Inspection on 27/06/06 for Chevy Chase

This inspection was carried out on 27th June 2006.

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

Other inspections for this house

Chevy Chase 16/04/08

Chevy Chase 10/05/07

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 10:00 27th June 2006 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.V290168.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.V290168.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.V290168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: Chevy Chase is a care home providing personal care and accommodation for up to 17 older people. The home is attached to the Percy Arms Hotel in the centre of the Northumberland village of Otterburn. The community facilities are limited, however there is a post office and general store, a coffee shop, community centre and social club. The home consists of 15 single bedrooms, 4 of which share 2 private sitting rooms, 2 single bedrooms have en suite toilet and washing facilities. One bedroom is registered for double occupancy. There is a passenger lift installed that gives access to the upper floor. The weekly charges are £358-45 and additional charges are made for all toiletries, personal newspapers and professional hairdressing. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first annual unannounced key inspection visit. The inspection was done in one day and took 6.5 hours. Time was spent talking to the homeowner, manager, some care staff and several residents and their visitors. Some of the home’s care records were reviewed and the systems that maintain residents safety. Questionnaires were provided for residents and visitors to the home and information provided by professional visitors is used in the production of the report. What the service does well: What has improved since the last inspection? Some improvement to care plans has been made with the manager identifying residents’ preferred daily routines and activities. Recent redecoration has brightened the communal areas of the home. Improvements to staffing numbers has released the manager to attend to management duties. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 6 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. Chevy Chase DS0000000527.V290168.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.V290168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Information is not readily available for prospective residents prior to admission. The manager prior to accepting a referral collects information to reduce the likelihood of accepting an unsuitable placement. The home does not provide intermediate care. EVIDENCE: On request the home were not able to immediately provide information about the home. Copies of two different Statements of Purpose were found but without a revision date it was difficult to determine which one was current. The copies included the home’s terms and conditions and complaints procedure. References to matron, nursing and nursing care identified at the last inspection were still present. These could wrongly give the impression the home can provide this service. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 9 Four files reviewed demonstrated the manager carries out a pre admission assessment of each resident before accepting them into the home. The files contained health and personal care assessments, a preferred routine for each resident and their preferred activities. Respite care is provided in the home when there is spare capacity but specialist rehabilitation is not. Chevy Chase DS0000000527.V290168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans are in place detailing residents’ health and personal care needs. Residents’ health is regularly monitored and an appropriate medication system is in place. Residents’ rights to privacy and dignity could be improved. EVIDENCE: Four care plans reviewed all contain information to assist care staff in providing care. Assessments of each resident’s abilities, health and personal care needs are in place and regularly reviewed. Recently the manager has added details of each resident’s daily routine and preferred activities but these have not been developed yet into a personal activities plan. Four residents spoken to all praised the standard of care provided but responses to questionnaires identified activities as an area for improvement. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 11 Residents assessed as having healthcare needs are supported by the community nursing service and appropriate equipment to maintain good health is obtained. A visitor to the home commented that her mother’s health is well maintained by the manager and care staff. 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 have received recent training associated with maintaining privacy and dignity in the home. 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. This at times appeared at odds with normal levels of respect. A carer was observed turning the television to another channel without asking two residents who were clearly watching the programme. However when the residents were asked to comment they were happy with the carer’s actions. 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. Consideration should be given to making this phone cordless, as residents should be able to use the phone privately. Two residents have a private line to their rooms. Chevy Chase DS0000000527.V290168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. Routines in the home are flexible to meet individual residents needs. Activities provided by the home are not good. Residents use local community facilities. Well-balanced meals are provided. EVIDENCE: Residents commented that routines in the home are flexible. Breakfast can be provided to suit individual requirements and one resident takes a break between main and sweet courses at lunchtime. Domestic routines are adjusted to suit individual preferences and each resident has a daily routine that is individual to them. The manager has detailed from residents’ their preferred activities but this has not been developed into an activities plan. As often only two staff is on duty in addition to the manager this is a difficult area to address. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 13 Two residents spoken to regularly use community facilities either alone or supported by their families and other residents go out occasionally with staff support. A mobile library visits the home fortnightly and weekly bible readings are conducted in the lounge. A relative who visits the home regularly stated the manager and staff make her welcome. 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.V290168.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents concerns are acted upon and they are protected by staff who are aware of vulnerable adult procedures. EVIDENCE: Residents spoken with stated that any concerns they have are addressed by staff. The home has a complaints procedure that is provided to each resident when they enter the home. Staff spoken with were aware of the homes policies and procedures relating to the protection of vulnerable adults. They have received recent training and new what to do if they suspected abuse. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 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 the following standard(s): 19, 26. The home was generally clean and well maintained. Some health and safety issues should be addressed. EVIDENCE: On a tour of the building the home was reasonably clean and maintained. Recent decoration of the communal areas has brightened the home. Residents’ bedrooms were individual in style and contained personal items brought into the home. Wooden door wedges were noted throughout the home and one door was wedged although no one was in the room. This is a dangerous practice. Pull chords in bathrooms and toilets were dirty and should be replaced and bars of soap are still used at communal washing points. This does not support good infection control. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Staff numbers have improved and training to meet residents’ needs is in place. A recruitment process is in place to ensure appropriate staff are employed. EVIDENCE: Following recent problems recruiting staff the home has obtained some European staff through a recruiting agency. This has enabled the manager to spend less time covering care shifts. Of seven care staff three have a National Vocational Qualification in care. Staff files contain details of training they have received. In addition to statutory training this includes; abuse awareness, catheter care, wound care and maintaining privacy and dignity. The manager has not produced a training chart to identify gaps in training. New staff have a nursing qualification from their own countries and have been provided with a full induction by the manager but she is finding it difficult to obtain training until they have resided in the United Kingdom for longer. Staff files contained appropriate information and Criminal Records Bureau checks from their country of origin have been obtained. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The manager is experienced and is aware of residents personal and healthcare needs. Maintenance contracts are in place but chocking of doors puts residents at risk in the home. Quality assessments have started. A system for recording residents’ finances is in place. EVIDENCE: The manager has recently achieved the Registered Managers Award. She has worked in care for many years and is aware of the personal and healthcare needs of older people. The manager has full control of the care provided on a daily basis and works with care staff in the home on a regular basis. Staff spoke highly of her managerial skills. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 18 The manager does not have regular staff meetings and although she states she meets with each resident regularly there is no record of any discussions or outcomes to demonstrate she has an open approach to residents wishes. A quality assurance system is being developed and questionnaires for residents and visiting professionals are being obtained. The home holds some monies at the request of residents. A file of expenditure is maintained and transactions are signed by two signatures. Receipts are not always kept. Appropriate maintenance certificates are in place and accident and fire records are well recorded. There were no thermometers in the home to ensure bath water temperatures are safe and several chocks were found in residents’ bedrooms and other areas against the advice of the fire authority. Infection control is reduced as soap bars are still used at communal washing points. Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 19 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 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 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4 Requirement A copy of the information provided to prospective service users should be available. The homes statement of purpose should not infer the home provides nursing care. Reference to MATRON and nursing should be amended. THIS REQUIREMENT IS OUTSTANDING FROM A PREVIOUS INSPECTION. 2. 3. OP19 OP26 12 12 Ensure the home is safe by removing door wedges and discouraging their use. Encourage good hygiene by replacing dirty pull chords in bathrooms and toilets and replacing soap bars at communal washing points with liquid soap dispensers. 31/07/06 31/07/06 Timescale for action 31/07/06 Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 21 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 OP10 Good Practice Recommendations Consider providing a cordless phone in the office to enable residents who use the phone to do so in their own rooms. • The manager should reflect on the recent privacy and dignity training and consider how staff practices may disempower residents. Continue the recent work done in relation to finding out about residents preferences for activities and introduce more stimulation and individual activities into the home. Produce a training matrix to identify any gaps in the training provided. Re-introduce staff meetings and involve residents by recording any discussions and there outcomes. Retain receipts for all purchases not made directly by the resident. Ensure a thermometer is available at each bathing point in the home. • 2 3 4 5 6 OP12 OP30 OP32 OP35 OP38 Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Chevy Chase DS0000000527.V290168.R01.S.doc Version 5.2 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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