. Health and safety checks carried are routinely carried out at the home. Records evidenced that water temperatures, fire drills and fire bells had been regularly checked. All equipment in the home had been properly maintained and serviced. There were two health and safety issues identified. The control of hazardous substances (COSHH) cupboard was unlocked. This issue was addressed by a member of staff at the time. It was noted that bottles of hand sanitising gels and liquid toiletries were left in various places through out the home. The managers commented that there had been a recent outbreak of vomiting and Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 23 that these were being used to minimise this. However a significant number of the residents living at the home have various levels of confusion. Risk assessments must be carried out on all sanitizing gels and liquid toiletries to ensure that residents are not put at risk in respect of these. Requirements have been made in respect of these standards. Please refer to pages 27 and 28 of this report. Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 24 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 N/A 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 2 X X X X X X 2 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 3 X 2 Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 12(3), 15 Requirement The registered person(s) must ensure that all care plans are signed and dated by a representative from the home. The registered person(s) must ensure that all residents or their representatives are encouraged and given the opportunity to agree to, and sign their care plans. If this is not possible then the reasons for the lack of signatures must be clearly documented in the individuals care plan. The registered person(s) must ensure that all members of staff are following the homes procedures in respect of the safe administration of medications. The registered person(s) must ensure that they make proper provision for the care and treatment of service users: all staff must have an understanding and an awareness of resident’s needs in respect of meal time activities. Staff must provide dignified and sensitive support to residents at DS0000013849.V330017.R01.S.doc Timescale for action 13/04/07 2. OP7 12(3), 15 13/04/07 3. OP9 13(2) 13/04/07 4. OP15 OP30 12(4)(a) 18(1)(a) 13/05/07 Chestnut View Care Home Version 5.2 Page 26 5. OP18 13(6) 6. OP19 23(2)(b) (d) 7. OP30 18(1)(a) 8. OP38 13(4)(a(b (c 9. OP33 24(2)(b) mealtimes. The registered person(s) must ensure that the manager undertakes the local authority multi agency training in respect of safeguarding adults. The registered person(s) must ensure that all parts of the home are kept clean and reasonably decorated. The communal dining rooms must be kept clean, in a good state of repair and decoration. The registered person(s) must ensure that all staff have the training required to undertake their role. The member of staff referred to in the body of the report must undertake a refresher course in manual handling. The registered person(s) must ensure that all risks to the residents are minimised. Risk assessments must be carried out and documented on all of the sanitizing gels, liquid soaps and toiletries which residents have access to. The registered person(s) must ensure that resident’s views are sought across all areas of the organisation’s quality assurance. The residents must be included in the yearly service user questionnaires. 13/05/07 13/04/07 13/05/07 13/04/07 13/07/07 Chestnut View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 27 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 View Care Home DS0000013849.V330017.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 View Care Home DS0000013849.V330017.R01.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. 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