Inspection on 27/04/05 for Chestnuts

This inspection was carried out on 27th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Chestnuts 30/04/08

Chestnuts 19/06/06

Chestnuts 27/09/05

Chestnuts 07/09/04

Chestnuts 26/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Chestnuts Yapton Road Barnham Bognor Regis PO20 0AZ Lead Inspector Mrs H Church Unannounced V223809 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chestnuts Address Yapton Road, Barnham, Bognor Regis, West Sussex, PO20 09AZ 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) 01243 554679 Cottage & Rural Enterprises Limited (Care) Miss Joanne Targett Care Home 6 Category(ies) of Learning disability (LD) registration, with number of places Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 6 Persons in the category LD (Persons with Learning disabilities) Date of last inspection 07/09/04 Brief Description of the Service: Chestnuts is detached modern house situated in a residential area in the village of Barnham, Bognor Regis, close to the main line railway station, public transport and local shops. It is registered to accommodate up to six residents in the category LD (Learning Disability) aged 18 to 65 years. All of the rooms are single rooms with the accommodation arranged over two floors There is a large lounge/dining room, a kitchen/diner and separate laundry room. The registered providers are ‘CARE’. The responsible individual on behalf of the charity is Mr Michael Keighley. The manager is Ms Jo Targett who has been registered as manager since December 2004. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, under the Commission for Social Care Inspection was undertaken at a time when residents were returning from their work or day care placements and would have been able to spend quality and unlimited time with the inspector to share their views of their life at Chestnuts. To prepare for this unannounced inspection, previous reports were reviewed, letters sent to the commission re-read and any formal paperwork sent to the commission of incidents and accidents that had happened to individual residents or had in general affected the smooth running of the home were examined. Two documents, namely the Statement of Purpose and Service Users Guide are provided to inform residents of how they may expect the home to be run and how they can make their views known to change any of the way things are arranged that will improve their lives there. These documents need to relevant and clear as they form the basis on which care and services are provided. These were examined and checked to see that each resident and their representatives have received this. During the inspection, all of the six residents living at the home were seen privately and records examined to see if they matched the way that the residents said they lived their lives there. All of the residents’ comments were very enthusiastic and all were fulsome in their praise of their life there with one resident saying “This is my home”. It was clear that residents are encouraged to contribute in all areas with recent examples of this being that one resident told me she had chosen the new table and chairs in the dining area and another resident said when showing the inspector the partly refurbished bathroom, “We are all going out to chose the tiles”. For their evening meal, the residents had agreed between them they all wanted to have own choice and were being supported by staff where necessary to cook their different choices to fit in with their evening arrangements. As the inspector left, some residents were in the kitchen either cooking their chosen meal or sitting at the kitchen table sharing what had happened during the day or discussing their plans. There was clearly a family life at the Chestnuts with residents feeling highly valued, consulted about every aspect of their lives and supported to choose their own futures both inside and outside the home. Residents said that Chestnuts is their home and they were very happy there. Records showed that staff provide the appropriate amount of support. There were no aspects of the inspection that required an immediate response or remedy. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There were few aspects of Chestnuts care that could be improved. However, staff do need continual support and training to maintain the agreed levels of independence and risk taking agreed for each resident. Although this support was provided on a day-to-day basis, it was clear from the comments of a new, but experienced member of staff that she was unfamiliar with the variety of Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 7 work being done by the day care specialists. The supervision, training and monitoring of staff as they develop their skills needs to cover these aspects. 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. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 to 4 Trial visits are provided according to the needs of the individual and the acceptance of the other residents so the individual can make an informed choice of where to live. Residents’ collective and individual aspirations and needs are discussed with all parties able to contribute an opinion. Care plans are well documented and continually updated to support the care needs of the residents. Residents are kept fully informed about the way care and services are provided and have received contracts and the necessary documents relating to the home. EVIDENCE: All of the residents were spoken with privately and four were seen again in the kitchen as they were cooking or preparing their chosen meal. The enthusiastic comments from all six residents on the way they lived their lives from group or individual activities was clear evidence that the home is being run according to the residents needs and wishes. Four care plans were examined after the individual discussions