Inspection on 27/10/05 for Chiltern Retirement Home

This inspection was carried out on 27th October 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 14/06/05

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 Inspection 27th October 2005 09:00 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 Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 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. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chiltern Retirement Home Address 23 Kingsfield Oval Basford Stoke-on-trent Staffordshire ST4 6HN 01782 711186 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) Mr D Arnold Mrs Diane Arnold Care Home 14 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (14), of places Physical disability over 65 years of age (4) Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: Chiltern House is situated in 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 shower 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 DS0000008210.V261927.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this unannounced inspection there were 12 people in residence, there were 2 vacancies. The inspection was carried out with the Deputy Manager who provided all relevant information and was helpful in providing further details on the broader aspects of the inspection. All residents were seen and the majority spoken to. Residents generally stated their satisfaction with the care provided by the home and commitment of staff. One resident raised the issue of inadequate lighting in the lounge area for reading purposes and also felt that an additional call alert point would be helpful. The home will pursue these matters. A visitor arrived at 9 a.m. to take here relative out for the day. She is a regular visitor, had good relaxed exchanges with staff and other residents and spoke highly of the care provided at Chiltern House. A new resident who had been in the home for 2 weeks said she had visited prior to her placement to view the home, was happy with the care provided and said that staff had helped her settle well into the home. The son of a former deceased resident still visits the home and has made a financial donation to the home in memory of his mother and recognition of the care she received. The home will purchase additional garden seating for residents. There was a focus during this inspection on quality of life issues for residents and the majority were spoken to about this and the impression gained was that residents were satisfied with the quality of life at Chiltern House. The 4 previous requirements of the last inspection have been actioned satisfactorily, the home has a good record of compliance with both requirements and recommendations made. The home was seen to be warm, comfortable and welcoming on this inspection. Staff were busily engaged in meeting residents needs and there was a relaxed and friendly atmosphere with positive exchanges between staff and residents. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 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 Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 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 Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 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): 1-5 Standards relating to Choice of Home were found to be met. EVIDENCE: The statement of purpose and service users guide have been updated since the last report. These are readily available for residents and staff in the reception area of the home. Since the last inspection the home have revised their pre-admission assessment tool which now includes all items in standard 3.3. The new document provides all comprehensive information required to identify needs. All required documentation had been completed prior to admission in relation to a recently admitted resident. She had been invited to the home and spent time prior to her admission to enable her to make an informed choice about the suitability of the home. Relatives had also visited the home and been involved in all negotiations. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 9 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 - 10 Standards relating to Health & Personal Care were found to be met. There is a pro-active approach to health care issues by all staff who understand the importance of early identification of health care needs. Residents are well supported during serious treatment processes. There is a safe system of medication in the home. EVIDENCE: Care plans were sampled and provided the required information to provide care. They were based upon assessed need and included a 24 hour plan of care for all outlining the preferred choices and actions throughout the day and night to deliver required care. Rising, retiring, bathtimes, likes/dislikes were recorded allowing staff to know and support chosen lifestyle. In relation to a recently admitted resident the plan was established from the homes own assessment and information provided by the discharging hospital. Risk assessments were included. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 10 The resident and relatives had been involved in the compilation of the care plan. The standard of assessment and recording was excellent. All care plans, including risk assessments are reviewed by the Manager or Deputy Manager on a monthly basis. There are 3 daily entries on contact sheets for all residents completed at the end of each staff shift. Night staff record relevant events and residents are checked at least hourly throughout the night and more often if required. Staff have a high awareness of health care issues and the need for early identification and action in relation to health care matters. Examples were discussed where appropriate referrals had been made to Consultants and serious conditions diagnosed and treated. A resident in bed and unwell on the day of inspection had been seen by the GP 2 days previously but the doctor was called again to ensure there was no further deterioration or treatment required. The physiotherapist had been called to see 2 residents in relation to mobility an exercise programme had been put into place relating to one resident and referral to the GP regarding medication made for the other. All residents are weighed monthly following a requirement of the last report. The Continence Advisor had recently made an assessment relating to a resident who was involved in the discussions and outcomes and her preferences sought regarding continence aids. On resident has hospital dialysis treatment 3 times per week. She is on a strict restricted fluid intake treatment for which the home have a chart and monitor very closely. There is a good and close working relationship between the home and district nursing service who are currently visiting only to provide dressings for a resident in relation to cellulitis and to oversee a bedfast resident who is totally dependent but presently clear of pressure area problems. Medication is provided by the Coop Pharmacy in blister packs (MDS) and a good service provided to the home with regular checks by the pharmacy. The system was inspected and all records relating to the receipt, storage, administration and disposal of medicines were found to be satisfactory. There is a safe system of medication in the home. