Inspection on 07/11/06 for The Chestnuts

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Chestnuts 08/06/06

The Chestnuts 12/12/05

The Chestnuts 09/05/05

The Chestnuts 07/09/04

The Chestnuts 01/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Chestnuts The 14 St Helens Road London SW16 4LB Lead Inspector Michael Stapley Key Unannounced Inspection 7th November 2006 09:30 Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 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 The DS0000025846.V314422.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 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 The DS0000025846.V314422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chestnuts The Address 14 St Helens Road London SW16 4LB 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) 020 8765 0299 NONE Mr Michael McDonagh Mrs Denise McDonagh Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 2006 Brief Description of the Service: Chestnuts is Registered as a home offering support to five adults with learning disabilities and either Autism or Aspergers Syndrome. Chestnuts is a large detached house located in the heart of Norbury and is only a few minutes walk from local shops, rail and bus services. Chestnuts has five single service user rooms, with a bathroom being located on the first floor of the home and a shower room situated on the second floor of the home. The lounge is large and comfortable. The wood-panelled dining room is a good size, providing a valuable additional communal space for service users. The home also has a large well maintained back garden with garden furniture and barbeque, which the service users make good use of. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. • This home was inspected under the National Minimum Standards Care Homes for Younger Adults. The inspection took place over one day on Tuesday, 7th November 2006. The home was represented by the Manager, Ms. Avis Reene and support staff who all contributed to the inspection process. The manager is supported on a day-to-day basis by one of the homes directors who offer supervision and support in the management of the home. Records examined included service user plans; care manager needs assessments and risk assessments, medication records, complaints, staffing records, health and safety and fire records. Previous requirements and recommendations were discussed with the registered manager who will be sending an action plan to the commission as agreed at the time of the inspection. • • • • What the service does well: • The home - is a small family home setting and staff endeavour to maintain this atmosphere of ordinary living, on an ordinary street within the local community. Service users - are very much the centre of attention in the home; all of them have a programme of day care, save for one who does not which to access such services. The home seeks to promote the independence of service users and ensure equality of service. Service users are encouraged wherever possible to become involved in the running of the home. DS0000025846.V314422.R01.S.doc Version 5.2 Page 6 • Chestnuts The • Care Plans - Individual care plans are very comprehensive and headings include a pen portrait of the service user, weekly activities, health needs and communication skills to mention a few. The arrangements for health care needs of the service users is good, all service users are registered with a local General Practitioner, the home has the support of the local pharmacist for advice on medication. Training - Staff members have access to a range of training courses, including NVQ’s to build on their skills to ensure that they are able to meet the service users assessed needs. • What has improved since the last inspection? It is evident from the work the new manager and her staff have completed since the last inspection that they have worked well together in meeting the majority of requirements and adapted to the changes that have been introduced for good practise. Service user guides / guides / statement of purpose – these have been reviewed and improved since the last inspection. The home has invested a great deal of time and effort in improving the environment and now has planning permission to develop the rear of the home which should make it a much more pleasant and welcoming place to be. PCP targets and goals – the home have achieved a number of goals and aspirations identified by service users within their own PCP meetings these are continuously reviewed and personal goals and targets are reset. Medication – the home has an excellent pharmacy provider with effective systems in place. NVQ trained staff – Since the last inspection a number of staff have completed their NVQ and a further number have commenced their NVQ training. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 7 Shift cover – The home now has a full team and therefore rely less on agency staff to cover shifts at the service. This means greater continuity of care and service delivery for the service users. Communication – Because the home now has a full team there is better communication and consistency of approach and a greater commitment to communication. What they could do better: • • • Training - The home needs to ensure that all staff has received equal opportunities, race equality and anti-racism training. Ageing and Death – The home needs to ensure it has discussed and recorded the wishes of service users as outlined in Standard 21. Networking and share knowledge – Now that the home has a full team they need to expand their networks and share there knowledge with other local providers as well as gain from their experience. ICT service users – The home could support service users in gaining and developing an interest in computers by using software that has been designed to be easily useable and understandable. The home could focus on the development of service user’s independence through simplistic tools to enable individuals to gain greater opportunities in a self-directive