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Inspection on 11/04/06 for Brendoncare Chiltern View

Also see our care home review for Brendoncare Chiltern View for more information

This inspection was carried out on 11th April 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The information available to potential residents and their families is comprehensive and helps them and their families to make an informed choice as to whether the home can meet their needs. The admission policies and protocols are robust, implemented thoroughly and ensure that resident`s needs can be met by the home. Resident`s health needs are met by the local primary and secondary health care services, with good evidence of multidisciplinary working. The systems for medication administration are good and there are clear procedures to ensure that the medication needs of the residents are met. Personal support is offered to residents in such a way as to protect their privacy and dignity. The routines in the home are flexible and residents are able to walk freely throughout the home and garden, giving them freedom and choice within their abilities. The home`s staff team are welcoming to families and friends, enabling residents and their families to maintain contact where they wish. The activities programme is designed to support the varying levels of ability of the residents, giving individuals opportunities to participate in social activity. The home has a satisfactory complaints process with evidence from resident`s relatives that concerns are acted upon promptly. Many residents are very vulnerable and the home`s vulnerable adult protection policies and staff training offer protection. The standard of the environment is good providing residents with a safe, wellmaintained and pleasantly decorated home in which to live. The gardens should be risk assessed to ensure that they are safe for residents to walk freely, an occupation that they clearly enjoy. The home has a satisfactory recruitment process with the necessary preemployment checks on staff being undertaken to protect residents. The training programme is comprehensive giving the staff the knowledge and skills necessary to care for frail elderly people. The home is well managed, financially viable and holds the necessary insurance cover to protect residents. Resident`s personal allowance, held by the home on their behalf, is managed well. The Brendoncare Foundation reviews it`s performance through regular quality assurance audit of all aspects of it`s service to improve the care for residents. The organisation`s health and safety policies and procedures protect residents.

What has improved since the last inspection?

The care plans have improved although there are still some further improvements to be made. The recruitment files have been updated and now contain the required information. Medication charts now have photographs of the residents. All staff have now attended an introduction to Dementia Care course accredited by the Alzheimer`s Society.

What the care home could do better:

Further improvements could be made to care plans to ensure that resident`s physical and mental health needs are fully described and a plan is developed to meet them. The improvement to the training records must be maintained to ensure that stafff have the mandatory training, with annual updates, that is necessary to protect residents from harm. All staff should undertake care of the dying training commensurate with their experience to ensure that they have up to date skills to care for dying residents. Including more every day activities that carers can participate in and reinforce with residents when the activities coordinator is unavailable would enhance the activities programme.The safety of the garden should be assessed and the necessary improvements made to protect residents

CARE HOMES FOR OLDER PEOPLE Chiltern View Nursing Home St John`s Drive Stone Aylesbury Bucks HP17 8PP Lead Inspector Christine Sidwell Unannounced Inspection 06:30 11th April 2006 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chiltern View Nursing Home DS0000019197.V288692.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 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 View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chiltern View Nursing Home Address St John`s Drive Stone Aylesbury Bucks HP17 8PP 01296 747463 01296 747138 slovelace@brendoncare.org.uk www.brendoncare.org.uk The Brendoncare Foundation 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) Care Home 31 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0), Old age, not of places falling within any other category (31) Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th December 2005 Brief Description of the Service: Chiltern View Care Home is a purpose built home providing nursing care for up to 31 elderly people with dementia. It is managed by the Brendoncare Foundation, which is a charitable foundation. The home is situated in Stone, a village on the outskirts of Aylesbury. There are limited local facilities, although the town of Aylesbury is approximately three miles away. The majority of rooms are single, none are en- suite. There are two shared rooms. The home has been designed to provide a safe environment with room for residents who have dementia to walk freely. It is divided into two units. Gardens are safe and accessible with extensive rural views. Qualified nurses are on duty at all times. Staff training is provided. All residents are registered with a local General Practitioner and have access to the specialist healthcare services provided by the local NHS Trusts. The provider makes information about the service available to potential residents on their website and in the form of a comprehensive brochure available from the home. The fees range from £748 to £850 per week. There are additional charges for hairdressing and chiropody. The home gives families and residents support to liaise with social service departments and the local Primary Care Trust, which may contribute to fees. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of an announced inspection, which took place over two days and covered the key National Minimum Standards of the Care Standards Act 2000. Policies, procedures and records were examined and care practices observed. The home manager, team leaders and home administrator were interviewed. A number of care and ancillary staff members were spoken to. The care of six residents was case tracked and four resident’s families were also spoken with. Residents were spoken with or observed if their dementia was such that conversation was limited. Comment cards were received from a general practitioner and two healthcare professionals and a number of families. What the service does well: The information available to potential residents and their families is comprehensive and helps them and their families to make an informed choice as to whether the home can meet their needs. The admission policies and protocols are robust, implemented thoroughly and ensure that resident’s needs can be met by the home. Resident’s health needs are met by the local primary and secondary health care services, with good evidence of multidisciplinary working. The systems for medication administration are good and there are clear procedures to ensure that the medication needs of the residents are met. Personal support is offered to residents in such a way as to protect their privacy and dignity. The routines in the home are flexible and residents are able to walk freely throughout the home and garden, giving them freedom and choice within their abilities. The home’s staff team are welcoming to families and friends, enabling residents and their families to maintain contact where they wish. The activities programme is designed to support the varying levels of ability of the residents, giving individuals opportunities to participate in social activity. The home has a satisfactory complaints process with evidence from resident’s relatives that concerns are acted upon promptly. Many residents are very vulnerable and the home’s vulnerable adult protection policies and staff training offer protection. The standard of the environment is good providing residents with a safe, wellmaintained and pleasantly decorated home in which to live. The gardens should be risk assessed to ensure that they are safe for residents to walk freely, an occupation that they clearly enjoy. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 6 The home has a satisfactory recruitment process with the necessary preemployment checks on staff being undertaken to protect residents. The training programme is comprehensive giving the staff the knowledge and skills necessary to care for frail elderly people. The home is well managed, financially viable and holds the necessary insurance cover to protect residents. Residents personal allowance, held by the home on their behalf, is managed well. The Brendoncare Foundation reviews it’s performance through regular quality assurance audit of all aspects of it’s service to improve the care for residents. The organisation’s health and safety policies and procedures protect residents. What has improved since the last inspection? What they could do better: Further improvements could be made to care plans to ensure that resident’s physical and mental health needs are fully described and a plan is developed to meet them. The improvement to the training records must be maintained to ensure that stafff have the mandatory training, with annual updates, that is necessary to protect residents from harm. All staff should undertake care of the dying training commensurate with their experience to ensure that they have up to date skills to care for dying residents. Including more every day activities that carers can participate in and reinforce with residents when the activities coordinator is unavailable would enhance the activities programme. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 7 The safety of the garden should be assessed and the necessary improvements made to protect residents 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 View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 8 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 View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 9 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): 1,2,3 and 6 Quality in this outcome area is good. The information available to potential residents and their families is comprehensive and helps them and their families to make an informed choice as to whether the home can meet their needs. The admission policies and protocols are robust, implemented thoroughly and ensure that resident’s needs can be met by the home. This judgement has been made using written evidence from residents records, their families views, the managers description of the admission process and an unanounced visit to the service. EVIDENCE: The statement of purpose and service users guide have been updated within the last year. The Brendoncare Foundation values statement states that each person will be treated with dignity and respect, irrespective of race colour, creed culture, health status or any other factor which can result in wrongful discrimination. The staff spoken to were aware of the organisations values. The manager confirmed that she or one of the unit team leaders visits all service users prior to their move to the home. There is comprehensive pre assessment documentation and this was seen to be completed for the last two Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 10 residedents to move to the home. They had both been reviewed after four weeks One family member of a recently admitted resident confirmed that she had been gvien the opportunity to visit the home prior to her relative moving to the home, that he had moved on a trial basis and that she had been made welcome at the home. She also confimed that the home and the care manager had reviewed the placement with her four weeks after her relative had moved in. Six residents files were examined, as part of the case tracking process, and all contained copies of the contract of care between the resident, placement organisation and the home. The home does not offer intrmediate care. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Overall quality in this outcome area is good. Resident’s health needs are met by the local primary and secondary health care services, with good evidence of multidisciplinary working. The systems for medication administration are good and there are clear procedures to ensure that the medication needs of the residents are met. Personal support is offered to residents in such a way as to protect their privacy and dignity. Further improvements could be made to care plans to ensure that resident’s physical and mental health needs are fully described and a plan is developed to meet them. This judgement has been made using available evidence, including an unannounced visit to this service. EVIDENCE: The care of six residents was assessed. All had care plans developed from an assessment of need. The care plans contained a photograph of the resident. Manual handling, nutritional and continence assessments had been undertaken. The outcome of the assessment was not always followed up with a written care plan, which should be addressed. There was evidence in the care plans that the local general practitioner sees residents regularly. The named nurses spoken to were knowledgeable about residents needs. On the day of the unannounced inspection the Friends of Chiltern View were having a Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 12 coffee morning, which afforded the inspector the opportunity to gain the views of relatives. Several family members said that they were happy with care that was offered and that they were kept informed as to their family members welfare. Four of the six residents whose care was assessed had family histories and their mental health needs had been identified. Two did not and one resident who had challenging behaviour did not have a care management plan to address this. Overall the standard of care planning has improved since the last inspection but could be further improved by improving consistency and ensuring that all residents had a thorough assessment of their mental health needs and care plans to meet them. There are comprehensive medication policies and procedures in place and the nursing staff spoken to were aware of these. No residents are able to manage their own medication. Records of all medication entering and leaving the home are kept. Controlled drugs are stored correctly and the records were checked and seen to be accurate. Controlled drugs are checked at every handover. There was evidence in residents records that their medication had been reviewed on a regular basis. The qualified staff said that medication is not given covertly. The staff said that should a resident refuse medication, an alternative formulation will be tried and advice would be taken as to whether the medication was really necessary. The medication administration records were completed accurately and all records had a photograph of the resident. The staff were observed to ensure that residents privacy was protected and all personal care was given in residents rooms. The manager said that residents could have a telephone in their rooms if they wished although none had chosen to do so. Residents were wearing their own clothes and the laundry systems were thorough, ensuring all items are labelled and returned to the resident. Not all residents had stockings and some were wearing socks with skirts. This should be addressed and appropriate stockings/hold ups purchased to maintain residents dignity and appearance when they are unable to maintain this themselves. The general practitioner who returned the comment card said that she was able to see residents in their own rooms. The gender balance of the staff team means that carers of the same sex can care for residents if they wish. Two relatives whose family members had died whilst in the home were spoken to. They both said that the care that their relative had received had been good and that they had also been given support. They both confirmed that when their family member condition deteriorated they had met with staff and the general practitioner and had discussed the care that was needed. One qualified nurse takes the lead on bereavement and has undertaken additional training to give her the necessary skills. The care staff spoken to said that they had not training in the care of the dying. This should be addressed. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. The routines in the home are flexible and residents are able to walk freely throughout the home and garden, giving them freedom and choice, within their abilities. The home’s staff team are welcoming to families and friends, enabling residents and their families to maintain contact where they wish. The activities programme is designed to support the varying levels of ability of the residents, giving individuals opportunities to participate in social activity although it could be enhanced by building everyday activities into the daily routine. The meals in the home are good and offer choice and variety as well as catering for specific dietary needs. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The inspection began at 06.45, giving the inspector the opportunity to speak with the night staff and observe the early morning routine. Residents were still in bed and had a drink but had not had breakfast. The night staff spoken to said that they started work at seven pm in evening and that residents went to bed between 8.00pm and 11pm. There was no evidence that residents were woken early. Most residents were up by 09.00am and breakfast was served in the lounge on trays from satellite kitchens. One resident spoken to had wanted to lay the tables for breakfast but had been discouraged from doing so. It is recommended that this is considered. The activities coordinator was Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 14 interviewed. There is an activity programme every day run by the coordinator. A weekly programme is posted in entrance hall The carers help by assisting residents to attend. Whilst the activities programme is good it is recommended that it is developed further to include every day activities which carers can participate in delivering with residents. The relatives spoken to said that they were welcome in the home at any time. Breakfast and lunch were observed. The standard of the food is good. Finger foods are available for those who find it difficult to manage a knife and fork. Pureed foods are also available for those with swallowing difficulties. The chef wishes to present these attractively using moulds but unfortunately the thickening agent has to be prescribed and this is not available locally. There is a varied menu and a choice of main course at lunch time. The dining room was laid attractively and residents were enjoying their lunch. The chef was aware of therapeutic diets required by individual residents. There is no one requiring a special meal on religous or cultural grounds. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 15 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 and 18 Quality in this outcome area is good. The home has a satisfactory complaints process with evidence from resident’s relatives that concerns are acted upon promptly. Many residents are very vulnerable and the home’s vulnerable adult protection policies and staff training offer protection to residents. This judgement has been made using available evidence, including an unannounced visit to the service. EVIDENCE: There is a complaints policy, which is available to residents and their families. There is a complaints log. The relatives spoken to said that they had not had occasion to make a formal complaint, as any concerns were addressed promptly. There is a protection of vulnerable adults policy and staff spoken to said that they had received training. There is a restraint policy. The manager said that restraint was seldom used. If necessary a multidisciplinary team plan would be agreed, with consent sought from the relatives and the senior management within the Brendoncare Foundation. A number of residents were sitting in ‘tip back’ gel chairs, which the staff said were an alternative to remaining in bed as the resident had lost their balance and were unable to sit safely. It is recommended that an occupational or physiotherapy assessment be obtained before residents are offered tip back chairs and these may cause a further loss of balance. The angle of the chairs must be adjusted regularly to ensure that residents are not looking at the ceiling for long periods. The staff said that the chairs were never used as a form of restraint. The manager said that all residents were on the electoral role, although in all cases the extent of their memory loss meant that they were unable to exercise their right to vote. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 16 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): 19,24 and 26 Overall the quality in this outcome area is good. The standard of the environment is good providing residents with a safe, well-maintained and pleasantly decorated home in which to live. The gardens should be risk assessed to ensure that they are safe for residents to walk freely, an occupation that they clearly enjoy. This judgement has been made using available evidence, including an unannounced visit to the home. EVIDENCE: The home is purpose built on one level with safe gardens, to meet the needs of those with disabilities. The gardens were tidy, although still in need of weeding and general maintainance. A part time gardener has been appointed and a start has been made to upgrade the gardens. There are extensive country views from the rear gardens to which residents have unlimited access. Some of the garden paths are uneven and this was raised by a family member in the comment cards. She said that, whilst the garden and the ability to walk freely in it, is important for many residents, she was concerned that not all parts can be seen from within the home and that residents may be at risk of falling. It is recommmended that the garden risk assessment is reviewed and Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 17 that any necessary steps to make it safe are undertaken. The home is secure. There are no CCTV cameras. The building is leased from the local Primary Care Trust who retain responsibility for it’s mainanence. Records were seen to demonstrate that regular maintainence was undertaken. The décor was good. There were no offensive odours. Most residents have their own rooms which are personalised to a limited extent. There are two shared rooms with curtains provided for privacy. There is ample communal space and a pleasant dining room. The laundry is well managed and very clean. There are policies in place for the control of infection which staff were observed to be following. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. The home has a satisfactory recruitment process with the necessary pre-employment checks on staff being undertaken to protect residents. The training programme is comprehensive giving the staff the knowledge and skills necessary to care for frail elderly people. The improvement to the training records must be maintained to ensure that stafff have the mandatory training, with annual updates, that is necessary to protect residents from harm. This judgement has been made using available evidence, including an unannounced visit to this service. EVIDENCE: A staffing rota is maintained. This showed good staffing levels. The night staff spoken to said that they usually had sufficient staff but that sometimes when they had residents with challenging behaviour or who were wakeful at night that they felt that more staff may be needed. The manager said that in this case additional staff would be approved. There are 10 ancilliary staff supporting residents and the care team. The rotas