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 11 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 - 15 Standards relating to Daily Life & Social Activities were found to be met. EVIDENCE: Most residents were spoken to and confirmed they were satisfied with life at Chiltern House. They confirmed that their choices were known and chosen lifestyles accommodated. There is no formal activities programme most spend the day in the lounge areas socialising, watching TV, reading etc. Residents access their bedrooms during the day as they wish. Several are taken for short walks to local shops by staff. Many go out with relatives. There is an open visiting policy and visitors seemed to be welcomed into the home. One visitor arrived at 9 a.m. to take her relative out for the day. Food provision in this home is traditionally good and residents again confirmed this during this inspection. Breakfast and the mid-day meal were seen to be served in the pleasant dining area, meals being a social occasion also. Residents confirmed the quality and quantity of meals served were more than satisfactory. A bedfast resident, totally dependent has liquidised meals and has to be fed, she maintains a constant weight which is closely monitored. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 12 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 Standards relating to Complaints & Protection were found to be met. EVIDENCE: There have been not complaints to the home or the Commission since the last inspection. There is a complaints procedure posted in the home and available in the reception area for visitors and residents. All staff have training in the procedures relating to abuse and the reporting of actual or suspected abuse. In fact the home produces an excellent booklet outlining the definitions of abuse and the procedures to be followed in reporting suspected abuse. A copy of this is given to each member of staff. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 13 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 There is a good standard environment which is well maintained, clean and hygienic. The home needs to improve the lighting in a part of the lounge area to allow residents to read more easily and also provide additional call system extension as requested by residents. EVIDENCE: The home is suitable for its stated purpose. It is well furnished along domestic lines and décor is maintained to a good standard. Bedrooms are bright and well furnished with good personalisation of rooms, residents encouraged to bring personal items from home. Facilities are good with assisted bath and walk-in shower on the ground floor which provide alternative bathing choices. Seven bedrooms have en-suite facilities. There is access to the first floor with a stair-lift and there are appropriate handrails/grab rails in relevant areas. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 14 The large lounge area divides naturally into two smaller groups allowing choice of seating, activity and socialisation. Some light restrictions for reading were raised on the last inspection and discussions with residents on this visit indicated that the lighting in the lounge area could be improved for reading and residents felt that a further call-point extension would be helpful in alerting staff. The home are asked to carefully consider the improvements suggested as a requirement of this report. The garden area is spacious and pleasant with patio doors opening from the lounge with good access to the garden. There is a range of good seating including tables and sun-shades, residents said they had enjoyed many hours in the garden are during the good summer weather. Standards of hygiene in the home were high, as usual – there are 21 domestic hours provided each week. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 15 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 – 30 The home meets the standards for staffing at this time. EVIDENCE: The staffing levels remain at required levels. There are 2 Care staff on duty plus Manager or Deputy during the day, although at the time of this unannounced inspection there were 3 carers and the Deputy Manager who was taking specific time to update care plans and carry out reviews. The overall dependency levels of residents has increased since the last inspection and the current staffing levels are adequate for the resident group. There have been no staff changes since the last inspection, although a part time post has been created due to reduced hours by a member of staff. A CRB check is awaited for new employee. The home are aware that new staff cannot commence employment without CRB check or POVA first check. Staff supervision continues in the home for all at 2 monthly intervals as required. The staffing group at this home has remained fairly constant over the years, many being employed for long periods of time, this provides experience and continuity for residents. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 16 The home achieved the required 50 of NVQ trained staff with the programme of training in place. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 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 – 32 and 35 – 38 The home is well run and managed in the best interests of residents. Records are to a good standard and staff supervision is carried out regularly as required. Safe working practices are in place and well recorded. The home must check self-closing devices on bedroom doors to ensure safety. EVIDENCE: The Registered Manager has the required experience and qualification to run the home, having recently completed the Registered Managers Award. The Manager is also joint proprietor of the home and provides a positive lead with an open management style. Staff are involved in all aspects of managing the home. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 18 Records seen during the inspection were of good professional standard. Policies/procedures were not inspected on this visit. A procedure relating to access to files by staff and residents was reported to have been provided since the last report. Supervision is in place for all staff. Health & Safety issues inspected were in place. It was noticed that 2-3 bedroom doors (fire doors) did not close onto the door rebates, this is required to ensure safety for residents in the event of fire. The self-closing devices clearly need to be adjusted and the home should check all fire doors to ensure appropriate closure. Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 2 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 3 3 2 Chiltern Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 20 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 2 Standard OP38 OP22 Regulation 23(4) 23(2)(a) Requirement Check & ensure all fire doors close onto door rebates. Review provision of lighting and additional call point in lounge area as identified. Timescale for action 27/10/05 27/11/05 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 Retirement Home DS0000008210.V261927.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Stafford Office 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 DS0000008210.V261927.R01.S.doc Version 5.0 Page 22 - 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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