Inspection on 27/09/05 for Chestnuts

This inspection was carried out on 27th September 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 27/04/05

Chestnuts 07/09/04

Chestnuts 26/07/04

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Southfields

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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 West Sussex PO20 0AZ Lead Inspector Mrs H Church Announced Inspection 27th September 2005 02:00 Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 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 Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 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 Adults 18-65. 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. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chestnuts Address Yapton Road Barnham Bognor Regis West Sussex PO20 0AZ 01243 554679 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) CARE (Cottage and Rural Enterprises Ltd) Miss Joanne Targett Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 persons in the registration category LD (persons with learning disabilities) 5th May 2005 Date of last inspection Brief Description of the Service: Chestnuts is registered to accommodate up to six service users in the category LD (Learning Disability) aged 18 to 65 years. The establishment is situated in the village of Barnham, close to train and bus services and local shops. All rooms are for single occupancy. The service is a voluntary charity. The registered providers are ‘CARE’. The responsible individual on behalf of the charity is Mr Michael Keighley and the registered manager is Ms Joanne Targett. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection, under the Commission for Social Care Inspection was undertaken during the afternoon at a time when residents may be present in the establishment having returned from their work or day care placements. To prepare for this announced inspection, previous reports and documents were reviewed that may have affected the smooth running of the home or residents lives. The Statement of Purpose and Service Users Guide inform residents of how they may expect the home to be run and how they can change things to improve their lives there. These documents need to relevant and clear as they form the basis on which care and services are provided. During the inspection, all of the two residents living at the home were seen privately and records examined of four residents to see if they matched the way that the residents said they lived their lives there. Both residents’ comments were very enthusiastic and all were fulsome in their praise of their life there. 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. There were no requirements or recommendations made at this inspection. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 6 What the service does well: 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. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 1 to 4 Trial visits are provided according to the needs of the individual and residents’ collective and individual aspirations and needs are included. Residents are fully informed about the care and services are provided and have received contracts and the necessary documents relating to the home. EVIDENCE: Two residents were spoken with privately and from their enthusiastic comments about the group or individual activities they had attended or contributed to it was clear that the home is being run according to the residents needs and wishes. Trial visits were recorded and a number of visits of varying lengths were provided. 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. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 6 to 9 The residents are clearly involved in all aspects of their care and supported to take identified risks according to their lifestyle. Information was kept confidentially according to their wishes. EVIDENCE: Four individual care plans were examined and they all matched the care the residents received. Residents are involved in choosing refurbishment and redecoration items and as part of the plan of care, take responsibility in caring for the rabbits and budgerigars, part of the garden and contribute to their own personal needs where appropriate. Two residents showed the inspector their new budgerigars and talked of their responsibilities with these. Another resident talked of her decision to take a part of the garden to work in. Both residents talked of the courses and day care activities they are involved in. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 11 to 17 All residents are consulted about their leisure activities both in the local community and at the main site where day care is provided. All residents have a choice of meals and are involved in menu planning. 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 home. Neighbours, families and friends had recently attended the barbeque and music event at the home and residents commented on this. Residents also spoke about their individual plans with their friends and families and were clearly supported to maintain these. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 18 to 21 All residents require supervision and all physical and emotional needs were met. Chestnuts are able to offer all support at all times. 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 and the strategies put in place to support them. Residents are supported where appropriate to take medication that is required during the time of absence from the home, either when attending day care or leisure activities. 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. This has occurred for many residents and full support is given at all times when needed. A memorial to a previous resident in the garden has proved a good focal point for remembering this resident. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 22 and 23 Residents are protected from abuse, self harm or neglect and felt listened to on all aspects of their daily lives. EVIDENCE: It was clear that residents’ views are listened to and acted upon as the residents discussed their choice and care of their pets, the prospect of choosing new tiles for the bathroom, their choice of meals and holidays. Two outside organisations provide independent advocates who attend the residents house meetings, which are held regularly with minutes kept of resident’s wishes. The Regulation 26 Notices showed that residents have a “Good and Bad Book” for residents comments. A recent complaint made was partially substantiated and it was clear that every effort was being made to rectify this disappointment. Training in Protection of Vulnerable Adults is considered a high priority and the member of care staff spoken with said he was intending to attend the update when the date has been agreed. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 24 to 30 The communal areas and resident’s bedrooms met all parts of the standards and a continuous programme of improvements is being met. 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 is nearing completion, this is 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 telling the inspector of her plans to redecorate in the colour she had chosen. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 14 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 32, 34 and 35 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 to 36 Recruitment procedures are in place and training and supervision is being provided. EVIDENCE: A new member of care staff is shortly to be recruited and this process was discussed with both the manager and her manager who was present during the inspection. A short list of suitable candidates had been drawn up and those I invited to attend an interview will be invited to the home to spend some informal time with the residents. The residents had planned to ask specific questions regarding their views on aspects of life that may comply or conflict with their own held views to help them make a valid contribution to the interviewing process. All care staff have completed National Vocational Qualifications level 3 as well as the mandatory courses provided by the organisation. The previously examined 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 DS0000014446.V252752.R01.S.doc Version 5.0 Page 15 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following 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. Residents’ rights, health and safety are well met. EVIDENCE: The manager has recently achieved National Vocational Qualifications level 4 and the Registered Managers Award. Her manager style was clearly commended by the member of care staff and implicitly by the residents. Care plans showed that all aspects of each resident’s health, safety and welfare needs are being met. Records are well maintained and kept in a locked filing cabinet in the office. All residents are 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 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 neighbours are welcomed. Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 16 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 4 3 X Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 4 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chestnuts Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 3 3 3 DS0000014446.V252752.R01.S.doc Version 5.0 Page 17 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard 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. Refer to Standard Good Practice Recommendations Chestnuts DS0000014446.V252752.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens 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. 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