lifestyle. The registered providers should give consideration to appointing a senior support worker to work alongside the manager and staff team. DS0000025846.V314422.R01.S.doc Version 5.2 Page 8 • • • Chestnuts The 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 The DS0000025846.V314422.R01.S.doc Version 5.2 Page 9 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 The DS0000025846.V314422.R01.S.doc Version 5.2 Page 10 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, 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good information and introduction opportunities for prospective service users to make an informed choice about moving to the home. Contracts between the home have been developed by the home although they do need to be in a format/language that is appropriate to each service user’s needs and level of understanding. Staff at the home have access to a range of training programmes thus enabling them to offer a reasonably effective care programme for service users. EVIDENCE: The home has a preadmission procedure; prospective service users are able to visit the home on an individual basis. Service users are only admitted to the home once a full assessment of their needs; compiled by their care manager or other relevant person has been received. Most of the service users at ‘The Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 11 Chestnuts’ had a clear process of introduction to the home according to their individual needs. The manager advised that assessment is on going and is seen as very much part of the care plan. Person centred care plans that are gradually being introduced are based on the home’s individual system which is an in depth assessment of all aspects of service users personal care, social, recreational and emotional needs. The person centred care plans that have been introduced are in an appropriate format, are user friendly and easy to read. The inspector noted that there were photographs of service users, family, friends and significant events recorded in the care plans inspected. The inspector noted that In addition service users could have their own ‘Personal Folder’, which is updated on a regular basis and is unique to each service user. The home carries out internal six monthly reviews where information is up dated and care plans changed as appropriate. There are also yearly reviews carried out with the service users, their families and other professionals as appropriate. The home has a reasonable training programme including NVQ training. The training programme includes first aid, health and safety, medication, person centred care plans, fire awareness training and more recently makaton. In addition the manager advised the inspector that Autism training has been arranged for February 2007. The home has developed and amended its Statement of Purpose following requirements made at the last inspection. The manager advised the inspector that it is reviewed on a regular basis in the light of changes to legislation and the needs of the service users. The Statement of Purpose includes all elements of regulation 4 including the skills of the staff team and their experience and how these can meet the needs of service users. All of the service users at the home have a contract/statement of terms and conditions. However these need to be further developed in a language/format appropriate to the needs of each service user. The manager showed the inspector a model she was considering using which was a clear improvement on the current contract in place. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 12 Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 13 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user care plans contain all the information required as per standard six. Staff at the home have all the information they require to satisfactorily meet the needs of the service users. Service users have individual risk assessments and risk management strategies carried out thus enabling them to participate in activities in the home and in the community with appropriate support. EVIDENCE: Service user individual care plans are comprehensive and contain all the elements of standard six. Care plans contain a pen portrait of the service user, weekly activities, health needs and communication skills. Service users and their respective families are involved in drawing up such plans as outlined in standard 6.6. In addition service users have a key worker and evidence of key Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 14 working was duly noted where appropriate. The home has become far more service user focused. Service users are encouraged to become far more involved in the home. House meetings are service user led and support is given to establish opportunities for training at local colleges or day centres where appropriate. The manager explained that the home has moved towards Person Centred Plans where ownership of the plan is given to the individual service user. While this is to be commended it was noted that staff still needed to undertake Person Centred Planning training. The manager advised the inspector that she would be discussing this matter with the homes external trainer and hoped to make arrangements for such training to take place shortly. Service users files sampled at random all had individual risk assessments and risk management strategies. Service users are encouraged to make their own decisions within the context of risk assessment. All service users have individual choice and the home provides an independent advocate for individual service users where desired, in addition it is evident that service users are empowered wherever possible through group meetings and key working. The home has a confidentiality policy that is available to service users and their respective families. Service users, their families and representatives are aware that all information about them is handled in a sensitive manner and that confidences are kept. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 15 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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily routines and house rules promote service users’ rights, and ensure equality and that all rights are enjoyed by service users. Service users are given opportunities to engage in age appropriate activities with an emphasis on using community-based facilities. Dietary needs are catered for and a balanced diet is provided, to ensure a nutritious diet based on personal preferences. EVIDENCE: During the inspection there were two service users at the home. The manager and staff were observed to interact with the service users in a positive manner. There was awareness from the staff that the service user’s privacy and individual choice must be maintained. The service users were observed moving Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 16 freely throughout the communal areas prior to going shopping with one of the staff. The home supports service users to access appropriate activities such as swimming, sports and leisure activities and making use of the library. In addition service users have access to local parks, cafes, theatres and shops. None of the five service users is able to travel independently therefore the staff team support service users to access community resources. Service users spoken to stated that they enjoyed the activities on offer at the home. Service users at the home usually have an annual holiday; the inspector was advised that this had unfortunately not been possible this summer due to circumstances beyond the control of the home. However plans are currently being made for service users to spend a long weekend at Butlins in Bognor Regis. The manager advised that the cost of holidays was an obvious problem. Some of the service users had the financial ability to pay while others were dependant on allowances from the state. Although the managing company contribute to the cost of holidays it was acknowledged that the cost of a minimum seven day holiday is not included in the contract. The inspector therefore recommends that the manager should write to the placing authorities to seek such funding. It is also suggested that this element of standard 14 be built into the contract of any new service user. Parents, relatives and friends are encouraged to visit the home whenever possible. Service users have access to a range of educational facilities and the manager advised that service users have access to the homes computer. It is suggested that the home consider having an Internet connection for service users. This would clearly be of benefit to service users as it would increase their range of leisure and educational opportunities. Weekly menus were constructed with the aid of the service user’s personal choice, advice from service user’s families and the experiences of the staff. One service user said that they enjoyed what they had to eat at the home. The home has access to its own vehicle and also uses community transport. The inspector noted that service users were weighed on a weekly basis and the results duly recorded on a ‘weight chart’. One of the male service users weighed only just over 7stone The manager advised that the service user had been referred to a dietician and the home were fortifying his food and his weight had improved. It is recommended that if there is any further weight loss a referral should be made to the homes GP. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 17 Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 18 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, 19, 20 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ medication is well managed to ensure good health. The home has yet to establish an up to date record of all of the service user’s wishes at death thus appropriate arrangements may not be made. EVIDENCE: Health records are maintained for each service user. Service users record examined during the inspection demonstrate that the service user had access to routine health checks and specialist health care. Significant events and accidents are recorded and monitored. The staff team at the home keep a central record of incidents as well as an individual record on service user’s files. Staff members monitor service user’s health and maintain up to date records. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 19 The manager advised the inspector that none of the service users self medicate. If any service user were to self medicate this could only be done after completion of a risk assessment for self-medication. In addition medication would need to be supplied by the pharmacist in a monitored dose system and appropriately stored. The home has appropriate medication policies and procedures. All service users have a ‘Medication Profile’ All of the staff team have now completed accredited medication training. The pharmacist visits the home on a regular basis. All requirements and recommendations from the inspection of 20th October 2006 have been complied within laid down timescales. In addition the pharmacist is available for consultation by telephone and at the pharmacy. All other medication records, including MAR sheets and service user profiles were correct at the time of the inspection. In addition the home keeps a list of specimen signatures for those staff that administer medication. The wishes of service users regarding death and dying have as yet not been clearly identified and recorded for all service users. The manager advised the inspector that given the sensitive nature of this standard such wishes would be discussed during the forthcoming reviews for service users. The manager advised the inspector that she is in the process of drawing up a template for this to be recorded. It is suggested that some of this should be in a pictorial format. This will help support service users and their families to record their wishes at the time of their death. In addition it was noted that consent to medication had not been recorded in the individual plan for all service users. The manager advised this would be completed again at the forthcoming reviews for service users. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 20 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The home has a detailed complaints procedure, which has been updated to include all the necessary information that service users, relatives and other parties may need to make a complaint. However it does not state that any complaint can be directed to the commission at any time. In addition details of any investigation, action taken and outcomes must be duly recorded. In addition the complaints procedure needs to be in an appropriate language/format for service users at the home. The manager advised the inspector that she was in the process of developing such a procedure that will be formatted with pictures and photographs so that it is more accessible to those who cannot read. Service users spoken to were clear about whom they would go to if they were unhappy and felt comfortable to raise any concerns. The Manager said that one Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 21 complaint had been made to the home since the last inspection and the inspector noted that this had been dealt with appropriately. There are also policies and procedures in place regarding the protection of vulnerable adults. The registered manager advised the inspector that arrangements have been made for all staff to undertake POVA training on 30th November 2006. The London Borough of Croydon’s Suspected Abuse of Vulnerable Adults Joint Policy is in place and the home also has its own policies on adult protection, whistle blowing and management of service users’ finances. In addition recruitment practices are generally secure to ensure that people are protected from unsuitable staff. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 22 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, 25, 26, 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. Service user’s bedrooms provide privacy and reflect individual interests and preferences. The home is homely, bright and clean with the necessary adaptations in place, thus providing the service users with safe, comfortable surroundings that meet their needs. EVIDENCE: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is a two story building in a quiet residential road. It is situated in Surbiton and is close to local shops and amenities. There is a large communal Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 23 lounge on the ground floor as well as a kitchen and spacious dining room. The furniture is domestic, flame retardant, and of reasonable quality although some does need replacing. The registered provider has drawn up a refurbishment programme for the home from November 2006-November 2007. This programme does not include works required to the rear of the house as this will be undertaken when an extension is built now that planning permission has been granted by the local authority. However the inspector is aware that the windows, doors and paint work to the rear of the home are in very poor condition and therefore need attention. Now that planning permission has been granted for the extension to the rear of the home the registered provider must send to the commission a date when it is expected to commence this work. All other maintenance and health and safety issues that were highlighted at the last inspection have been complied with. The home was very clean and hygienic and free from offensive odours through out on the day of the inspection and systems are in place to control infection in accordance with relevant legislation and published professional guidance. Laundry facilities were found to be reasonable and fit for purpose. The home has thermostatic valves fitted to the bath to avoid any scalding accidents. The temperature of the water is taken and duly recorded. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 24 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): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team at the home have a range of skills and ability, which appear to meet the needs of the service users. The staff team have all had Criminal Records Check, as a safeguard to offer protection to the homes service users. EVIDENCE: The home offers reasonable training opportunities to staff at all levels within the home, although staff would benefit by taking specialist-training courses such as that offered by BILD. The inspector noted that none of the staff had still not undertaken disability equality training, race equality training or antiracism training. The manager advised that this training is planned for February 2007. However a requirement has been repeated that this training is made available to all staff within the home. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 25 New members of staff complete an induction programme covering various subjects including health and safety, fire drills, and introductions to service users and other staff. The induction programmes are signed, dated and kept on staff files. Criminal Records Checks are completed before a new member of staff can begin work in a home. The home has a small but experienced staff team consisting of manager and support workers in addition to regular care bank staff. The home does not have a deputy manager due to the fact that there are only five residents at the home. However it would benefit from the appointment of a senior support worker who could work alongside the manager and deputise in her absence. The manager offers professional support to the support workers through regular supervision, which is in line with the standard. There are always two members of staff on duty who also undertakes sleepingin duties. There are suitable on call arrangements in place in case of an emergency. The inspector evidenced that a training plan was in place for The Chestnuts. In addition the manager has introduced an annual appraisal for all staff. The training needs for staff are identified