Inspection on 05/07/05 for Cheviot Nursing Home

This inspection was carried out on 5th July 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 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 Nursing Home 08/05/09

Cheviot Nursing Home 11/04/07

Cheviot Nursing Home 20/12/05

Cheviot Nursing Home 10/03/05

Cheviot Nursing Home 24/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Cheviot Nursing Home 11 Park Road Colchester Essex CO3 3UL Lead Inspector Diana Green Announced 5 July 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. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cheviot Nursing Home Address 11 Park Road Colchester Essex CO3 3UL 01206 763648 01206 763987 admin@balkernegardens.fednet.org.uk Balkerne Gardens Trust Limited 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) Mrs Jean Hudson Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (3), Physical disability (1), Physical disability of places over 65 years of age (33), Terminally ill over 65 years of age (2) Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 33 persons)2 Persons of either sex, aged 65 years and over, who require general palliative care (not to exceed 2 persons)3 Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 3 persons)4 Persons of either sex, aged 65 years and over, who require intermediate care. Care to be provided in the new wing of main building; bedroom numbers 2, 3, 6, 8, 9, 10 and 11. Dedicated lounge/dining facilities to be provided and designated sessions for rehabilitation (not to exceed 7 persons)5 One person, under the age of 65 years, who requires care by reason of a physical disability, whose name was made known to the National Care Standards6 The total number of service users accommodated must not exceed 33 persons Date of last inspection 10 March 2005 Brief Description of the Service: Cheviot Care Home provides nursing and personal care with accommodation for up to 33 older people. The home provides intermediate care and is also registered to care for service users with a terminal illness.Cheviot is owned by a charitable organisation, named Balkerne Gardens Trust Limited. The home is located in a quiet cul-de-sac within walking distance from Colchester town centre. The home was opened in 1990 and consists of a two-storey building with a newer purpose built wing also two-storey.There are 29 single en-suite bedrooms and 2 double en-suite bedrooms. There is a passenger lift. The home has enclosed gardens to the rear of the property that are attractive and accessible to wheelchair users. Cheviot is accessible by road and rail and the nearest station is in Colchester. Parking is available in the small car park and adjacent road. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 5/07/05, lasting 5 hours. The inspection process included: discussions with the registered manager, five staff, a social worker, Macmillan nurse, four residents and four relatives; a partial tour of the premises including a number of residents’ rooms, bathrooms, communal areas and the laundry; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Fourteen standards were covered, and one requirement made and action had been taken promptly to address previous requirements and recommendations. It was evident that Cheviot Nursing Home aims to provide and is successful in achieving a high standard of personal and nursing care for residents. The manager and staff were welcoming and helpful throughout the inspection. What the service does well: The home provides a welcoming, homely environment and consistently high standards of nursing and personal care: residents and their relatives were unanimous in their praise of the manager and staff and said they were very caring. The relative of one service user said that the home was recommended to them and they were impressed with the standards of personal care and the consultation with relatives was good. A resident said their GP had recommended the home and the staff were “amazingly friendly, helpful and cheerful and there were lots of them”. Residents’ health needs are met appropriately and well monitored and prompt referrals are made to GP’s and relevant health professionals where required. Cheviot provides a successful multi-disciplinary approach to care that is evident in the positive outcomes for residents. The manager is well supported by the Care Director and through peer group management meetings. The Care Director is frequently in attendance at the home, ensuring that residents and their relatives are happy with the care provided at Cheviot. Staff are employed in sufficient numbers and are skilled to care for the needs of residents through regular training and supervision by the manager. Additional staff hours are provided as necessary to ensure the needs of Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 6 residents are met appropriately. One resident said ”they will always find time to talk to you”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 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 Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 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 &6 The service operates a thorough and responsible pre-admission assessment process: care and attention is given ensuring that the home can meet the individual’s needs, resulting in appropriate admissions. Residents receiving intermediate care are enabled through treatment and rehabilitation to maximise their independence and return home. EVIDENCE: Assessment of all prospective residents is undertaken by a registered nurse prior to admission, and information on the person’s needs is recorded. Evidence of pre-admission assessments were present on all four files inspected. Copies of care management assessments were held on file where relevant. The assessment documentation was being developed to ensure that assessments were recorded comprehensively as previous assessments were brief in detail. Cheviot is registered to provide intermediate care with the current focus on hospital avoidance rather than step-down facilities. The multi-disciplinary team who also provided training for care staff undertook assessments for these Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 9 residents. A pilot to establish a registered nurse as a key worker for residents receiving intermediate care had been implemented. Weekly occupational therapy/physiotherapy treatment was provided. A social worker spoke positively of the service and said that it was successful in building peoples’ confidence. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 10 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 &10 Residents health and personal care needs are consistently well met within the home. Staff treated residents with dignity and respect. EVIDENCE: Four care files were inspected. All contained care plans that covered all key needs (physical and social), provided good detail of the action required of staff to meet residents’ needs, and had been regularly reviewed. Assessments for moving and handling/mobility, pressure areas, continence needs and risk assessments for falls were recorded in the files inspected and had been regularly reviewed. New documentation was being introduced that demonstrated best practice in wound care. Residents and their relatives spoken with said they were aware of the care plan and this was also evidenced by their signatures. Residents spoken with felt that staff gave them the level of support and assistance they required, and provided care in an appropriate way. Staff were observed to treat residents respectfully, and to assist them in a discrete and dignified way. All relatives spoken with were very positive about the personal and healthcare support provided by the home. One relative said that staff gave their loved one plenty of attention and treated them like a Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 11 person. One health professional said that care staff treat residents as individuals and make them feel it is their home. Care plans detailed the action required to meet these needs and the provision of appropriate pressure relief equipment and continence aids. The standard of personal care was observed to be good. Records showed appropriate and prompt referral to health professionals, and GP’s. The manager stated that the home is well supported by the local GP practice that attends the home weekly and residents also have a choice of their own GP. The training records confirmed that care staff received training on privacy/dignity at induction and when providing personal care. Residents and their relatives stated that staff were very caring and respectful towards them and made every effort to uphold their privacy and dignity. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 12 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) 13 & 15 Visiting arrangements are open and relaxed; staff encourage contact with the local community. The home supplies sufficient quantity and quality of food, and provides a well balanced diet that meets individual needs and choices. EVIDENCE: Four visitors spoken with said they were able to visit at anytime and found the home and staff very welcoming. Relatives said they were able to meet in private and in the visitors’ room or communal rooms as they wished. Residents were encouraged to maintain contact with the local community and were supported to take part in activities such as gardening assisted by volunteers who attended regularly. All four service users spoken to were positive about the meals provided, and confirmed that a choice of food was available. The main meal on the day of the inspection was well balanced, looked appetising, and was eaten well by residents; nutrition records showed a good range of meals being provided and good monitoring of nutritional intake. A full choice was available for breakfast that was served from 07:30 onwards. Lunch comprised a main dish and an alternative choice. Several choices were offered on the menu for teatime including a hot supper and snacks were always available. Service users were able to eat in the dining room or conservatory but could also choose to eat in Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 13 their room. Relatives spoken with confirmed that staff assisted service users in an appropriate and respectful way during their lunch. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 14 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) 18 Appropriate policies, procedures and practices were in place to promote the protection of residents from abuse. The organisation actively promoted awareness of protection issues through staff training, recruitment practices and respecting individual rights. EVIDENCE: The home’s policy and procedures for the protection of vulnerable adults were currently being updated. The manager confirmed that updated information published by the EVAPC (Essex Vulnerable Adults Protection Committee) had been obtained as was to be issued to staff the following day at a training session on the subject. The manager had not yet received training but was clear on the process to follow in the event of an allegation. This directed the manager to seek advice from the Care Director who had received training from EVAPC. Records inspected showed that appropriate pre-recruitment checks on new staff were undertaken prior to appointment (see standard 29). Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 15 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 & 26 Cheviot is safe, well maintained and has a homely environment; heating and lighting were satisfactory. The home was clean and hygienic with safe infection control practices evident. EVIDENCE: A partial inspection of the premises was made that included communal areas, a number of residents’ rooms, the sluices, bathrooms and the laundry. The home was in a good state of maintenance and decoration. There was a programme of refurbishment in place. Communal rooms were clean and well decorated and furnished to provide a homely environment for residents. Residents spoken with said their rooms were always kept clean. The gardens were attractive and well maintained and the majority of rooms had an exceptionally pleasant outlook. The gardens provided good access for residents. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 16 The heating, lighting, water supply and ventilation met the relevant environmental and health and safety requirements as evidenced from the home’s records. Checks to minimise the risks from Legionella were undertaken annually and included chlorination of boilers. Rooms were centrally heated with controls in individual rooms and radiators were guarded as part of a risk assessment. The home was clean and hygienic throughout with no odorous smells. The infection control practices in place were observed to be safe. The home had two sluice disinfectors, one on each floor of the premises that were well maintained. The laundry was equipped as required and very well organised. Laundry and sluice facilities were located away from areas where food was prepared or eaten. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 17 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 The staffing levels (skill mix, number and competence) are appropriate to the needs of current residents. Recruitment practices for staff were thorough but without CRB disclosures for volunteers the protection of service users cannot be assured. EVIDENCE: There were thirty-two residents at the home including 7 receiving intermediate care. Staffing numbers and skill mix met the levels agreed with the CSCI; from inspection of the staff duty rota and discussion with staff and residents, there was evidence that staffing levels were well maintained, and met the needs of residents. The home has a bank of staff to cover annual leave and sickness and agency staff are rarely used in the home. The files of two new staff members were inspected: these contained evidence that all the required checks had been obtained (two satisfactory references, CRB/POVA checks) and copies of birth certificates, passports, photographs obtained before the individuals commenced employment at the home. Both had received a statement of terms and conditions of employment. The home’s code of conduct complies with the General Social Care Council Code of Conduct and is provided to all staff on appointment. The manager confirmed that volunteers recruited to the home had no CRB disclosure. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 18 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) 31 & 38 The home is well managed and run in the best interests of residents. The manager promotes an open, positive and supportive atmosphere that enables staff to feel confident and competent in their practice. EVIDENCE: The registered manager of the home is an experienced registered nurse with NVQ level 4 and has more than10 years management experience and evidence of updated training undertaken. The home was well managed and run in the best interests of service users. Ongoing training was provided to ensure that the manager and staff were familiar with the conditions/diseases associated with old age. Staff spoken with said they felt confidant in approaching the manager and were supported in their practice. Residents and relatives spoke highly of the manager and Care Director who was frequently in attendance and Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 19 well known to them. Relatives confirmed that communication was good and they were kept well informed. The home had a health and safety policy statement and there was evidence from the records and in discussion with the manager and staff that safe working practices were in place. All accidents, injuries and incidents were wellrecorded and appropriate action taken. Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 20 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x x x x x x 3 Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 7,9,19 Schedule 2 Requirement The registered person must ensure that volunteers who have regular contact with residents have a Criminal Records Bureau disclosure undertaken. Timescale for action Immediate on receipt of report. 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 Good Practice Recommendations Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 22 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Cheviot Nursing Home I56-I05 S15322 Cheviot V221353 050705 Stage 4_Updated.doc Version 1.40 Page 23 - 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. 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