Inspection on 09/11/07 for Chignal House

This inspection was carried out on 9th November 2007.

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

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Chignal House 107 Chignal Road Chelmsford Essex CM1 2JA Lead Inspector Sarah Hannington Unannounced Inspection 9th November 2007 12:00 Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 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 Chignal House DS0000069760.V351269.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 Adults 18-65. 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. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chignal House Address 107 Chignal Road Chelmsford Essex CM1 2JA 01245 422901 01245 421189 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) Paradise Lodge Care Home Ltd Mr Vyramuthu Rattinam Loganathan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Chignal House opened in May 2007 and provides accommodation for three residents who have a learning disability. Chignal house is a detached property in a residential street. The property is fully in keeping with other properties around it. Visitor car parking is available on the front driveway. Chignal House is within a short distance of a country park, near a parade of shops and has nearby community transport to access Chelmsford town centre. Within Chignal House there is one communal lounge situated at the rear of the property, with patio doors leading to a good-sized garden. There is a large fitted kitchen and an area housing a dining table and chairs, which also contains the laundry facility. All bedrooms are single occupancy with two on the ground floor, one on the first floor that has an en suite facility. A bathroom is on the ground floor and there is a separate shower room. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit inspection mainly focused on all Key standards. The inspection took 5 hours to complete. The registered manager and proprietor were present through the inspection. Prior to this inspection CSCI (Commission for Social Care Inspection) sent out surveys to all interested parties. Information collated from surveys and discussion during the site inspection will be reflected within this report. Additionally the manager was sent a (AQAA) Annual Quality Assurance Assessment form by CSCI that asked how well the home is meeting the needs of the people who live at Chignal House. We also looked at what else we already know about the home and compare it with what the proprioter had said the information provided on the (AQAA) documentation we received back. During the site visit one service user and four staff were spoken with during this process. There was also a tour of the premises. What the service does well: The manager and staff at Chignal House provide a warm and relaxed home environment. The team are professional, experienced and observation evidenced that interaction between them and service users is caring and supportive. Service users are included in the day to day running of the home and involved in recruitment of the staff provided. They give each individual an opportunity to live as independently as possible. The care given is very person centred and service users are encouraged to use family and outside agencies as additional support to gain views and support them in achieving their goals. A quote from the manager on the AQAA form states; our ambition as a business and a care establishment is to maintain the standard set and will do this by continuous monitoring, researching, evaluating the needs of our service users in order to deliver the highest level of care required to achieve the highest results.’ Chignal House DS0000069760.V351269.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. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to ensure service users receive information and can visit the home prior to admission. EVIDENCE: A service users spoken with evidenced that visits and the service users guide had gone ahead prior to admission and that Chignal House was their choice after this process. Care plans are based on initial assessments from the placing authority and the manager carries out their own pre-assessment of need. Once in placement care plans are adjusted and change according to the changing needs of each individual. A quote from the manager on the AQAA form states; ‘The home has a “preadmission” questionnaire for prospective residents where all issues of suitability and compatibility of the accommodation, personal support, needs to cultural and faith are identified.’ Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has demonstrated that a person centred care plan process for the service user is in place and that a good system of risk assessing is in place for most areas of need. EVIDENCE: A service user spoken with evidenced that he was aware of what was in his care plan and that his views, wishes and aspiration underpinned this. Through documentation looked at on the site visit evidenced that consultation had gone ahead and that the service user is kept informed about any changes made. The manager is very proactive in encouraging the service users at Chignal house to take positive risks, to have autonomy and to mould the service and support provided around the individual’s choices. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 10 A quote from the manager on the AQAA form states; ‘ the manager provides the service user with a folder called “how we support you” this includes a care plan outlining each individuals needs to promote choice and independence. This documentation is signed by the service user, advocate or social worker or community nurse present.’ Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager encourages service users to fully participate in the lifestyle that they choose which enables service users to live a full and valuable life. EVIDENCE: At the time of inspection there was one service user present at Chignal House. This individual is very clear and precise about the lifestyle choices that they want to make and have made this very clear to staff. In response the manager and staff had set up social events within their local community, which supports them in these choices and may possibly lead them to finding a partner, which is one of their long-time ambitions in life. The manager and staff actively support this individual to live the lifestyle that they choose, whilst giving sound and practical advice. Evidenced through discussion with this individual, staff and looking through documentation it is apparent that this individual is respected, well supported and their rights as a citizen are protected. