Inspection on 07/11/07 for Cheviot Court

This inspection was carried out on 7th November 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cheviot Court 02/11/09

Cheviot Court 06/10/08

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Cheviot Court Cheviot Court Horsley Hill South Shields Tyne & Wear NE34 6RF Lead Inspector Mr Steve Tuck Key Unannounced Inspection 2:30pm 7 , 22 , 29th, November and 7th, December th nd X10015.doc Version 1.40 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 Cheviot Court DS0000070542.V349814.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 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. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cheviot Court Address Cheviot Court Horsley Hill South Shields Tyne & Wear NE34 6RF 0191 497 5222 0191 497 5225 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) Southern Cross OPCO Ltd Mrs Beryl Grace Anderson Care Home 73 Category(ies) of Dementia (29), Old age, not falling within any registration, with number other category (44), Physical disability (5), of places Sensory impairment (5) Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 The maximum number of service users who can be accommodated is: 73 2. Date of last inspection Brief Description of the Service: 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 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 twenty-nine 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 Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 5 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. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report is about the first Key inspection of Cheviot Court since it was purchased by Southern Cross OPCO Ltd in August 2007. Before the visit: We looked at: • Information we have received since the home was registered by the current owner in August 2007. • How the service dealt with any complaints & concerns since then. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service, their relatives and staff by questionnaire. The Visit: One unannounced visit was made on 7th November 2007 followed by announced visits on the 22nd, 29th November and 7th December 2007. During the visit we: • Talked with the people who use the service, the staff and the owner / manager. • Observed life in the home. • Looked at information about the people who use the service & how well their needs are met. • Looked at other records, which must be kept. • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. • Looked around parts of the building to make sure it was clean, safe & comfortable. • Checked on what improvements had been made since the last visit. We told the manager what we had found. This report represents the findings at the time of the inspection. It is acknowledged that some work may have commenced to address some of the findings highlighted within this report What the service does well: People who live at Cheviot Court or their relatives gave a variety of comments about their experiences of care at the home. Comments included: Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 7 “Staff are very friendly and caring, they say hello and make brief conversation.” “All the staff were most helpful and informative.” “The home is comfortable and well kept.” “The care is of a high standard – when there are enough staff on.” “Cheviot Court has gone through some changes over the last 6-12 months i.e. buy outs. It has had an impact on staff moral however the manager has stayed focused and worked hard to restore staff moral.” “Staff are friendly and caring.” “Any reported concern is acted upon quickly.” “All staff are very good when it comes to (getting) medical assistance.” “It would be a great asset if there were more activities and visits to reduce boredom and to stimulate the minds of the mentally active.” People who move to the home have their needs assessed by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important as people often have complicated needs that require well managed and agreed ways of supporting them. The home is purpose built to a good quality standard and only a few years old. Bedrooms are large well appointed, have their own toilets and the furniture, fillings and decorations are good quality. All rooms are bright, cheerful, well kept and hygienic. Each area of the home has dining and sitting rooms which are comfortable and give variety for people who live there. Maintenance continues to take place to make sure that the home stays in good condition and there are plans to improve the garden areas for people with dementia. One relative said, “The cleaners keep the place looking nice, they do a good job - it always smells clean here.” Care is provided to people with a wide range of needs, with varied expectations and backgrounds. This diversity is reflected in the staff team, giving the manager the opportunity to recruit staff from the same local background as the people living in the home. This ‘match’ helps staff to understand peoples needs and people who use the service are more reassured that they get support from people who understand them. One person who lives at the home said, “Most of the staff are Shield’s lasses, you feel that you know them.” Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 8 People living at the home benefit from well-trained staff, many of whom have worked there for several years, which helps them get to know people well. Staff receive good levels of training with the majority having an NVQ level 2 or above. And other is being provided so that they have the right skills to support the people who live at the home. Both care practice and staff recruitment practices are governed by equal opportunity principles. People who live at the home are protected, they are safeguarded from abuse by staff who are trained to look after their best interests. If people have complaint then these are taken seriously and properly responded to by the home’s manager. The home has a competent manager who knows the people who live there well and is able to successfully direct staff how they are to be supported. The registered manager has suitable qualifications experience to be in charge of this home. As well as this, a representative of Southern Cross carries out monthly visits to the service to check it is running in the right way. In this way the service is well managed. All people who live at the home are able to choose the food that they would like to eat which is made from fresh wholesome ingredients by talented catering staff. So that all everyone can have a healthy, well balanced and interesting diet. Staff are very respectful and courteous to the people who live at the home. Service users described how their privacy is respected during their stay. All bedroom doors can be locked and staff treat these as people’s own private areas. Service users and relatives are able to tell the owner what they think about how the home is run which helps them to have control over their lives. What has improved since the last inspection? What they could do better: All people who stay at the home must have a contract which gives details of the terms and conditions of their residency. Detailed information about the money that the home keeps for people who live at the home must be kept with accurate records which can be checked easily. The manager must also write to everyone after they have been assessed to confirm that their needs can be met by the home. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 9 Plans of care must be written in enough detail to show the specific actions staff are to take to support peoples’ needs, preferences and lifestyle. And care plans must be written in enough detail so that they can be used to co-ordinate the work of staff and show if changes in peoples’ condition have taken place. Where people have dementia, the home must follow current best practice to make sure that peoples’ plan of care and staff support is relevant to their history and needs. There needs to be better structured meaningful activities for people with dementia and adaptations made to the surroundings so that people can find their way around and remain as independent as possible. Where people are likely to be injured through falling over, there must be an assessment carried out to work out a list of measures which are to be put in place to minimise the risks of injury. People living at the home must get the medication that they have been prescribed and measures continue to be taken to make sure that mistakes are avoided. Where staff decide that people need to have medication, then their decisions need to be consistent and written down. There must be enough staff at the home so that the people who live there can get the support they need. The manager must make sure that there are sufficient hoists available so that people who need to use them do not have to wait. Although owners from Southern Cross ask people who use the service for comments, the manager must have written plans in place about the level of quality of each area of service, and the actions which are going to be taken to maintain or improve these. 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. The summary of this inspection report can be made available in other formats on request. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 10 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 Outcomes Statutory Requirements Identified During the Inspection Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A range of information about what life is like at the home is available to help people to decide if they want to move there. Each persons needs are assessed before they move to the home. This helps to make sure that their needs can be met there and inappropriate admissions are avoided. Some people who fund themselves do not have contracts in place to protect their rights and help them to make informed choices. EVIDENCE: The home has a written Statement of Purpose that provides information about the different services that it aims to provide Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 12 The home also has written information called the Service Users Guide which gives all of the important information that people need to know about living there. This includes information about how to make a complaint and the most recent Inspection report. Everyone living at the home and their relatives have seen this information before they chose to live there. One relative said, “Its useful to have the guide in her relatives room because it helps her to remind herself about some of the details of how the home is supposed to support people”. The manager confirmed that, on request, this information can be made available in other languages and audiotape. Although no one who has needs which left them unable to use a written document, for example those people with dementia, had yet to use this facility. The manager said that she prefers people to visit the home before they decide to move in, for example by offering visits and overnight stays and families and friends are welcomed People who have been placed at the home by the local council have a signed agreement about the purpose of their stay, proposed length of stay, and fee levels. But some people who fund themselves do not have a contract which clearly sets out all of their rights including how fee rates are to be increased. Each persons needs are assessed before they move to the home, either by a local authority social worker, the manager, or by both. This is so that the manager can be sure that the home is suitable for meeting the needs of people who are going to live there. The manager also finds out the cultural and lifestyle needs of people who wish to move to the home to make sure that these can be met. As a result of these measures, all of the people living at the home at present have been properly placed and the home is able to meet their needs. Where people have specialised needs or they are already having treatment the manager asks for advice and guidance from other healthcare specialists to make sure that these needs are best met. The home does not provide care for those people who have been admitted on a short-term basis to get special therapy while they recover from injury or hospital treatment. No one has been admitted to the home with these needs. The manager was very clear about her responsibility only to admit people who can be successfully supported, and about the number and type of care that the home is registered to provide. This helps to make sure that only people whose needs can be met are admitted to the home. But, the manager does not yet write to people to confirm that their assessed needs can be met there. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Each person has an individual plan of care, which should set out in their preferences and how their assessed needs will be met. But these do not fully describe the measures which staff are to use therefore making it difficult for them to consistently meet peoples’ needs. Peoples’ health care needs are generally met by the home which makes service users confident that they will not have to leave should they become unwell. The way that staff at the home store and give out medication should help to make sure that people living at the home receive the medical treatment they have been prescribed. Further improvements will make sure that people receive their medication safely. People who live at the home feel that they are treated with respect and their privacy is upheld which helps them to stay confident and empowered. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 14 EVIDENCE: All people who live at the home have a plan of care which gives a description of how their physical emotional and lifestyle needs are to be met. Staff regularly write significant events or monitoring observations into these records. However the care plans themselves did not match the actual support and intervention which staff currently carry out. Staff have a variety of knowledge and experience of caring for people living at the home but this information is not yet successfully combined in the care plans so that these can be used to consistently provide fully co-ordinated care. All of the staff interviewed could describe peoples’ needs, preferences and histories, however the potential areas of good practice were not generally shared with colleagues nor were these recorded in the care plan. Additionally care plans are usually written when people had first moved to the home and their needs and wishes had changed with time. But staffs’ increased knowledge and understanding of their needs had not been written into care plans. Or where peoples’ social or physical needs had changed significantly for example if someone had needed to be admitted to hospital, then these details were not recorded. The home Registered to provide care to people who have dementia. Care planning arrangements for these people do not yet reflect current best practice. For example, care plans do not specify how people who have an altered sense of time or reality are to be supported or what their personal timescales actually are. Care plans, which place the person at the centre of a network of support for their needs and lifestyle requirements, are yet to be put in place. This can be particularly important for people who become increasingly reliant on staff as their level of dementia increases. One relative said, “ I keep telling them about my mam, her life, the things she’s done, things she likes. But some staff don’t seem as if they understand how important it is for people to know about you when you can’t tell them yourself.” Although some people have been identified as being at risk from falls, the risk assessment process has not been fully used, so it is not clear what measures that staff take to reduce the risk of people falling and being injured. The manager has been careful to make sure that people living at the home are able to be successfully supported there and do not require nursing care. She has a full understanding of their needs and works in close partnership with community based healthcare staff. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 15 Due to their levels of need, most people who live at the home are not able to organise their own medicines, and appointed staff therefore help in this area. Staff at the home have taken training in relation to medication administration. Medication is securely stored but one record out of the three looked at in detail was not accurate and the amount of medication prescribed and administered did not match making it impossible to tell whether the correct medication had been given. The manager and staff demonstrate a caring and supportive approach for those people who are dying and the families and friends of those who have passed away. There were many compliments at the home from recently bereaved relatives thanking the home for their support and care. Wherever possible staff and the manager make sure that the spiritual and cultural needs of people are known and understood so that these can be acted upon when this is required. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are encouraged and supported by the staff to lead fulfilling lives with their rights as individuals being respected. Contact with family members and friends are supported where possible so that service users keep links outside of the home. The meals provided offers an interesting balanced diet which helps service users to eat healthily and supports their physical and emotional wellbeing; and service users and families are involved in planning the menu. EVIDENCE: People talked of the things that they do both inside and out of the home, in the local and wider community. For example games sessions, shopping visits, social events and entertainment. There are photographs of celebrations and events and people and their relatives talked about these. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 17 For some of the people who are unable or do not wish to leave the building there is a range of activities taking place some of which have been suggested by service users. Whilst people with dementia take part in some activities, and the manager and staff have ideas, a structured programme, specifically designed to support and interest people with these needs is not yet in place. There were many visitors to the home, all of whom appeared comfortable with the environment and staff. One relative said, “ Activities are better than they used to be, the staff make a lot more effort although my mam doesn’t want to take part in the things that are going on at the moment.” Children are made particularly welcome by people who live there and appear to benefit greatly by their continued visits. People living at the home are encouraged to make choices about their diet. Most said that they like the meals at the home and that they are asked what they would like to eat. Staff were observed asking service users about their choice of meal, size of portion to make sure that service users can make choices about what they eat. Staff were available during meals to offer support and assistance where needed and this makes meal times a relaxed and unhurried experience for people. Menus were available which confirmed that a range of meals are provided which gives people who live at the home a balanced diet and refreshments are available throughout the day and night. A range of fresh fruit and vegetables are used in the preparation of food at the home which increases the nutritional benefit for people. People who live at the home and their families are involved in choosing the meals which are included in the menu. Meals are prepared by a dedicated chef who is keen to cook food in the style which meets both the nutritional needs and lifestyle preferences of the people who live at the home. Some people have particular requirements which may relate to their physical or emotional needs which are monitored by care staff and the chef so that they can be supported. One person living at the home said, “the food went through a bad patch, they told us what we had to eat and the chef resigned so everyone complained. The chef’s back now and the foods’ back on track.” Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a complaints system which people who live at the home or their families can use if they are unhappy, have a grievance or dispute. They also give feedback when they are happy with the service. This helps them to have control over their lives and shows that their views are valued. People who live at the home have support to access advocacy services which can help make sure that their best interests are represented. There are measures in place which protect people who live at the home from being harmed which helps to promote their safety and security. EVIDENCE: There is a clear procedure in place at the home which tells people how to complain and the length of time a response will take. Observations of the manager’s and staff’s day-to-day practices show that they ask for peoples’ views and promote choice and decision making. People living at the home and their visitors said that they would feel comfortable about approaching senior staff if they had any concerns, and most were confident that these would be dealt with. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 19 People living at the home are encouraged to take part in local or national elections and to maintain their roles as citizens in any democratic process. Whilst there have been no instances where abuse has taken place, the home has an adult protection procedure which has been used where abuse has been suspected. This has helped to make sure that the people who are vulnerable and living at the home are properly protected. There is a staff guide that gives clear instructions about the actions which they must take if abuse is disclosed or witnessed. All staff spoken to are knowledgeable of these practices and have had training as part of their introduction to the home. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This judgement has been made using available evidence including a visit to this service. People live in purpose built homely and attractive accommodation, which promotes their privacy, independence and comfort during their stay at the home. The home is clean, pleasant and hygienic which supports the health and lifestyles of people living there. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 21 EVIDENCE: Cheviot House is a purpose built home which has been specifically designed to provide accommodation for older people with a range of needs. The building is bright, spacious and modern and is furnished and decorated to a good standard. It offers warm, comfortable and cheerful accommodation for older people resident on three floors. On the first floor there are two adjoining sets of rooms where people who have dementia type illness live. These areas can be separated so that they can operate as two distinct areas which helps to create a more homely atmosphere. The building has been thoughtfully designed to provide a good selection of lounge and dining areas to give people a variety of places in which they can spend their day. Each of the floors or areas has at least one lounge and a separate dining area. There are corridors with seating areas which are popular places for people who live at the home to spend their time talking to each other, staff and visitors. All areas are well furnished with comfortable seating, attractive occasional furniture and good quality floor coverings and wall decorations. Some refurbishment has been taking place to the first floor and further maintenance is being planned by the manager in a few areas. There are several garden and patio areas around the home one of which is to be developed into a sensory garden to support people who have