during the annual appraisal and duly recorded following which arrangements are made for staff to attend such training. In addition all staff that is employed at the Chestnuts has an identified training plan. While there has been a significant improvement in the training offered to the staff at the home it was noted during the course of the inspection that there was not a dedicated training budget as outlined in standard thirty-five. It is therefore recommended that such a dedicated budget be sought for the home as clearly it would make it a great deal easier for the manager to plan and develop staff training on an annual basis. The inspector noted that all staff at The Chestnuts is now receiving supervision at least six times each year. The supervision format is comprehensive and contains all elements of standard 36.4 Records seen during the course of this inspection were signed and dated by the registered manager and member of staff. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 26 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, 39, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home appears to be open and transparent with clear lines of accountability, which is aimed at ensuring the well being of the service users. EVIDENCE: The registered manager offer support and supervision to the support workers at the home. There were good support mechanisms in place and the manager meets with one of the directors on a regular basis to discuss any issues concerning the home, efforts are made to meet any concerns or improve the service. The home has an annual development plan and business plan for Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 27 2006-07, which was available for inspection. The managing company ensure all records are in place by completing monthly regulation 26 reports. Such reports have been sent to the commission as per requirements made at the last inspection. Records required for the safety and well being of service users are in place including accidents, water temperatures, complaints, incidents, food records, fire records, staff and service user’s case files, medication records. Fire drills are up to date and a fire risk assessment had been completed. There is a need to ensure that all new and existing staff has received fire prevention training as the last such training was in July 2005. The residents are beginning to benefit from a stable staff team and a continuity of approach this generates. However for residents and their stakeholders these developments need to be consolidated and built on in order for them to be confident that their best interests are safeguarded, their views are taken into account and the home is well managed. The system for consultation with service users, families, stakeholders and other interested parties is reasonable. The quality assurance system includes relatives, staff and outside professional questionnaires. The home will need to evidence that the results of the surveys are published and acted on for the benefit and wellbeing of the service users at the home. The manager audits service user’s finances on a monthly basis Most of the policies and procedures that are relevant to service users are now in a suitable format including complaints and service user guide. All certificates in respect of health and safety were evidenced during the course of this inspection. Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 28 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X 3 2 X Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 29 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 YA24 Regulation 23 Requirement The registered person must send to the CSCI, local office details of when the planned building works at the rear of the house are to be commenced given that planning permission has now been granted by the local authority. (The building works should form part of the development programme regarding the renewal of the fabric and decoration of the home internally) The registered person must ensure that all staff undertake disability equality training, race equality and anti-racism training (Requirement not met as at 31/08/06) The registered person must make suitable arrangements for all persons working at the care home to receive suitable training in fire prevention. Timescale for action 31/03/07 8. YA35 18(1) 31/12/06 9. YA42 23(4) 31/12/06 Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 30 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. 2. 3. 4. 5. Refer to Standard YA5 YA14 YA20 YA21 YA22 Good Practice Recommendations It is strongly recommended that all service users’ contracts should be in a format /language appropriate to each service users needs. It is strongly recommended that all service users in longterm placements have as part of the basic contract price the option of a seven-day holiday outside the home. It is strongly recommended that the registered person obtain consent to medication for all service users and record this in the individual plan. It is strongly recommended that service user’s wishes concerning terminal care and death are discussed and duly recorded. It is strongly recommended that the homes complaints procedure be amended to include a statement that any complainant may complain to the commission at anytime of an investigation and that the said procedure is in an appropriate language/format for service users. It is strongly recommended the home has a dedicated training budget. It is strongly recommended that all staff receive specialist training such as that offered by BILD or NAS as part of their individual training and development plan. It is strongly recommended that all staff undertake PCP training as part of their individual training and development plan. 6. 7. 8. YA35 YA35 YA35 Chestnuts The DS0000025846.V314422.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 The DS0000025846.V314422.R01.S.doc Version 5.2 Page 32 - 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. 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