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 12 Meals provided are reflected of service user choice, nutritious and of good quality. Service users are encouraged to shop, prepare and cook meals. A quote from the manager on the AQAA form states; ‘ The home has an advocate and an inclusion worker for service users to seek advise on education, employment, relationships and facilities available in their community.’ Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal healthcare support is well managed and provides good care for residents. EVIDENCE: The manager and staff of Chignal House provide individuals with the nearest type of everyday living style that we would all expect to have. A service user spoken with evidenced that they had the support from staff that they needed, wanted and preferred. Alongside this policy, procedures and overall assessments maintained a clear, safe and well-managed approach in supporting individuals. Consistency and continuity of support is on going. Documentation and discussion with the manager and proprietor, evidenced that one service user, who has recently moved into Chignal House and then went to a assessment centre whilst medication is reviewed, has been sensitively and fully supported by a multi-disciplinary approach. The manager evidenced through discussion and through documentation that he has great skill, experience when dealing with this type of complex situation. The manager and proprietor have a good relationship with the local PCT team, GP and nurses. Other specialised service are provided if needed. Both service Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 14 users health needs are fully monitored, assessed and information around this is accurate and updated. Regular health checks go ahead and good communication between professionals working with the manager and service users is good. Medication policy and procedures are in place and to a good standard. At this present time no medication is in use until one of the service users returns from a period of stay at an assessment centre. However old medication MAR sheets and systems were looked through and evidenced as being well recorded, no omissions were found, all medications had been well accounted for as required by the relevant legislation and standards Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager’s policy, procedures and training of staff protect residents from abuse. EVIDENCE: A service user spoken with knew how to make a complaint and who to. No complaints have been recorded within the home or made to the CSCI since the being registered. A good policy and procedures around complaints are in place. Complaints procedure is included with the service users contract, service user guide and statement of purpose. Training in the protection of vulnerable adults from abuse is in place for all staff. Safe guarding guidance from the local authority and the homes policy and procedures is in place. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home environment is good and provides a clean, comfortable environment in which to live. Some assessments around the use of COSHH materials by service users need to be developed further and access to training/information provided for all service users who have ‘open’ access to these materials. EVIDENCE: The environment is clean, odour free and appropriate for the use of the service users at Chignal House. The home has only just opened in the last six months so some items such as pictures, soft furnishings and ornaments are still being put into place. A quote from the manager on the AQAA form states; ‘Prior to the home opening, we had spoken to the new service users and asked them what colours and types of room furnishings they wanted. Service users will have the opportunity to contribute towards choosing the colour of the hallway and the Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 17 type of carpet needed. The lounge is nice and comfortable and offers service users a plasma television with sky, DVD player and freeview. The home has been vigilant in identifying most areas of risk for individuals, however evidence during inspection identified that COSHH (chemicals or substances hazardous to health) are being stored underneath and along side the kitchen sink. It is not to say that individual service users cannot use these products, but individual service users should be supported by specific related risk assessments and to provide those individuals with access to training/information around COSHH. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff on duty, their experience and skill was able to meet the needs of residents and to a good standard. Good recruitment policies, procedures and records are in place, which protect residents. EVIDENCE: A member of staff on duty was spoken with on the site visit and evidenced that they were experienced, knowledgeable about the service users and knew their individual needs well. Staff showed a good understanding of how to access and use outside agencies relating to individual needs and explained how they are safe guarding those individuals. Staff have had appropriate core and specific service user led training and had undertaken the NVQ qualification. Observation showed that the interaction between staff members and service users is appropriate, professional and caring. Recruitment practices are good and staff have received appropriate checks prior to start dates. Service users are included on the interview panel when recruiting new staff for the home. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management systems are good and the home is run in the best interests of residents. The health, welfare and safety of both the clients and staff are promoted and protected. EVIDENCE: The manager is experienced, well qualified and competent in his post. The manager has a clear aims and objectives for the home and ensures that all staff are well trained and supported in their roles. The manager moulds the service provided around the individual needs of the service users. Overall the health, safety and welfare of the service users are protected. Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Chignal House DS0000069760.V351269.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action 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 YA41 Good Practice Recommendations The manager should develop further protocols around some of the risk assessments that will be developed around individual service users taking risks to enable them to participate in every day chores. This is specifically related to the use of COSHH materials. 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