Inspection on 16/04/08 for Chevy Chase

This inspection was carried out on 16th April 2008.

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

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

Chevy Chase 10/05/07

Chevy Chase 27/06/06

Chevy Chase 09/02/06

Chevy Chase 14/10/05

Chevy Chase 21/02/05

Chevy Chase 11/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Chevy Chase Percy Arms Hotel Otterburn Northumberland NE19 1NR Lead Inspector Allan Helmrich Key Unannounced Inspection 16th and 17th April 2008 11:45 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 Chevy Chase DS0000000527.V362340.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. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chevy Chase Address Percy Arms Hotel Otterburn Northumberland NE19 1NR 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) 01830 520057 01830 520567 percyarmshotel@yahoo.co.uk Mrs A Emerson Mr C Emerson Mrs Marie Elizabeth McStay Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Chevy Chase DS0000000527.V362340.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 category: Old age, not falling within any other category - Code OP, maximum number of places: 17 The maximum number of service users who can be accommodated is: 17 10th May 2007 2. Date of last inspection Brief Description of the Service: Chevy Chase is a care home attached to the Percy Arms Hotel in the centre of Otterburn, a rural village in Northumberland. Community facilities are limited. There is a post office and general store, a coffee shop, community centre and social club. There home are 15 single bedrooms, four of which share two small, private sitting rooms. Two of the bedrooms have en suite toilet and washing facilities. One bedroom is registered for double occupancy. There is a passenger lift to the first floor. Nursing care is not provided. The weekly charges are £409. Additional charges are made for toiletries, personal newspapers and professional hairdressing. Information kept in the reception area includes the homes service user guide and a copy of the last inspection report. The file is kept on a shelf under the signing in book. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection was unannounced and was undertaken over two days. Before the visit we looked at: Information we have received since the last visit on 10th May 2007; How the service dealt with any complaints and concerns since the last visit; Any changes to how the home is run; The provider’s view of how well they care for people; The views of residents, their relatives and other professionals who visit the service. During the visit we: Talked with people who use the service, Talked with the registered manager and staff on duty, 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, including medication, Checked that staff had the knowledge, skills and training to meet the needs of the people they care for, Looked around the building to assess if it was clean, safe and comfortable, Checked what improvements had been made since the last visit. Six out of ten residents returned a questionnaire as well as one health care professional and two relatives. What the service does well: The home is small and provides a friendly and homely environment. A visitor commented that Chevy Chase has home from home qualities. Residents enjoy each others company and also the company of the staff team. Residents are encouraged and enabled to use the village facilities. Residents’ health is well monitored. Meals are well presented and tasty. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6. People who use the service experience good quality outcomes in this area. People are given good information to help them decide about moving into the home. Their needs and wishes are assessed before they are given the chance to move in. The home does not admit people for intermediate care. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Information about the home and a copy of the last CSCI report are kept in the reception area. A recently admitted resident stated that she was content with the information provided to her. Each resident has a copy of the service user guide and complaints procedure in their bedside cabinet. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 9 The file for a newly admitted resident was seen. All the basic information needed to limit the possibility of admitting someone whose needs could not be met was obtained before a place in the home was offered. The file also contained a copy of the assessment of need produced by the local authority. Following admission a range of health assessments and care plans were produced to ensure appropriate care is provided. This assessment information was good. The manager stated that respite care is offered but that rehabilitative care is not provided in the home. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. Care plans are in place that identify residents’ health and personal care needs. Residents’ health is regularly monitored and an appropriate medication system is in place. Staff show respect to residents and attend to their needs sensitively. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Four care plans reviewed all contain information to assist care staff in providing care. One care plan of a recently admitted resident did not contain a photograph to identify them. Assessments of each resident’s abilities, health and personal care needs are in place and regularly reviewed. Risks in daily living such as the prevention of falls is assessed and appropriate action to limit these is taken. There was information about each resident’s daily routine and Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 11 preferred activities and where residents prefer not to be involved this is recorded. None of the records included a personal activity plan but whenever an activity takes place this is recorded. Several residents spoken to during the inspection stated they enjoy living in the home and get appropriate support from the staff team. Some residents regularly use the facilities in the village; shops pubs and the village hall. Each Thursday members of the local church visit and involve those residents who choose in bible reading. Residents assessed as having healthcare needs are supported by the community nursing service and appropriate equipment to maintain good health is obtained. The home’s system for recording, storage, handling and dispensing medicines is appropriate to the size of the home. Policies and procedures to assist staff are in place and all staff dispensing medicines have been trained. Staff were observed during the day speaking to residents appropriately and attending sensitively to their needs. Residents spoken to were happy with the way staff spoke and reacted to them. This is a small home and residents and staff appeared very comfortable with each other. There is no public phone in the home. The manager stated that any resident wanting to use the phone is enabled to use the office phone. Recently a cordless phone has been purchased to enable residents to take calls privately. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience adequate quality outcomes in this area. Routines in the home are flexible and residents are encouraged to be independent within their capabilities. Residents use local community facilities. Well-balanced meals are provided. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Residents commented that they choose what to do and where to go. Throughout the day residents were seen talking with staff and chatting to each other in the lounge. One resident was out for most of the day with a friend and the records showed that other residents regularly use the village facilities. The manager has detailed from residents’ their preferred activities. However this is a small home with a small staff team, often only two staff are on duty in addition to the manager and therefore providing individual activities is a Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 13 difficult area to address. One resident is provided with tea and bread each morning in her bedroom before breakfast. Domestic routines are adjusted to suit individual preferences. Two residents spoken to stated they use local village facilities either supported by staff or with family members. Returned questionnaires mentioned a lack of activities with comments; sometimes there are activities, there are never activities and activities are limited. The inspector took a meal with residents at lunchtime. The meal was well presented and tasty. Residents’ needs were addressed appropriately throughout, portion sizes varied to suit individual tastes and appropriate mild encouragement was provided by staff. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience adequate quality outcomes in this area. The views of people who live in the home are listened to. They are protected from harm through policies, procedures and in-house staff training. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints procedure that is provided to new residents and their families. The manager meets regularly with residents individually or in small groups to ensure they are comfortable in the home. No record is kept of these discussions to demonstrate that any dissatisfaction is addressed. The home maintains a log to record any concerns but nothing was recorded since the last inspection. Residents spoken to all stated they would be happy to talk to the manager or staff if they had a concern and this was also supported by the returned questionnaires. Staff demonstrated they know where policies and procedures related to the protection of vulnerable people are. They also stated that although they have not attended any training related to these issues, the manager has provided Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 15 some training in the home using question and answer sessions. Training related to restraint and challenging behaviour was not recorded on the home’s training plan. Residents spoken to during the inspection stated they feel safe and supported in the home. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 16 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 and 26. People who use the service experience adequate quality outcomes in this area. The home was generally clean and well maintained. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home is clean and reasonably well maintained. Following a water leak the ceiling in a corridor requires redecoration. Residents’ bedrooms were individual in style and contained personal items brought into the home. An odour around one bedroom is being addressed by regular ventilation. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 17 A bathroom on the first floor has no water to the bath and only limited water at the sink. This means that anyone using the toilet needs to return to their bedroom before washing their hands. Although the home was found to be clean, the cleaning schedule states bedroom cleaning is required weekly. A more specific schedule is required to show daily tasks. The laundry is appropriate to the size of home. Equipment can meet disinfection standards and instruction regarding washing is posted for staff. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 18 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. People who use the service experience good quality outcomes in this area. A caring staff team employed in numbers sufficient to meet health and personal care needs supports residents. Recruitment processes ensure appropriate staff are employed to care for vulnerable people. A staff training and development programme is in place for new recruits to ensure they can provide an appropriate standard of care in the home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The staff team looking after the current residents consists of three staff from 8-00am until 1-00pm then two staff until 9-00pm. During the night there is one member of staff on duty with another sleeping on the premises in case of an emergency. Of the seven care staff employed, four have achieved a National Vocational Qualification (NVQ) in care and the others are involved in this award. No new staff have been employed in the home for two years. All staff have been provided with a code of conduct. An audit sheet is not available to the Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 19 manager to ensure a thorough recruitment process is followed should the home employ anyone in the future. Although no new staff have been employed recently the home does have a training and development programme in place to ensure staff working with vulnerable people are appropriately trained. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 20 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, 33, 35 and 38. People who use the service experience good quality outcomes in this area. Someone qualified, competent and experienced in the care of older people manages the home. The home is run in a way that benefits the people who live there. Some quality monitoring systems are in place to measure the quality of care provided. The home is reasonably safe for the people who live there. We have made this judgment using a range of evidence, including a visit to this service. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has managed a care home for several years and demonstrated throughout the inspection her awareness of the personal and healthcare needs of older people. The manager has obtained the Registered Managers Award and has full control of the care provided on a daily basis. Staff spoke highly of her managerial skills. She has regular staff meetings, these have an agenda and minutes are produced. She also meets with each resident regularly either individually or in small groups. This is done with an agenda but there is no record of the discussions or outcomes to demonstrate she has an open approach to residents’ wishes. A quality assurance system is being developed. Currently the manager is reviewing issues directly related to the care provided. Questionnaires for residents and visitors are used but the issues identified for improvement have not been developed nor have the results been published. The home has a business plan to develop the service. The home holds some monies at the request of residents. A file of expenditure is maintained and two signatures sign transactions. The monies held for one resident were checked and found to be correct. Accident and fire records are well recorded. Maintenance certificates are in place for gas and electrical items and lifts and hoisting equipment has been recently serviced. Water temperatures were checked and found to operate within the safe, comfortable range. Cleaning materials used in the home are safely stored and information related to safe working is posted for staff in the laundry area. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X 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 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 23(2)(j) Requirement The manager must ensure that hand washing facilities are available in the first floor bathroom/toilet identified at the inspection. Timescale for action 31/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP7 OP12 OP18 OP19 OP29 OP33 Good Practice Recommendations Ensure that a recent photograph of new admissions is included in their care plane to enable staff to identify the resident. Look at ways of meeting individual social needs within a small staff team. Review the training provided to staff relating to the protection of vulnerable people to ensure it meets current expectations. Review the domestic cleaning rota to ensure it meets the desired standard. Produce an audit sheet for use in recruitment to ensure a good process is maintained. Continue using the quality monitoring system employed in DS0000000527.V362340.R01.S.doc Version 5.2 Page 24 Chevy Chase the home and develop those areas identified for improvement with action plans. Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region 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 Chevy Chase DS0000000527.V362340.R01.S.doc Version 5.2 Page 26 - 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!