Inspection on 06/10/08 for Cheviot Court

This inspection was carried out on 6th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cheviot Court 02/11/09

Cheviot Court 07/11/07

Similar services:

Ashlea Mews Residential Home

Harwood House

South Chowdene Care Home

Farmborough Court

St Albans Place (14)

Bisley Drive (18)

Carrdale

Ransdale House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cheviot Court Cheviot Court Horsley Hill South Shields Tyne & Wear NE34 6RF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jim Lamb     Date: 0 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Cheviot Court Horsley Hill Cheviot Court South Shields Tyne & Wear NE34 6RF 01914975222 01914975225 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southern Cross OPCO Ltd care home 73 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: The maximum number of service users who can be accommodated is: 73 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia, over 65 years of age - Code DE(E), maximum number of places: 29 Old age, not falling within any other category - Code OP, maximum number of places: 44 Physical Disability, over 65 years of age - Code PD(E), maximum number of places: 5 Sensory Impairment, over 65 years of age - Code SI(E), maximum number of places: 5 Date of last inspection Brief description of the care home Cheviot Court is a care home situated in the Horsley Hill area of South Shields which provides accommodation and personal care for seventy-three people. The building is in Care Homes for Older People Page 4 of 27 Over 65 0 44 0 0 29 0 5 5 Brief description of the care home a well established residential area with several residential estates nearby. The home was first registered with Southern Cross in August 2007 but has been operating with different owners for several years before that. The home was purpose built for the people who live there. Service users accommodation is on three floors with twentynine people who have dementia living in two areas on the first floor and with forty-four older people living on the ground and second floors. The service is operated and managed by Southern Cross OPCA Ltd. The building provides 73 good-sized single rooms, all with en-suite toilet facilities. There are also communal toilets, showers and bathrooms, situated throughout the building. Each floor has several lounge and dining areas which have been set out to make best use of the daylight and views of the gardens and the surrounding area There are car parking spaces at the rear of the building including disabled parking bays near the entrance. There is easy access into building through the main doors into the reception area. Cheviot Court is next to local shops, is a short bus or car ride from South Shields town centre. There is access to local transport directly outside the building. The weekly fees for living at this home are #375 - #460. The costs of newspapers, hairdressing, private chiropody and toiletries are not included in the fees. Further details of fees can be found in the homes Service User Guide. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out Before the visit, we looked at Information we have received since the last visit. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The Visit, an unannounced visit was made on 06/10/08 Care Homes for Older People Page 6 of 27 During the visit we, Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, checked what improvements had been made since the last visit. We told the manager/provider what we found. What the care home does well: What has improved since the last inspection? What they could do better: It is recognised that the manager has worked hard to address the requirements from the last inspection visit, however there is still one very important requirement that Care Homes for Older People Page 8 of 27 remains outstanding. This relates to staffing levels in the home. There are still insufficient staffing levels in the home to fully meet the service users holistic needs. On the Elderly mentally Infirm unit there are 29 frail service users, some with very complex needs. for four days a week there are 5 staff on duty for some part of the day, and there are 4 staff for the remaining 3 days. This is not acceptable, as this compromises the welfare and the care needs of the service users. There should be a minimum of 5 care staff on duty from 8am to 10pm. The unit on the second floor accommodates 24 service users, some with complex physical needs, There are three staff on this unit. Again, to ensure that service users needs are fully met properly, there should be additional staff made available particularly at peak times such as mealtimes. to ensure good quality outcomes for service users, the quality assurance system must include gaining feedback from service users, relatives, and professionals. The service must also implement an annual development plan. To safeguard the welfare of the service users, all risk assessments should be agreed, understood by all concerned and signed by the service users or their representatives. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users and their representatives have the clear information needed to choose a home which will meet their needs. Evidence: The care records for three service users were examined. These showed that the manager makes sure that a full assessment of the new service users needs is carried out by the persons social worker before they come into the home. The manager also carries out her own assessment, to be doubly sure that the home can meet the needs of the new person. More detailed assessments are carried out once the new service user has come into the home. These include assessments of risk, of nutritional needs, of social needs, moving and handling needs, behavioral needs, and a dependency rating scale is also completed, this is based on activities of daily living. As a result of all these levels of assessment, the manager can clearly demonstrate that Care Homes for Older People Page 11 of 27 Evidence: all the service users are in a home that can give them the care that they need. All service users are provided with a contract explaining the homes terms and conditions, and fees. The service users guide is now available on audiotape. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are fully involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: There are comprehensive assessments in the service users care plans. There is also a comprehensive risk assessment of service users. There are advocacy arrangements, as well as family input to represent service users. Care plans and risk assessments are drawn up with service users and their relatives. Plans are amended and reviewed on a regular basis. To ensure that all care plans and risk assessments are understood and agreed, service users who are able, and their representatives should sign these. The care records lacked detailed social assessments. Discussion with the service users key workers and the activities co-coordinator demonstrated that they had very good knowledge of each persons social interests and their needs, but these had not been fully documented. However the home has commenced life storybooks for each service user, and these do include service users interests, hobbies past and present. It was agreed that this information should be used to implement detailed social care plans. By Care Homes for Older People Page 13 of 27 Evidence: the end of the inspection visit, one of the key workers had already completed a detailed social care plan for one of the service users. There are systems in place that will ensure that the placement and the service users plans are reviewed annually. These involve the care managers and the service users representatives. The service users confirmed that their privacy and dignity are respected at all times. Service users care records showed that they have access to external health care services.G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The medication systems were examined for ordering, receiving, administering and disposal. All were found to be well maintained. All staff has had accredited medication training. Appropriate systems and procedures are in place for the management of controlled drugs. The dispensing pharmacist offers good support and advice. Service users said that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. Six of the seven visitors/relatives spoken to were extremely complimentary about the home and the care provided. Three agreed that the service was exceptional. Another said, it matched the standards of a very good hotel. One said, I give the home almost ten out of ten. All seven did say that they would like to see more staff employed. One visitor, (none relative) said that she was not happy with the placement at all, and did not think the home was appropriate for the person that she visited. However, she said that the persons family were happy with the placement. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily living and activities made available are flexible and varied to suite service users expectations, preferences, and capacities. Evidence: Despite the lack of specific social care plans: each service user has a skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies. There is a wide range of daily activities available, and entertainers frequently visit the home, and there are regular outing to places of interest. The home employs two social activities coordinators one for 25 hrs and one for 16 hrs per week. There are photographs of events and celebrations that have taken place, and the home regularly holds themed events. There are monthly religious services held from various denominations, and all service users are invited to attend these services. Beamish museum outreach service also makes visits to the home, and Groundwork, a government funded organisation visits the home twice weekly and they provide social activities. On the day of the inspection the activities co-ordinators organised a bingo session followed by a film show, the latter was shown on a huge pull-up screen. All service users are supported Care Homes for Older People Page 15 of 27 Evidence: to maintain very close links with their families. They can choose who they want to see and when. The Homes menus are based on the Nut Meg concept. At least two hot meals are provided each day. The menus have been drawn up with help and advice from a nutritionist, and they are varied, nutritional and well balanced. Special diets are provided for as and when necessary. All those spoken to said that the meals were very good and that they were always offered a choice. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good, clear, user-friendly complaint and protection system. Service users are safe and their views are listened to and acted upon. Evidence: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is written in a way that ensures service users fully understand its contents. Three service users said that they had been given copies of the procedure and that staff listened to their complaints and always dealt with them fairly. The home keeps a record of complaints.The home has a Whistle Blowing policy, the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Healths document, NO SECRETS. Staff are aware of these procedures and have easy access to them.Safeguarding adults training is ongoing for all staff.Service users can deposit cash for safe keeping in the homes safe and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded. There was plenty of evidence of personal spending. Receipts are obtained for purchases and numbered to cross-reference to the transaction. Weekly checks of balances and cash are carried out. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a very clean, comfortable, safe and pleasant environment for those living there. Evidence: The home was extremely clean, well decorated and well maintained. The grounds were tidy, safe, and highly attractive. The fire service and the environmental health department had made visits to the home. Requirements made by these organisations had been met. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. The lounge areas are very homely and attractive. On the middle floor, there has been good use made of the memory Lane concept implemented. This scheme helps service users with memory problems, to become more orientated in their surroundings. Doors have been painted in different colours, and specific themed areas have been created to stimulate their senses and memory. Bedroom doors have been fitted with brass knockers and a post box. The manager explained that the concept still needs to be developed further by having more signs and additional artwork. There are plans to incorporate doll therapy, and specific areas will have street names etc. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in very good condition. All rooms have en-suite facilities. All rooms are highly personalised, and they all exceed the minimum size required. Some service users have Care Homes for Older People Page 18 of 27 Evidence: had their own private telephone line installed in their rooms, and this enables them to keep in contact with their family and friends. Lighting was bright and domestic in design. Service users bedrooms have opening windows and restrictors are in place where needed. The rooms were centrally heated and the heating level could be controlled within each bedroom. There was emergency lighting throughout the home. Water is stored at over 60C Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was exceptionally clean and free from offensive odours. The kitchen was spacious and clean and well organised. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are insufficient numbers of staff on duty to meet the holistic needs of the service users. Therefore, the welfare of the service users is not safeguarded properly. Evidence: Staff levels on the day of the inspection do not meet an acceptable level. The home provides care for 73 service users. The numbers of care staff were on duty: 10 staff between 8am and 10pm with 6 staff between 10pm and 8am. The home is split into three units over three floors. On the ground floor there are 3 staff across the day. The staff on duty said that they could easily meet the needs of the service users, as many were quite independent. EMI middle floor, for 29 service users there are 4 staff on duty for three days, and 5 for parts of the remaining four days. This unit is split into two wings. Four staff is clearly not enough to meet the holistic needs of this highly dependent and vulnerable group of service users. On the day of the inspection, there were two poorly service users confined to there rooms, another service user is terminally ill and requires two staff at all times to meet this persons holistic needs. Three other service users require assistance to eat. The majority need two staff to assist them with there personal care needs. Therefore it is essential that this unit is always adequately staffed with a minimum of 5 staff every day from 8am to 10pm. On the third floor there are 3 staff, and 22 service users. However the service users on Care Homes for Older People Page 20 of 27 Evidence: this unit are also quite dependent, there are 7 wheelchair users, several need two staff to assist them with their personal care, and two require full assistance to eat. Staff on this unit should be provided with additional assistance particularly at peak/busy times, such as mealtimes. The Area manger for the home, agreed to look at the dependency levels of the service users, and review the current staffing levels. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. The homes training programme meets the National Training Organisation requirements for the first six months. Staff receive at least three days paid training each year. The service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. The service has a good staff training and development programme in place. All statutory training was up to date and 98 of the staff team has completed NVQ level 2/3. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides clear leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The manager has the appropriate qualifications, experience and skills necessary to manage the service. Staff were clear about their responsibilities, and had excellent knowledge of the service users care needs. Service users are told when inspections take place and there are copies of reports available for relatives and others to see. A quality system is in place to monitor the quality of the service provided. Daily and monthly audits take place. This quality assurance system should also involve gaining feedback from service users, relatives and professionals involved with the home, this has not happened yet. The outcomes must then be published and made available to all prospective service users. The home must also implement an annual development plan. There is a health and safety policy and a range of associated procedures. Staff receive training in health and safety and safe working practices (fire safety, moving Care Homes for Older People Page 22 of 27 Evidence: and handling, first aid, food hygiene, and infection control). The service has an internal training officer who holds meetings to discuss staff training needs. Servicing and maintenance agreements are in place for facilities and equipment.All fire safety checks: tests and instructions to staff are conducted at the required frequency and recorded. Water storage tanks, gas and electrics are checked annually. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 18 The home must employ 01/12/2008 sufficient numbers of staff to fully meet the holistic needs of the service users. The level of staffing clearly restricts the ability of the service to deliver person centered care and support. 2 33 24 The service must establish and maintain a system to review and monitor the quality of care provided. A copy of the report should be made available to all prospective service users, this information will enable them to make a choice about where they want to live. 01/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 27 1 7 People who use the service must have their social recreational activities, interests, and hobbies assessed, and these should then be recorded in their own social care plans. Plans should clearly state how to meet each individuals expectations. To safeguard service users welfare and to keep them safe, risk assessments should be understood by all involved, agreed and signed by service users or their Representatives. 2 8 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 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!