dementia. All of the single bedrooms have their own bathroom with a toilet and sink. Bedrooms are very well equipped with good quality wardrobes, drawers and seating. People who move to the home can bring their own furniture and entertainment systems if they wish. Most people had taken the opportunity to personalise their rooms. Where people wish, bedroom doors can be fitted with devices to keep them open so that they can be held open for easy access, without causing a fire risk. The temperature in all bedrooms can be controlled by service users and rooms can be ventilated to prevent them from becoming stuffy. Overall service users were very satisfied with the good quality of accommodation. One person said, “Its like a hotel here, they make a good job keeping it decorated and clean.” On each floor or area there are a selection of toilets and bathrooms some of which have adaptations to help people who have difficulty using them. Although there was only two hoists available which mean that some people Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 22 would have to wait if they needed this equipment to transfer around or use the bathroom. People who have dementia live in two distinct areas of the home. The manager plans to make a number of changes to these areas so that current best practice can be followed. For example, changes to signage around the home, the placing of appropriate photographs and creating distinct colour contrasts / schemes to people to find their way around. This will help to support people with dementia who may become increasingly needy. There is a thorough cleaning programme at the home which makes sure that there are no unpleasant odours and this maintains a healthy environment for the people who live there. Laundry facilities are well maintained and run to make sure that that all laundry is hygienically cleaned and reduces the risks of cross infection. The laundry is well equipped and in a service area away from peoples’ rooms. Arrangements are in place to make sure that clean clothing is always returned to their owner and mistakes are avoided. The home is inspected by the Fire Prevention Authority and South Tyneside Council to make sure that the building and safety systems are suitable for the protection of those who live and work there. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 23 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. At times there are insufficient staff on duty to effectively meet the needs of residents. Many of the staff have undertaken training to make sure that their care practice is good and the manager guides them to make sure that they support people properly. The ways that staff are employed is robust and makes sure that people living at the home are protected from those who are unsuitable to work with vulnerable persons. EVIDENCE: Under normal circumstances, the manager has organised the home so that overall there are sufficient staff available to meet the needs of service users who currently live there. However the deputy manager, who is part of the first floor staffing team is also required to carry out additional duties on the ground floor each weekday afternoon, therefore leaving the first floor short of staff. The senior manager has agreed that the deputy’s hours on the first floor will Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 24 now be replaced from additional staff so that the support for the people is not reduced. As well as this several relatives commented that staffing levels are lowered if people who live at the home need to be supported by staff so that they can attend hospital appointments. One person who lives at the home said, “The staff are very helpful, however there are times when I think they could do with more help, it can be very busy.” Another said, “Occasions have arisen where a resident requiring the toilet has waited for over ten minutes, another was left on the toilet after buzzing.” All staff that have been employed at the home have undergone a specific programme of induction training within the first weeks of their employment. The provider company has made sure that the induction programme matches the standards set by the national training organisation, ‘Skills for Care.’ Almost 85 of the staff team have now attained NVQ awards in care at level 2, the remainder are all working towards either Level 2 or 3. There is a plan in place which describes the training which staff are to undertake and is based on their personal training requirements and interests. The manager makes deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links which helps to ensure that people are confident with the way in which they are supported. Examination of files for staff newly appointed in the home confirm that rigorous checks are carried out before they are employed to work in there. This includes receiving appropriate references and completing the necessary criminal record check. Staff files contain employment history, records of training and any training certificates. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 25 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The service is managed by a person who is fit to be in charge. She offers leadership, supervision and direction to the staff so that they can meet the needs of people who live there. Steps are in place which makes sure that peoples’ financial interests are safeguarded but records are compiled in a way that makes it difficult to check if they are accurate. Arrangements to make sure that the health safety and welfare of service users and staff are in place and are successful. The views of service users and their families are taken into consideration when planning how the home is to be run which empowers people living there who Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 26 can have their say. But the plans which show what arrangements are in place to make sure that the quality of the service continues to improve, are not written down. EVIDENCE: The Registered Manager has attained National Vocational Qualifications at level 4 in Management and in Care. She is also a qualified nurse. She has managed several care homes before this one. She is supervised by a representative on behalf of the company who owns the home who also carries out monthly visits to the service to report on its operations. She is supported by a team of senior staff who have clear lines of accountability within the home and within the organisation. The manager makes sure that staff have supervision six times per year where their practice and training needs are discussed. There is also effective day-today communication and decision making between herself, senior and care staff. The manager runs the home in a way that is clear, open and objective. She has an open management style and is approachable so that service users and relatives are consulted about issues affecting the home. Senior managers collect the views of the people who live at the home, families and friends so that they can check to see if the service is meeting the needs and expectations of all parties. This helps to monitor progress and develop the service. But there is not an overall management plan for the home which shows the specific steps and timescales that are to be taken to achieve targets and make sure that good quality services are attained. Satisfactory insurance and public liability cover is in place to protect the service, its staff, the people who stay there, and visitors. The home helps some people to manage their day-to-day spending and records are kept of these transactions but it was found that these did not match the amounts of finances held, reportedly because of a computer error. Peoples’ accounts were not separated which makes auditing of individual accounts impossible. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for the people who live there and staff. The home has been subject to inspections by the Fire Authority and local council to make sure that it home is safe. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 2 3 3 3 Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NA 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 OP2 Regulation 5 Requirement The registered person must make sure that each person has an agreed copy of the terms and conditions of residency issued to. A copy of this document must also be kept on each persons file. This is to make sure that people’s rights are protected. This is a new Requirement. The manager must send a letter to service users after they have been assessed to confirm that their needs can be met by the home. This is a new Requirement. The manager must make sure that all care plans must be sufficiently detailed to show the specific actions staff are to take to support their needs preferences and lifestyle. Evaluations must reflect the progress towards those goals. This is a new Requirement. The manager must make sure that all support for people with DS0000070542.V349814.R01.S.doc Timescale for action 19/02/08 2. OP3 14b 19/02/08 3. OP7 15 01/04/08 4. OP7 12 01/04/08 Cheviot Court Version 5.2 Page 29 dementia follows current best practice and this is recorded in each persons care plan. 5. OP7 13 This is a new Requirement. The manager must make sure that all people who are likely to fall and injure themselves at the home have an assessment of the risk and a list of measures which are to be put in place to minimise the amount of harm. This is a new Requirement. Where people are prescribed medication to take only when they need it, the manager must make sure that staff have clear guidance which show how staff have made these judgements. This is a new Requirement. The manager must make sure that there is an accurate record of all medication held at the home. This is a new Requirement. The manager must make sure that the process for monitoring and making sure that medication is accurately administered, is effective. This is a new Requirement. The manager must make sure that there is a structured programme of activities, which and is specifically designed for people who have dementia and follows current best practice guidance. This is a new Requirement. The manager must make sure that there are sufficient hoists available so that people who need to use them do not have to DS0000070542.V349814.R01.S.doc 19/02/08 6. OP9 13 19/02/08 7. OP9 13 01/02/08 8. OP9 24 19/02/08 9. OP12 16 19/02/08 10. OP22 13 01/02/08 Cheviot Court Version 5.2 Page 30 wait. 11. OP22 23 This is a new Requirement. The manager must make sure that adaptations to the home are in place that support people with dementia and follow current best practice. 01/04/08 12. OP27 18 This is a new Requirement. There must be sufficient suitably 01/02/08 qualified and experienced staff at the home at all times. This is to make sure that people who live at the home get proper support. This is a new Requirement. The manager must make sure that plans are written down which describe how the home responds to service users comments and detail the measures that will be put in place to improve the quality of the service. 01/02/08 13. OP33 24 14. OP35 17 This is a new Requirement. The manager must make sure 01/02/08 that there are accurate records of peoples money which is held by the home for safekeeping and that there is a system in place so that these can be checked easily. This is a new Requirement. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations The Service User Guide should state that respite care can DS0000070542.V349814.R01.S.doc Version 5.2 Page 31 Cheviot Court 2 OP1 be provided at the home. Copies of the Service Users’ Guide should be available at the home in other formats e.g. on cassette or Computer Disc, or in easier to read format. Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © 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 Cheviot Court DS0000070542.V349814.R01.S.doc Version 5.2 Page 33 - 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!