Inspection on 13/02/06 for Chiltern Cheshire Home

This inspection was carried out on 13th February 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chiltern Cheshire Home 08/05/07

Chiltern Cheshire Home 01/12/05

Chiltern Cheshire Home 23/11/04

Chiltern Cheshire Home 22/09/04

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

CARE HOME ADULTS 18-65 Chiltern Cheshire Home Packhorse Road Gerrards Cross Bucks SL9 8JT Lead Inspector Gill Gentles Unannounced Inspection 13th February 2006 1:00 Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 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 Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 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. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chiltern Cheshire Home Address Packhorse Road Gerrards Cross Bucks SL9 8JT 01753 480950 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) www.leonard-cheshire.org.uk Leonard Cheshire Ms Hanne Abildgaard Care Home 22 Category(ies) of Physical disability (0), Physical disability over 65 registration, with number years of age (0) of places Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No persons over the age of 65 to be admitted. Date of last inspection 1st December 2005 Brief Description of the Service: Chiltern Cheshire is a purpose built home set in Gerrards Cross. The home provides care for 22 adults who have a physical disability. Personal care and support is provided for both men and women between the ages of 18 and 65 yrs old. The home is situated in close proximity to the town centre where all local facilities can be found. Service Users utilise these services and the facilities of the nearby towns of High Wycombe, Slough and Uxbridge. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on Monday 13th February at 1 pm by Gill Gentles and Nicky Cahill. Six standards were assessed during the visit. The focus of this inspection was spending quality time talking to residents who were in the home. Residents were in the dining areas enjoying relaxed lunches; which allowed the inspectors time to converse with a large number of residents for well over an hour. All residents spoken with appeared to be happy, relaxed and comfortable in their surroundings, respect for each other and the staff members was evident with jovial banter being observed between all parties. Residents confirmed that the home is well managed and that the manager in post is doing a good job maintaining the practices and high standards of the previous manager by continuing to involve residents in decisions about the home e.g. recruitment, attending resident committee meetings etc. A number of residents felt that they had lost some of the power they used to have, but acknowledged that this was due to the unfortunate death of the resident group co-ordinator last year, but they now feel it is growing in strength again with a new chairman in place. Through discussions residents confirmed that the home offers an abundance of activities in and out of the home. There is now an employee who is solely responsible for co-ordinating volunteers of which there are over 100 now who accompany residents out and about e.g. football matches, university tutorials, shopping, cinema, theatre etc. Meals were discussed and all reported that the food was good and the chef provides a selection for each meal and is very accommodating if individuals prefer something different. Menus are displayed around the home and residents are asked in an evening what they would like for the following days meals. A number of residents commented that due to individual needs changing there are times during the day when staff are rushed off their feet. The manager periodically, in line with resident needs, reviews the staffing levels. At the time of the inspection, staffing levels were felt to be adequate to meet the current needs. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 6 What the service does well: 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. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 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 Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The core standards were not assessed during this inspection, as at the previous inspection in December 05 they were met. EVIDENCE: Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The core standards were not assessed during this inspection, as at the previous inspection in December 05 they were met. EVIDENCE: Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 The home provides a supply of nutritious and balanced foods ensuring residents are supported and encouraged to maintain a healthy diet. EVIDENCE: Meals were discussed with residents and all reported that the food was good and the chef provides a selection for each meal and is very accommodating if individuals prefer something different. Menus are displayed around the home and residents are asked in an evening what they would like for the following days meals. Mealtimes are flexible, with the main meal being offered midday. A number of residents had chosen to have lighter lunches and their main meal in an evening, which is easily accommodated by the kitchen. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 Personal support is provided adequately and appropriately by the staff in the home ensuring residents receive personal support in the way they have identified in the Care Plans. The home has a medication policy and procedures in place, ensuring residents are safe from harm EVIDENCE: All residents receive personal care in a way that they have identified in their care plans. Care plans clearly identified the times that residents wish to get up and receive the personal care. There are also clear guidelines relating to movement and transfer of each individual from the wheelchair to bed and vice versa. There appeared to be no specific time for residents to go to bed. The manager has ensured that the home has all the appropriate equipment required to ensure the promotion of independence. Residents are responsible for their personal appearance by selecting their attire, hairstyles etc. Residents are afforded the opportunity to express preference in who provides their personal care. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 12 Additional support is available in the home from Physiotherapists and activity co-ordinators and external support from other professionals e.g. speech therapist etc. Through discussion with residents it was clear that the staff team consists of a cross section of cultures, with a large amount of staff originating in European countries i.e. Denmark, Poland. There are also a number of African and Japanese staff and volunteers. The residents reported this being a positive experience for all concerned. Residents reported that they also learning new languages. There has been no change since the previous inspection in December 05 when a number of residents were found to be supported and encouraged to retain, administer and control their own medication. There are risk assessments in place with clear procedural guidelines for each individual who self–medicates. Individual residents (where appropriate) have consented for the home to receive, record, store, administer and disposal of medicines on their behalf. In general medicines were found to be stored appropriately and in line with the guidelines issued from the Royal Pharmaceutical Society of Great Britain. However a couple of issues were noted. Creams and ointments etc are now being dated when opened. There were however two gaps noted on the Medication Administration Records for February 06 with no codes being used. It was discussed with the manager to remind staff that they must ensure Medication Administration Records are completed adequately. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The core standards were not assessed during this inspection, as at the previous inspection in December 05 they were met. EVIDENCE: Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The core standards were not assessed during this inspection, as at the previous inspection in December 05 they were met. EVIDENCE: Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 Documentary evidence shows a high percentage of staff are adequately and appropriately trained to ensure residents are cared for by competent and qualified staff. EVIDENCE: There appears to be an effective staff team in sufficient numbers to support residents assessed needs. The number of staff on duty ensure uninterrupted work with individuals, the smooth running of the home and management of any emergencies that may arise. Staff observed during the visit were seen to have the characteristics of being approachable, good communicators, interested, motivated and have developed good relationships with the residents based on mutual respect. The manager and the organisation have strived towards ensuring staff are trained to NVQ level 2, however there has been some difficulty that is now being addressed. The organisation has accessed “Care in the Shires” to provide NVQ training to the home. At the time of the inspection 7 staff had completed NVQ level 2 and above. The home has recently employed a training co-ordinator who has managed the enormous task of co-ordinating the training for all staff and has produced up to Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 16 date information relating to the mandatory training, Protection of Vulnerable Adults and Medication. Out of 50 members of staff there are: • • • • • • • POVA - 44 trained 6 require training (4 new members) - Refresher Training required for 27 FIRE – 33 staff require refresher that has already commenced and will be completed by the middle of March 06. FOOD HYGIENE - 40 members in total should have this training - 15 require training INFECTION CONTROL - 43 members in total should have this training 18 require training. MOVING & HANDLING all staff except 5 are up to date. FIRST AID - 34 members in total should have this training - 7 require training of which 4 are new MEDICATION –23 members in total should have this training - 4 require training The home is working hard to ensure all staff are trained appropriately and there is a rolling programme in place to ensure this is maintained. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 A competent manager is in place to ensure residents benefit from a well run home. EVIDENCE: Hanne Abildgaard who was registered in 2005 manages the home. Her experience has been through successfully working her way up the career ladder at Chiltern Cheshire. Hanne has completed her Registered Managers Award and is committed to expanding her knowledge base. Her overall responsibilities are to ensure that the aims and objectives of the home are achieved, policies and procedures are implemented and that staff have an understanding of their content and that residents have current Care Plans and contracts and that they understand the terms and conditions of living in the home. Promoting residents independence and to ensure that residents voices are heard by involving them in the running of the home. Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 18 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 X 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 X X X X X X Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 19 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 YA20 Regulation 13(2) Requirement To ensure that there are no gaps on the Medication Administration Records and to date creams and lotions when opened. Timescale for action 13/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Chiltern Cheshire Home DS0000022961.V284062.R01.S.doc Version 5.1 Page 21 - 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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