Inspection on 12/05/05 for Cheverells

This inspection was carried out on 12th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cheverells 20/11/07

Cheverells 10/01/07

Cheverells 09/12/05

Cheverells 23/11/04

Cheverells 14/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Cheverells Limers Lane Northam Bideford Devon Lead Inspector Dee McEvoy Unannounced 12 May 2005 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cheverells Address Limers Lane Northam Bideford Devon EX39 2RG 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) 01237 472783 Mr Philip Woods Care Home 36 Category(ies) of MD(E) Mental Disorder - over 65 (36), registration, with number OP Old age(36) of places PD(E) Physical Disability - over 65 (36) Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26/1/05 Brief Description of the Service: Cheverells Care Home provides 24-hour personal care for up to 36 men or women over the age of 65.The home is registered to care for service users with physical disabilities and mental health disorders.Cheverells is a large detached Victorian property with several purpose built extensions, situated just outside Bideford, with views across the River Torridge. The bedrooms are spacious, light and well appointed. The majority have ensuite facilities. Decoration and furnishings throughout the home are of a high standard. The home appeared clean and well cared for.Communal areas are also spacious and include three sitting rooms, dining room and a sun lounge. Externally the home is well maintained and sound. The garden is mature and beautifully kept; there is a pond with wild mallard ducks and a wooded area. An attractive chrome ‘barrier’ surrounds the pond. The garden is accessible for service users to enjoy. The registered providers have commissioned an Occupational Therapist assessment of the home and have implemented many of the recommendations. A ramped entrance has been built to further increase access to the home. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first of the current year and took one day to complete. There were 32 residents living at Cheverells on the day of inspection and the inspector saw the majority of them; 7 residents were interviewed as well as three members of staff, two visitors, one Community Nurse, an independent trainer and the owners Mr & Mrs Woods. The inspector toured the premises and inspected a number of records. Cheverells continues to provide a very good quality of care for residents with a wide range of needs. The residents spoken with had a very high regard for the staff who support them, and continue to be satisfied living at the home, comments included “ I am very happy here, it is relaxed and homely.” Two relatives were also spoken with and praised the care and attention their relative had received at the home; comments included “Mum is in safe hands.” What the service does well: What has improved since the last inspection? A senior carer had been allocated 15 hours a week to ensure that care plans and risk assessments are reviewed regularly and accurately reflect residents’ needs. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 6 Since the last inspection the storage and recording of controlled medicines has been reviewed and now meets with this standard. Staff training continues to develop to ensure that all staff have the necessary skills to meet the various needs of the residents. 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. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home’s assessment process is thorough and ensures that the home is able to meet residents’ needs. EVIDENCE: The home’s admission process is well managed and includes good assessments and visits to prospective residents at home or in hospital. When possible prospective residents are invited to visit the home prior to admission to ensure that the home meets their needs and expectations. All four assessments looked at were detailed. One resident said, ”I chose this home as it has a good reputation locally. I am confident that they can look after me.” Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 & 11 Continued improvement has been made to the content of individual care plans ensuring that health and personal care needs are well meet. Improvements have been made in respect of the safe handling of medicines but attention is needed to ensure that records are accurately maintained. Personal support is offered in such a way as to promote residents’ privacy and dignity. Residents with palliative care needs receive the care they need in a sensitive and respectful way. EVIDENCE: Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 10 Four care plans were look at; each contained detailed information ensuring that staff had all the relevant information to satisfactorily meet the health and social needs of the residents. Personal profiles had also been completed with residents and families to ensure that staff were aware of preferences. Care plans were regularly reviewed to reflect changing needs. Good risk assessments have been completed. Comprehensive daily care notes are kept reflecting on the care received by residents. A senior carer has 15 hours of dedicated time per week to ensure that all care plans are up to date and relevant. A visiting community nurse said that she was confident that staff followed instructions and the District Nurses (DNs) were also alerted appropriately to any emerging needs. She added, “The residents appear to be well cared for.” The system for managing medication has improved however on some occasions hand written Medicine Administration Records (MAR) charts had not been signed by two staff, which is good practice. Residents told the inspector that they were treated very well by staff and that their privacy and dignity was respected, comments included, “Couldn’t do any better than here, the owners and staff are lovely” and “The staff are wonderful, I have all I need.” Care staff were observed to be respectful and sensitive in their dealings with residents. One resident was receiving palliative care. The home works closely with the District Nurses to ensure that needs are met and that the appropriate equipment and support is available. Visiting relatives told the inspector “This is a wonderful home, we are extremely pleased with the care.” The family had been encouraged to visit freely and arrangements had been made for them to stay with their relative overnight with their relative. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 14 Residents experience a stimulating and varied life at the home with various activities and visitors are encouraged. EVIDENCE: Many residents said that the routine within the home was flexible; one said, “ We do as we like, lots of freedom.” Activities are varied both inside and outside the home. Residents’ interests and preferences are recorded and there are opportunities for them to maintain previous interests and contacts. Several residents have maintained friendships and activities outside the home; for example, one enjoys a weekly game of bridge and another enjoys regular trips out with family and friends. Individual shopping trips are also arranged for residents. Several residents mentioned the new friendships they had made at the home one said, “The company is nice, I have made new friends and found old ones.” Two visitors spoken with and one responding with a comment card found the home to be welcoming, one said, “There is a homely atmosphere here, everyone is approachable and friendly” another said “We come and go as we please.” Visitors were ‘more than happy’ with the overall standard of care provided to their relatives. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 12 Residents are supported to maintain their independence and encouraged to exercise choice and autonomy. Residents spoken with gave examples of how staff meet individual needs and respect residents decisions and choices; one said, “I like my own company and don’t usually get involved in the activities. Staff respect this. They know me well.” Residents are encouraged to make their private space their own; bedrooms visited had been personalised with many items of furniture, pictures and photographs. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Residents and relatives were confident that their concerns would be listened to and acted upon. Residents are protected from abuse by robust procedures and well informed staff. EVIDENCE: No complaints had been received by the home from residents or relatives since the last inspection. All residents and relatives spoken with were aware of whom to speak to if they had any concerns and all were confident that Mr & Mrs Woods would deal with concerns. All residents said they were happy living at the home. The complaints summary in the hallway requires information regarding timescales and the contact details of CSCI. This information is held in the full complaints procedure, which is in the Statement of Purpose. All residents spoken with felt safe within the home and confident in the staffs’ abilities to meet their needs one said, “The staff are kind and attentive, really lovely girls”, another said, “I have no worries here.” Staff spoken with had received adult protection training and were aware of the various forms of abuse and confirmed that they would always challenge and report poor practice. Procedures for dealing with any incidents are in place. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 Residents enjoy a well-maintained, homely and attractive environment, which meets their individual needs. EVIDENCE: Cheverells is maintained to a high standard both internally and externally. The home is clean and bright and furnishings are of good quality. There are three large lounges and other communal spaces around the home. Residents spoken with were very happy with the environment, comments included, “The home is lovely and the garden is beautiful. It is well looked after” and “There are nice places to sit around the home. It is always lovely and clean.” Many residents enjoyed the well-kept gardens, which attracts wildlife including a variety of ducks. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Residents benefit from having skilled, experienced and friendly staff who have a good understanding of their needs. Some attention is needed to ensure that all staff recruitment files contain the necessary records to protect vulnerable adults. EVIDENCE: Residents confirmed that their needs and wishes were met in a timely way, one said, “They work so hard, they are wonderful”; staffing levels were sufficient to meet residents’ needs. The home has a low turn over of staff and low sickness rates. Staff described the good team work as one of the strengths of the home, one said, “The management is excellent, we all work as a team” another said “This is a pleasant place to work.” Two staff recruitment files were examined; both contained the majority of information required including CRB checks but both files had an outstanding reference. A request had been made for the references however no response had been received; the owners were asked to chase the outstanding references. The opportunity for staff training at the home is excellent and ensures that staff have the necessary skills to meet the residents’ needs. An independent trainer provides monthly sessions to ensure that staff are aware of all policies and procedures and are constantly up dated on good practice to maintain the current excellent standard of care provided. An NVQ assessor is also employed by the home to provide 12 hours of staff training and support a week. One staff member described the training at the home as “Brilliant.” A number of staff were attending manual handling training on the day of the inspection. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 & 38 Residents are supported by a staff team, which is well managed and appropriately supervised. Residents receive care in a safe environment. EVIDENCE: Staff are well managed and receive the necessary support and supervision to do their jobs competently. Regular one to one supervision is given to staff, who felt supported and valued at the home. (Standard 38 was not fully inspected on this occasion.) Safety is maintained for residents with the provision of thermostatic valves to ensure safe water temperatures and restricted windows on the first floor. All mandatory training was up to date. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 3 x x x x x 3 x 3 Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 18 YES 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 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. 2. 3. Refer to Standard 9 16 29 Good Practice Recommendations It is recommended that all hand written MAR charts are signed by two people. It is recommended that the complaints procedure in the hallway is up-dated to include timescales for action and contact details of CSCI. It is recommended that the outstanding staff references are requested again. Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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 Cheverells D54-D06 S22173 Cheverells V226090 120605 Stage 4.doc Version 1.30 Page 20 - 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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