showed a stable staff team. Limited agency staff are used and the rotas showed that, where thay are used, the home endevours to provide continuity by using regular agency staff who are known to the residents. All staff are at least 18 and no one under 21 is left in charge of the home. The cultural and ethnic background of the staff reflects that of the residents. The manager has stated in the pre inspection questionnaire that 12 of 25 carers, 48 , have achieved the National Qualifications in Care at Level 2 or above. The recruitment files of five staff members were inspected. All had the required documentation, references and criminal records bureau checks in Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 19 place. One new member of staff was spoken to. She confirmed that she was undertaking an induction programme and would be commencing the National Vocational Qualifications. She said that she had been made very welcome and felt that she was given the support that she needed to care for this vunerable group of residents. A team leader has been asked to oversee the training programme. She has begun to update the training records although it is not yet possible to see easily from the records whether all staff have had have had the mandatory training, with the annual updates, that is required. The manager should take advice from the organisation and ensure that a consistant method of record keeping is agreed and implemented and that all staff have the mandatory training, with annual updates, that is required. A requirement was made a the last inspection that all staff have dementia care training. This has now been achieved and all staff have undertaken an introduction to dementia care accredited by the Alzeimers Society. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. The home is well managed, financially viable and holds the necessary insurance cover to protect residents. Residents personal allowance, held by the home on their behalf, is managed well. The Brendoncare Foundation reviews it’s performance through regular quality assurance audit of all aspects of it’s service to improve the care for residents. The organisation’s health and safety policies and procedures protect residents. This judgement has been made using available evidence, including an unannounced visit. EVIDENCE: After considerable time with acting management arrangements, the Brendoncare Foundation has appointed a new manager, who has had experience in managing care homes. She is in the process of registering with The Commission for Social Care Inspection. The staff spoken to were pleased that a manager had been appointed and said that she created an open atmosphere. She is only responsible for one service and has support from the Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 21 Brendoncare Trusts central team. The organisation has an equal opportunities policy and procedure. The manager described the quality assurance programme The manager said that the quality assurance programme comprises audits of care, training, hotel services and financial procedures. Accidents and incidents are collated monthly and quality reports are received by the Care Committee, a sub-committee of the board of Trustees. There was evidence that these audits are undertaken. The manager said that a survey of staff views is undertaken annually and that the results are collated at head office. She also stated that an annual survey of residents and family views is undertaken and that this was due in April of this year. Certificates were seen to demonstrate that the home holds suitable insurance cover. The Brendoncare Foundation 2005 Annual Review showed that the organisation as a whole was financially viable. Most residents affairs are dealt with under power of attorney or guardianship. The home holds small amounts of personal allowance on behalf of the residents. This is managed well with records and receipts of all transactions kept. There is a health and safety policy. Risk assessments have been undertaken. COSHH data sheets are available. The handyman has attended COSHH training. There is a fire safety policy. The staff spoken to described the fire evacuation policy. Records were seen of fire alarm and emergency lighting tests. A recent fire safety inspection had requested that a fire risk assessmnet was undertaken and this has been completed. The chef stated he had received training in new requirements of the food hygiene legislation which came into force in January 2006. The kitchen was clean and tidy on the day of the inspection and appropriate records were kept. Records were seen to demonstrate that the annual maintenance checks of electrical appliances, gas appliances, and hoists had been undertaken. There is an accident book and accidents and incidents are collated regularly. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 22 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12 Requirement All residents should have a comprehensive mental health assessment and a relevant care plan be developed. This is an unmet requirement of the previous inspection and a new timescale has been set. All staff must have basic mandatory training with annual updates. This is an unmet requirement of the previous inspection and a new timescale has been set. All staff should have care of the dying training commensurate with their responsibilities. Timescale for action 30/09/06 2. OP30 18 30/09/06 3 OP30 18 30/09/06 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 Good Practice Recommendations DS0000019197.V288692.R01.S.doc Version 5.1 Page 24 Chiltern View Nursing Home 1 2 Standard OP12 OP19 It is recommended that the activity programme be developed to include more every day activities that carers can assist the residents with. It is recommended that the safety in the garden is reassessed and any necessary improvements made. Chiltern View Nursing Home DS0000019197.V288692.R01.S.doc Version 5.1 Page 25 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. 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