Inspection on 14/06/05 for Chiltern Retirement Home

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chiltern Retirement Home 01/10/07

Chiltern Retirement Home 23/05/06

Chiltern Retirement Home 27/10/05

Chiltern Retirement Home 25/02/05

Chiltern Retirement Home 09/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Chiltern Retirement Home 23 Kingsfield Oval Basford Stoke on Trent Staffordshire, ST4 6HN Lead Inspector Peter Dawson Unannounced 14 June 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chiltern House Address 23 Kingsfield Oval Basford Stoke on Trent Staffordshire ST4 6HN 01782 711186 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr D Arnold Mrs Diane Arnold Care Home 14 2 14 4 Category(ies) of DE(E) registration, with number OP of places PD(E) Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25 February 2005 Brief Description of the Service: Chiltern House is situated int a residential area close to Newcastle and is easily accessible by public transport There are 10 single and 2 shared bedrooms, seven have en-suite facilities. There is an assisted bathroom and separate showe room with walk in shower, both located on the ground floor. There are bedrooms on the ground and first floor, with access to the first floor via the stairs or stair lift. Additional categories of registration are for two people over 65 requiring dementia care and four people over 65 who may have a physical disability. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home has a good record of care provision and compliance. Two unannounced visits will therefore be made to the home in the current year. There were 12 people in residence at the time of this unannounced inspection including one person on respite care. There were 2 vacancies. Two people had been re-assessed and transferred to nursing home care since the last inspection. Good standards of care were evidenced in discussions with residents and staff and also from sampling of records. All residents were seen the view of most sought. Three visitors were seen but not spoken to during the inspection but clearly “at home” during their visits. This is a small home providing very individualist care for residents. There are very close relationships between residents and staff with a small committed staff group. There is a high staff awareness of health care needs which are well recorded. Two aspects of health care require some attention and one in relation to preemployment checks for staff. The inspection indicated a high level of care practice was in place and the health, safety and protection of residents were paramount in the running of the home. What the service does well: A pro-active approach to health care. Staff are diligent in identifying, reporting and acting upon any changes in the health of residents. There is a record of close working with health care professionals and early referral for assessment. A small resident and staff group with close relationships and bonds between them. Open management and dialogue at all levels from residents to owners. Visitors feel at ease in the home and contacts with families promoted with relatives informed of any changes in care. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 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. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-5 The statement of purpose should be reviewed and updated. There are adequate contracts in place for all residents. Pre admission assessments are made and should be recorded. There was evidence of appropriate introductions to the home prior to admission. EVIDENCE: There is a statement of purpose and service users guide which is generally made available to prospective residents. These have not been reviewed since their origination in 2002 and this should be done and the information updated. Contracts are provided by the relevant Local Authority for funded residents and contracts provided by the home for self-funding residents. Contracts are signed by residents who retain a copy. Pre admission assessments are carried out by the home in all cases. Care Management assessments are provided for residents funded by the Local Authority and some who are privately funded. Needs assessments by the home Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 9 should cover items in standard 3.3 and be recorded to ensure needs are identified prior to admission and can be met by the home as required. Residents and their families are directly involved in this process. The homes capacity to meet needs are defined in the statement of purpose. Assessments provide the basis for identifying and ensuring that needs can be met. The home readily requests reassessment in instances where needs change and alternative placements can be pursued if necessary. Two residents have been transferred to nursing homes since the last inspection one because of deterioration in physical condition the other due to deterioration on mental health status. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 - 10 Health and personal care needs are clearly defined in care plans. Complex and special health care needs are included. There is good staff awareness of health care needs. The system of medication inspected is safe and well recorded. There was evidence from observations that privacy and dignity is respected. EVIDENCE: Care plans are generated from assessed needs. They were sampled and there was evidence of a good standard of information available to provide care. A recently admitted resident with complex health care needs were clearly defined and the actions required by staff to sustain those aspects of health care. There were examples of good social histories and medical histories compiled with help from residents and relatives. Plans are generally reviewed on a monthly basis as required. Where health and personal care needs change the plan is amended or new plant established. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 11 Whilst residents and relatives are involved in care plan compilation they are not signed by residents/relatives as recommended in standard 7.6. the home may wish to move towards this practice. Health care needs are clearly identified and monitored in this home, with has a good record of early identification of health care needs and referral to and working with health care professionals. There was a focus during the inspection upon health care which included discussions with residents and Manager and inspection of health care records - there was evidence of attention to detail and clear understanding of actions required to be taken to maintain the health care needs of residents. Optical and auditory tests had been carried out as required following discussions with some residents. One resident had not had a visit from the chiropody service for 7 months, although requests had been made by the home. Alternative arrangements identified by the resident were not satisfactory and the home will review the arrangements for chiropody care for this resident. There were examples of staff support following diagnosis of serious medical conditions. Early identification such a condition by staff is commended and the swift action followed to ensure hospital admission. There are no pressure are management problems in the home at this time and District Nurses visiting only for the usual routine checks. A highly dependent resident who is cared for in bed for the greater part of her day is free from pressure area problems, she is regularly turned etc. and requires total care from staff. Her continued sustained care and health is a credit to staff. A recently admitted resident requires dialysis at hospital 3 days per week and there is a detailed plan of care in place identifying actions to be taken and relevant hospital telephone numbers in the event of any concerns. Residents appeared to be weighed if there were concerns about possible weight loss. It is required that all resident are weighed monthly and this is recorded. If there are concerns about weight loss (or gain) those residents should be weighed weekly. Medication records were inspected and found to be satisfactory. There is a safe system of medication administration in the home. The Co-op Pharmacy provides an MDS system to the home and carried out 3 monthly checks of the system in the home. All staff have received appropriate accredited training. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 - 15 Chosen lifestyles are accommodated. Residents were satisfied with arrangements for their social, religious and recreational needs. Visitors were seen to move freely in the home and at ease. Food provision was confirmed to be good and satisfactory. EVIDENCE: Most residents were spoken to and confirmed they were satisfied with care provision and that their expectations and preferences were being met. They confirmed that chosen lifestyles are understood and acted upon by staff. An example was of the husband of a relative coming to the home for lunch several days each week. There is no formal activities programme in the home residents were seen pursuing their individual choices during the inspection: watching TV, crocheting, reading newspapers or chatting together. There are regular visits to the home by entertainers which is particularly enjoyed by most residents. A request from residents for a local outing resulted in all except 4 very dependent residents going to nearby theatre for lunch. Several residents go out with relatives and all residents are reported to have visitors. Three visitors were seen but not spoken to during the morning of the inspection. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 13 Food provision in this home has been traditionally good and residents confirmed during this inspection their continued satisfaction with the quality and quantity of food. The dining area is of good size with split recessed area and tables always seen to be well laid and attractive. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 -18 The complaints procedure clearly states the procedure in place. A copy should be readily available for visitors in the reception area. Rights are protected. Relatives involved in decision making where capacity may restrict residents. All have regular visitors and advocates not required at time, although the home is aware of the services of the independent advocacy services available. All staff have written instructions for reporting abuse. EVIDENCE: There have been no complaints to the home or to the Commission since the last inspection. There is a complaints procedure posted in the dining area, but not in the reception area where visitors have constant access. It is recommended that a copy of the procedure is made available in this area particularly for visitors use. All staff have training in, and are aware of, the procedures for reporting suspected or actual abuse. There are clear written procedures in place relating to adult protection. All staff have copies of the procedures. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 - 26 The environment is safe and well maintained. There are adequate toileting and washing areas available, the majority of bedrooms have en-suite facilities. Bedrooms are pleasant well furnished and all highly personalised reflecting individuality of residents. Standards of hygiene are excellent. EVIDENCE: The home is suitable for its stated purpose. It is well furnishing along domestic lines and décor is maintained to a good standard. Bedrooms are bright and well furnished. There is good personalisation of bedrooms all having items identifying the personality of the resident. There were examples of items of furniture being brought from home the accommodate preference and individual identity. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 16 There is an assisted bath and walk-in shower which provide alternative choices for bathing. Seven bedrooms have en-suite facilities and toilet areas are located near to communal areas. The grounds are well maintained and provide a pleasant outlook to the garden area from several bedrooms and patio doors provide easy access to the garden. Some light restrictions for reading were raised in conversation with residents but the Manager is aware of this and appropriate actions in place to deal with it. The building complies with all requirements relating to fire prevention and there are regular drills and servicing of equipment. The large lounge area naturally divides into two small groups allowing choice of seating, activity and socialisation. The dining area is of good size, is a split room with recessed area used for residents to spend time alone, listening to music or a venue for visitors. Bedrooms are accessed as required during the day, all rooms have thermostatically controlled valves for individual heating preferences and all hot water outlets in resident areas have fail-safe valves fitted. The laundry is domestic is size and equipment and provides adequate facilities for the resident numbers. Continence laundry is handled by means of the red bag system allowing good infection control practice. There are 2 shared bedrooms in the home. One presently unoccupied as there are vacancies. Privacy screens are provided and used in the other occupied double bedroom. The home does not have a shaft lift but has a stair lift used by residents only with staff assistance and risk assessed. There are grab rails at appropriate points and toilet seats/frames to assist in the toileting areas. The home has an Oxford mini-hoist which is presently used for a totally dependent resident. Standards of hygiene in the home were high. Cleanliness was excellent and there were no mal-odours. Infection control practices were in place with disposable barrier equipment readily available for staff in all toilet/bathroom areas. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 -30 The skill mix and numbers of staff are satisfactory. NVQ training completed and in process should ensure 50 of trained staff by 2005 as required. Other aspects of training were not inspected on this visit. Recruitment procedures are in place but CRB checks must always be obtained prior to employment. The dating of some records is needed. EVIDENCE: There are 2 care staff and the Manager or Deputy on duty during the day. One waking night care worker and an on-call person sleeping in at night times Monday – Thursday. There are 2 waking night care workers at other times. Additionally the person sleeping-in will provide additional care 6 – 8 a.m. which is the peak time when residents rising. There are domestic hours of 21 per week. Care staff provide some general tidying of rooms in the day and night staff hoover communal areas etc. Laundry is done by care staff as required. The staffing levels are adequate for the perceived dependency levels of the current resident group. There have been no changes in staff since the last inspection. Records sampled indicated in one instance a new care worker had commenced duties, albeit well supervised prior to CRB being obtained. It is a requirement that all Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 18 staff must provide CRB checks prior to employment. Some staff records relating to new staff were not dated and it was unclear at what point documents had been received by the home and training received by the employee. The Manager will rectify this. Staff supervision has been resumed since April this year and now provided and recorded at 2 monthly intervals. There are presently 7 staff with NVQ2 or above, this is 42 of the total staff of 17. Additionally 1 member of staff is currently studying NVQ. This will ensure the home reaches the required level of 50 of trained staff by 2005. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 33 & 36 38 The home is well run and managed. The interests of residents are paramount in the home. Financial matters relating to the home and residents were not inspected. Staff supervision is again in place. Record keeping is to a good standard and the health, safety and welfare of residents promoted. EVIDENCE: The Registered Manager has the required experience and qualification to run the home. She has recently been awarded NVQ4 and the Registered Managers award. These are the required qualifications for all Registered Managers required by 2005. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 20 The Manager, who is also proprietor provides a positive lead in the home and works closely with all staff. There is an open style of management, staff aware of the details of the operation of the home and financial requirements and restrictions. Residents views are sought on a daily basis and acted upon. Records seen and sampled indicated a good standard of recording by staff to appropriate professional levels. Policies and procedures were not inspected on this visit. The home should provide a policy relating to access to files by staff and service users. Health and safety requirements are met. Fire records indicated all requirements relating to testing of equipment and drills were in place. There is a fire risk assessment in place. There is an ongoing process of maintenance of equipment and the environment to ensure safety. Individual risk assessments spot checked in relation to some residents had been carried out and adequately documented. Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x 3 3 3 Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 8 8 3 Regulation 12(1) 12(1) 14(1) Requirement All residents must be weighed monthly and weekly where there are concerns about weight loss. Review chiropody care for resdient indentified and arrange necessary appointments The homes needs assessment must be carried out and recorded prior to admission covering items in standard 3.3. CRB checks must be obtained for all staff prior to employment. Timescale for action Ongoing Immediate Ongoing 4. 29 19(1) Ongoing RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Chiltern Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Retirement Home E51 E09 S8210 Chiltern House V232978 140605 Stage 4.doc Version 1.30 Page 24 - 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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