to see if they matched the way the residents were living their lives and their future expectations. All of the records accurately reflected the care being provided, the risk levels supported and their future aspirations and the work being done to try and achieve these. One of the residents said he felt unsettled recently but he was talking about this to “S”. Records showed that this was an independent counsellor from a local organisation, set up to support people who Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 10 are experiencing social exclusion or at risk of being socially isolated through various disabilities. The trial visit of the last resident was clearly recorded and a number of visits of varying lengths were provided. At that time the manager had not been involved in the initial assessment but for future admissions, the manager will be involved in this process so she will be fully conversant with all the care needs of the individual and the other residents. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 to 9 The outcome for residents was good. All six residents were clearly enthusiastic about the way Chestnuts was a home to them and talked about their input in to the choice of furnishings, curtains, bathroom tiles and furniture. Four residents said they were having a free choice for tea. All of the residents talked of themselves, what was happening for them and what they were going to do and who they were going to see. EVIDENCE: Four individual care plans were examined and they all matched the care the residents had been describing. One resident proudly said she had chosen the new dining room table and chairs. Another resident told the inspector that he and the others were going to choose the new bathroom tiles and proudly showed off his garden and the new raised flower beds designed by him but made by CARE’s main site. The residents had agreed that the canaries were too noisy for their original site in the lounge so they all worked together and made an outside aviary. One resident said this was “much better” and according to the manager was easier for cleaning and maintenance. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 12 Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 to 17 The outcome for residents was good. All six residents were very enthusiastic about the lives they led. Residents have the opportunity to pursue and take part in group and individual activities both inside and outside the home with each other and other friends and enjoy activities within the local community. Forming relationships are encouraged with appropriate risk assessments in place. EVIDENCE: Records showed that resident’s leisure activities and personal family contacts were being maintained and had goals set to develop these. Resident’s comments of these aspects of their lives did match the written records and from the work being undertaken by key workers and the comments made by the member of staff on duty, it was clear that each resident was being provided with opportunities to develop their individual lives through activities, contacts from their peer group and families and the responsibilities they had been encouraged to take both in and outside the Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 14 home. Neighbours had attended barbeques and residents commented on these events. Residents spoke about their plans, one was going out with her sister for the evening whilst another was forming a new friendship with someone from outside CARE. Residents spoke of “looking after the rabbits”, “the canaries” and “growing these (vegetables) for our meals”. Two residents were attempting some weight loss and had set up a chart seen partially completed on the kitchen wall to chart their progress. The meals being unpacked from a shopping trip included foods based on healthy living with reduced fat and sugar items, which both residents were clearly planning to include in their diet. Residents said they had opted for a “free choice” meal for the evening of the inspection and this was very popular with much laughter and chatting between all parties during this process. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 to 21 The outcomes for residents were met. Although generally none of the residents require physical personal care all residents require supervision. One resident had recently had broken her leg and this involved everyone in the home changing and moving furniture and fittings to support her during the healing process. Therefore it was clear that when a need for this arises, Chestnuts are able to offer all support. EVIDENCE: Four care plans were examined and all of these showed evidence of updated emotional health care needs with strategies to meet residents changing needs The commission had received accident reports of the resident who had broken her leg and the strategies put in place to support her through the incident and the healing period. The resident did not wish to enlarge on this incident but she clearly remembered the event and was happy with the outcomes. Two residents were being supported to take medication during the inspection process and it was clear from their comments that staff were aware of the support required. All medication was stored in a locked cabinet in the manager’s office and was only accessed through the senior person on duty. All four care plans showed the support required when being involved in death. One resident was upset about the theft of his plant from his mother’s grave and with the manager was planning to provide a memorial at Chestnuts for Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 16 him to visit without fear of this being tampered with. A memorial to a previous resident was already in situ in the garden and time had proved this was a good focal point for remembering this resident. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 This standard was met as it was clear that residents are protected from abuse, self harm or neglect and felt listened to on all aspects of their daily lives. All six residents spoke of different events in which they had been supported. EVIDENCE: It was clear that residents’ views are listened to and acted upon as the residents were taking part in a “free choice” meal and each of them was anxious to talk about their individual choices. The residents found a solution when the canaries were proving too noisy in the lounge and worked together to provide an aviary in the garden. Each resident had been given a free choice of a holiday, which ranged from “Disney World in France”, “Norfolk”, “Warwickshire” and “Tenby”. One resident was very excited about his plan to go to Ireland. Two outside organisations provide independent advocates and records showed that one of these organisations is supporting that one resident. The Regulation 26 Notices showed that residents have a “Good and Bad Book” for residents comments. Residents have house meetings regularly and records showed that their wishes were being carried out. Examples of this are the decisions about the canaries and the arrangements made to help a resident who had broken her leg. An independent advocate attends to support residents. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 18 The current West Sussex Multi-Agency Policy and Procedure for protecting vulnerable adults from abuse was available in the home and the new member said she had received training in this. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 to 30 The communal areas and resident’s bedrooms were clearly meeting all parts of these standards and therefore outcomes for residents were good. Improvements had taken place to improve facilities with more improvements being made. EVIDENCE: The lounge/dining room was of a suitable size and decorated, refurbished and arranged to allow all six residents to participate in activities. The computer had been assessed for access by individual residents and been moved out of the lounge so residents could play computer games without disturbing other residents watching television. All areas were seen to be clean and welcoming and even where the bathroom was partly refurbished, this was clean and welcoming and fully useable. Resident’s rooms were of a good size and decorated in an individual style with personal items arranged according to their wishes. One resident was very proud of his display of pictures whist another showed his video collection. All residents said how much they liked their room. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 20 Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 to 36 Recruitment procedures support the need for a competent and qualified staff team who are able to provide residents individual and group needs. EVIDENCE: The resident’s care plans showed the support required for maintaining and developing all aspects of daily living was being monitored and from the residents’ comments, this matched the records. Four care plans were examined and it was seen that the support required was being provided. One new member of staff spoke about her previous experience working in another care home and her training with CARE. She said this complemented and updated her previous training. Two other staff are obtaining national Vocational Qualifications with two others qualifying in National Vocational Qualification level 3. A robust recruitment process shows three references required which exceeds the standard. The relaxed atmosphere between the manager, the member of staff and the residents was apparent throughout the inspection with residents deciding how they wished to spend their evening, what support they wanted and were able to discus freely any concerns they had over the day’s activities. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 to 40 and 42 to 43 The management style benefits and protects residents who feel confident their views are respected whilst acknowledging their rights as citizens. EVIDENCE: Four care plans showed that all aspects of each resident’s health, safety and welfare needs were being recorded with strategies being put in place to meet these. Records are well maintained and kept in a locked filing cabinet in the office. All six residents were able to express their views with confidence and were willing and eager to share their experiences of life at Chestnuts with me at all times during the inspection process. All of the comments were very positive and even where one resident is receiving counselling, the comments were very good. Residents demonstrated that their choices were respected in every aspect of life from decorating their rooms, the choice of food, the activities, the responses to their suggestions and the open days when relatives, friends and Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 23 neighbours are welcomed. At the time of the inspection, residents were planning their individual days out with their key workers. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 4 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 4 4 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chestnuts Score 4 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x 3 3 H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 25 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 No Regulation Requirement Timescale for action 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 36 Good Practice Recommendations Supervison must be provided at the required intervals. Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 26 Commission for Social Care Inspection 2nd Floor Ridgeworth House Worthing West Sussex BN11 1RY 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 Chestnuts H60-H11 S223809 Chestnuts V223809 270405 Stage 1.doc Version 1.30 Page 27 - 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!