Inspection on 08/12/08 for Chilton Care Centre

This inspection was carried out on 8th December 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Chilton Care Centre 04/02/08

Chilton Care Centre 01/03/07

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Chilton Care Centre Hunter Terrace Chilton Co. Durham DL17 0EX Lead Inspector Steve Tuck Key Unannounced Inspection 8th December 2008 10:30 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 Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chilton Care Centre Address Hunter Terrace Chilton Co. Durham DL17 0EX 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) 01388 724011 01388 724012 chiltoncarecentre@yahoo.co.uk www.guardiancarehomes.co.uk Guardian Care Homes (UK) Limited manager post vacant Care Home 40 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (22) of places Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 22 2. Dementia - Code DE, maximum number of places 18 The maximum number of service users who can be accommodated is: 40 4th February 2008 Date of last inspection Brief Description of the Service: Chilton Care Centre provides a home to older people who need help with their personal care needs and older people who have dementia. The home was first registered in 2006 and provides accommodation over two floors. Set in the village location of Chilton the home is near local shops and is on a bus route. There is a choice of communal lounge areas and dining areas. There are forty rooms. All have en suite facilities with shower. There are communal bathrooms where people can be assisted to have a bath if needed At the time of this inspection fees charged ranged from £394 to £526 per week. The costs of newspapers, hairdressing, and toiletries are not included in the fees. Fees vary depending on people’s circumstances, further details can be found in the homes Service User Guide. Fees for private chiropody and hairdressing are in addition the these charges. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is ONE Star. This means the people who use this service experience ADEQUATE quality outcomes. Before the visit We looked at Information we have received since the last Key Inspection. How the service dealt with any complaints or concerns since then. Any changes to how the home is run. The providers view of how well they care for people. We asked them to examine their own service and write to us with the results. We sent surveys to people who use the home, people who arrange for people to live there, those who visit the home to support people like doctors and therapists and the staff who work in the home to ask what they think about services there. The Visit An unannounced visit was made on 8th December 2008. During the visit we Talked with the people who use the service the staff, the manager and visitors to the home. Observed life in the home. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. Checked on what improvements had been made since the last visit. We told the acting manager what we had found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home needs to be better managed. There has not been manager who has been assessed by the Commission for Social Care Inspection as being sufficiently skilled, trained and competent, at this home for over a year. The way that people are protected from abuse, harm and neglect need to be improved; and procedures, which are designed to protect them, must be used without delay if any abuse is suspected. Peoples finances must also be protected so that they and their families can be confident that their interests are being protected and they are not being financially abused. There must be enough suitably qualified and experienced staff available to meet the needs of people living at the home. This includes people who have been identified as being more vulnerable or need more supervision because they have dementia type illness. Some people at this home need a lot staff support because they are vulnerable or have behaviours which challenge. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 7 The homes acting manager and owners must make sure they do not admit people to the home who they are not unable to support. The home has not been suitable for some people with complex needs or behaviour which is challenging to people living at the home or other staff. The home has not had the resources and facilities to people with these needs. The way that the home decides how to support the people who live there needs to be improved. There must be care plans in place which have enough detail to show the specific actions staff are to take to support their needs preferences and lifestyle. And these must be followed. Reviews must reflect the progress towards those goals. This home provides services for people with dementia type illness. However improvements must be made so that all support for people with dementia follows current best practice and this is recorded in each persons care plan. The way that people are supported to take their medication needs to be improved so that there are no mistakes and people always get the treatment they have been prescribed. The building needs to be adapted to make sure that people with dementia type illness are supported in an environment which suits their needs and follows current best practice. And hygiene needs to be improved so that rooms and corridors no longer have unpleasant odours. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 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 Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, 4 and 5 Quality in this outcome area is or poor. This judgement has been made using available evidence including a visit to this service. People who wish to move to the home get information about what the home has to offer them. But while the needs of people who have been admitted to the home are known, for some people the home does not have the capacity to support them. EVIDENCE: Information about the home for people who may be interested in moving there is available and called the Service Users Guide. This includes the terms and conditions of residency so that everyone should be clear about what the home sets out to do for the people who live there. However key areas are missing such as, the homes complaints procedure and the last Commission for Social Care Inspection (CSCI) report. This information is not yet available in different Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 10 formats for example for people with sensory disabilities or for people who have dementia type illnesses. By looking at the records kept at the home we could see that each persons needs are assessed before they move to the home, either by health services staff, local authority social workers and the acting manager. This should have identified the main needs that people have, and given the manager an understanding of the type of care they would need. However examination of records showed that some people whose needs had been identified, had been admitted by the home by the previous acting manager without the home having capacity to support them. For example, although the home is registered to provide services for people who have dementia type illness, they have been unable to effectively support people whose symptoms and needs are severe or complex. For example, Someone with behaviour which challenged staff and people living at the home was knowingly admitted to the home without there being enough skilled staff or support available to make sure they and other residents remained safe. Another person who is vulnerable to abuse because of dementia type illness was admitted to the home without there being enough support available to make sure they were safe. Staff said, “Some people are really difficult to manage, they can get angry or upset when we cant give them enough of our time.” Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each person has an individual plan of care, which should set out in detail their preferences and how their assessed needs will be met. But these are not always carried out nor do they fully describe the measures which staff are to use therefore making it difficult for them to consistently meet peoples’ needs. EVIDENCE: All people who live at the home have a plan of care which gives a description of how their needs are to be met. Staff write about some but not all events or what they have seen into these records. However the care plans themselves did not match the actual support and intervention which staff currently carry out. Staff have a variety of knowledge and experience of caring for people living at the home but this information is not yet successfully combined in the care plans so that these can be used to consistently provide fully co-ordinated care. All of the staff interviewed could describe peoples’ needs, preferences Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 12 and histories, although some more detailed knowledge than others. However the potential areas of good practice were not generally shared with colleagues nor were these written down in care plans. People living at the home are not generally involved in their care planning and people don’t sign them. One relative said, “ I know they write things down but my mother isn’t shown what this is and I’ve not seen it either.” The acting manager agreed that improving care plans and the quality and consistency of the support given to people, was one of the objectives for this service. There were some records in place which show that the staff and manager have considered how to protect people from risks however these were not always completed. Staff at the home judge how to support people who are at risk from falls and help them to use equipment which maintains their fitness and independence around the home. But the ways that the manager makes sure that they are as safe as possible is not always written down in their care plan. Where staff have identified how people are to be kept safe then the actions they are to take is not always carried out. For example one person who needed support because she is vulnerable was not supported by staff in the way that was described in their care plan. The home provides care to people who have become frail and may also have dementia type illness. Care planning arrangements for these people do not yet reflect current best practice. For example, care plans do not specify how people who have an altered sense of time or reality are to be supported or what their personal timescales actually are. Care plans, which place the person at the centre of a network of support for their needs and lifestyle requirements, are yet to be put in place. This can be particularly important for people who become increasingly reliant on staff as their level of needs increases. Due to their levels of need, people who live at the home are not able to organise their own medicines, and appointed staff therefore help in this area. Staff who are trained in this area administer medication at the home. Medication is securely stored and records are kept which should help staff to make sure that people living at the home have the medication that they have been prescribed. But records examined had mistakes. For example: • Five people had received medication that had not been signed for (one on two occasions). Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 13 • • There is no record kept in the home of the actual Prescription that has been given by the General Practitioner or hospital consultant. Codes used to describe occasional changes in medication administration did not match the system that was in place so it was difficult to tell if medication had been administered or not. One persons medication was placed in a container to be given later, increasing the likely hood of a mistake being made. • The relationships between staff, residents and relatives, were friendly. Care was delivered in private and staff were seen to knock on doors and wait for permission before entering. People living at the home said, “Its OK living here.” “The staff are lovely, they’re always very busy they work very hard.” Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some people who live at the home are encouraged and supported by the staff to lead fulfilling lives. But this could be improved if staff had a better way of supporting the lifestyle needs of people who are more needy or have a dementia type illness. EVIDENCE: The acting manager and staff help people who live in the home to stay in contact with family members and friends. People who are able to get around the home or local community on their own and staff talked about what they do both inside and out of the home. For example visiting their local church and shops. For some of the people who are unable or do not wish to leave the building there are some limited activities which take place. There is an activity coordinator although staff have little time to spend with people to talk to them Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 15 and helping them to fill their time. However the activities have not yet been developed and currently provide only basic opportunities. The acting manager also acknowledged that staff found it difficult to get people to take part in activities. The home provides for the majority of people who have dementia type illnesses. Although staff do spend time talking to people when they can, which is good, there is also little for people to engage in. A programme of activities, specifically designed to support, interest and help to structure the lives of people who have a variety of memory loss is not yet in place. Inspection during the day and evening showed that the majority people who have dementia type illness were finding it difficult to remain satisfied and expressed their views about having insufficient things to interest or occupy them and too few staff to support them. Some people were arguing and others were displaying behaviour which challenged staff. One person said, “Its just boring here.” Another said, “I would like someone to help me to knit but they always say they haven’t the time. A number of people were noted to be walking up and down corridors repeatedly without any intervention from staff. Staff at the home like to encourage relatives or friends to visit regularly and people living there said that they like it when people visit and make them feel welcome. Information about advocacy is available although no one has used an advocate. Some people living at the home have brought small items with them making their rooms homely and reflective of their previous lifestyles, religious beliefs or cultural backgrounds. People living at the home are encouraged to make choices about their diet. Most said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen asking people about their choice of meal and size of portion to make sure that people got what they wanted. Although there were no menus or photographs of meals which would help people who have dementia type illness to make better choices. Staff are available during meals to offer support and assistance where needed. The chef has a good knowledge of the meals which people living at the home prefer. Menus were available which confirmed that a range of meals are provided which give people a balanced diet and refreshments are available throughout the day and night. Where people need it food supplements are available to help people to maintain their health for example if they have diabetes or have difficulty maintaining their weight. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 16 Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The measures which should protect people who live at the home have been unsuccessful and failed to protect them from being abused. EVIDENCE: There is a complaints procedure which people can use if they are not happy. This informs people about who they should make a complaint to and how much time that a complaint will take to look at. However there were no records of any complaint that had been made available at the home. Since the last inspection there has been three occasions where people living at the home have been abused. These included, - People who were vulnerable to abuse from others because of their dementia type illness, were not monitored and safeguarded by staff. - People with dementia type illness were left unattended without any staff support at all. - Peoples finances which they had entrusted to the home were not properly safeguarded, leaving them vulnerable to financial abuse. There are clear Policies and Procedures in place at the home which specify the actions that staff and management must take if abuse is found or suspected. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 18 This includes contacting other organisations, including the Police, the local Council and the Commission for Social Care Inspection, who then co-ordinate further actions. However, this procedure is not always carried out properly. For example, when one instance of abuse was suspected, the owners failed to inform other agencies, including the Police until one week after the suspected abuse had been found. Following an investigation it was shown that abuse had actually taken place. Since Following joint meetings between representatives of the homes senior management, Durham County Council Safeguarding Teams and senior management, the Police and The Commission for Social Care Inspection, the organisation has taken steps to make sure that people living at the home are no longer likely to be abused while living there. This included the appointment of a new acting manager. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in an environment which is homely and should promote their privacy, independence and comfort during their stay. But this could be improved if the home was better designed to meet the needs of people with dementia type illness and odour control was more effective. EVIDENCE: All communal areas and some of the bedrooms were viewed during the inspection. The building has been designed to provide living areas on two floors with different lounge and dining areas and give people a variety of places in which they can spend their day. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 20 The outside of the building is well maintained with attractive garden areas and particularly the inner gardens which have been developed to provide a secure and open space with a greenhouse and sitting areas where people can spend time outside. On the ground floor there are some areas which show that ongoing refurbishment is taking place. Some of the walls in the communal areas have been repainted and furnishings are generally attractive and in good condition. People did say that they were happy with their rooms and some had brought personal possessions and keepsakes which made them feel at home. One relative said, “It’s a home from home.” One person living at the home said, “We tried to bring in things that would help her to settle in.” This home aims to provide specialist services which support people who have dementia type illness. People who have dementia live on the first floor of the home. At the time of the inspection there were no adaptations in place which help to make sure that current best practice for people with dementia can be followed. For example, changes to signage around the home, the placing of appropriate photographs and creating distinct colour contrasts / schemes to people to find their way around. Research by experts has shown that adaptations like this help to support people with dementia who may become increasingly needy. As well as this the design of the first floor makes it difficult for staff to be able to support and monitor everyone who lives there. For example the lounges are at opposite ends of the building so when staff are busy supporting people in one area, other people in different areas do not get staff support. During the inspection five people did not have any staff to support them for 15 minutes. There are parts of the home where there is a significant odour problem. Four rooms and one corridor were noted to have a particular problem, making that part of the home unpleasant for those people living there. There are laundry facilities are in place to make sure that that peoples clothing and linen is hygienically cleaned and the risks of passing on any infections is reduced. Arrangements are in place to make sure that clean clothing is always returned to their owner and mistakes are avoided. . The home is inspected by the Fire Prevention Authority and the local council to make sure that the building and safety systems are suitable for the protection of those who live and work there. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. At times there are insufficient staff on duty to meet the needs of the people who are living at the home. This means that they may not get their needs met and could put them at risk of harm or neglect. EVIDENCE: The acting manager was unable to give any evidence of how she or the owner had made calculations about how many staff should be available at the home. There was no evidence that the specific care needs of the people living at the home had been accounted for; and the number of staff needed to support them had been considered. As well as this staff who are taking short term sickness absence or holidays were not replaced. This illustrates that staffing levels at the home were allowed to be arbitrary dependant on the good health of staff. There has been serious incidents at this home where there have been insufficient staff on duty to support the people who live there. On one occasion people who are vulnerable because of their dementia type illness were left unattended without any staff to monitor or support them and make sure they are safe and protected from being abused. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 22 At this inspection there were two care staff and senior to support nineteen people on the first floor, four of whom were described as having behaviour which challenged staff because of their dementia type illness. Some people require the support of two staff, for example to attend to their personal care. On these occasions only one staff was available to support the people living in this part of the home. Twelve staff had enrolled on specific training to equip them with the skills and knowledge they need to help protect people who are vulnerable at this home. However no one had completed this training and four staff had “dropped out” of this training. The manager has made deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links which can help people to be confident with the way in which they are supported. Several new staff have been employed at this home in the past 12 months. The acting manager described the recruitment practices which appeared to be robust and should safeguard vulnerable people from unsuitable workers. There was evidence that employment checks had been carried out to make sure that they were suitable to work with vulnerable people. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes owners have struggled to make sure that the home is run properly but there has been recent changes in management which could help to improve the quality of care practice and decision making at the home and improve the quality of life for people living there. EVIDENCE: This home has not had a manager who has been assessed by the Commission for Social Care Inspection as being sufficiently skilled, trained and competent, for over a year. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 24 The current acting manager had only been appointed for several weeks before this inspection. The manager has worked at the home for two years, as senior carer and then deputy manager from August 08. She has an National Vocational Qualification in Care at Level 2 and is currently undertaking level 3. She is planning to enrol on MVQ Level 4 in management and has already completed 2 years training as a nurse (although she is not yet a qualified nurse). In the few weeks since her appointment the manager has taken steps to improve the way the home is being run. The owners have drawn up an improvement in response to the previous inspection on 19/09/08 and following three adult protection incidents. The owners and senior managers have stated that they are committed to improving the way that services are provided at the home. The accounts that record peoples money which they had asked the home to keep, and payments for their fees did not match. This was investigated by the Police and Durham County Council to make sure that peoples finances are safeguarded. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for service users and staff. The home is also subject to inspections by the Fire Authority and local authority environmental health officers to make sure that the home is safe for people to live and work there. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 25 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 2 X 3 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 1 X X 3 Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP4 Regulation 16 Requirement The person responsible for the home must make sure that people are not admitted to the home unless the service has the resources and facilities to meet the needs of people who wish to live there. This is to make sure that only people who can be properly supported are admitted. 2 OP7 12 This is a new Requirement. The person responsible for the home must make sure that all support for people with dementia follows current best practice and this is recorded in each persons care plan. This is to make sure that people who have dementia at the home are supported in ways that are most suitable for them. 3 OP7 15 This is a new Requirement. The person responsible for the home must make sure that there are care plans in place which have enough detail to show the DS0000067881.V374540.R01.S.doc Timescale for action 01/05/09 01/06/09 01/06/09 Chilton Care Centre Version 5.2 Page 27 specific actions staff are to take to support their needs preferences and lifestyle. Reviews must reflect the progress towards those goals. This is to make sure that staff plan and review how they work with people and that they write this down so that everyone in the home works in the same way. 4 OP9 13 This is a new Requirement. The person responsible for the home must make sure that there is an accurate record of all medication held and administered at the home. This is to make sure that people get the treatment they have been prescribed. 5 OP18 13 This is a new Requirement. The person responsible for the 01/04/09 home must make sure that people are protected from abuse, harm and neglect; and procedures, which are designed to protect them, are used immediately if any abuse is suspected. This is to make sure that people are protected from abuse. 6 OP27 18 This is a new requirement. The person responsible for the home must make sure that there are sufficient suitably qualified and experienced staff available to meet the needs of people living at the home. This is to make sure that there are enough staff to meet the care needs of people who live at Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 28 15/01/09 01/05/09 the home. 7 OP31 8 This is a new Requirement. The person responsible for the home must make sure that there is a manager in place who has been assessed by the Commission for Social Care Inspection as being fit to manage this home. This is to make sure that people live in a home which is well run in their interests. 8 OP35 17 This is a new Requirement. The person responsible for the home must take steps to safeguard peoples finances. This is to make sure that people living at the home are not financially abused. This is a new Requirement. 01/04/09 01/09/09 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 OP12 Good Practice Recommendations The person responsible for the home should make sure that there is a structured programme of activities which is specifically designed for people who have dementia and follows current best practice guidance. This is to make sure that people with dementia have their lifestyle needs met. The person responsible for the home should make sure that adaptations to the home are in place that support people with dementia and follow current best practice. This is to make sure that people with dementia are supported in an environment which best suits their needs. DS0000067881.V374540.R01.S.doc Version 5.2 Page 29 2 OP19 Chilton Care Centre 3 OP26 4 OP30 5 OP33 The person responsible for the home should make sure that odour control is improved in all rooms and corridors identified at this inspection. This is to make sure that the home is kept in a hygienic and pleasant condition. The person responsible for the home must make sure that all staff have training which equips them to be able to recognise abuse and know what steps to take if they see or suspect abuse has occurred. This is so that staff are skilled in protecting the people they care for. The person responsible for the home should make sure that they hear the views of people who live at the home and their relatives so that they can take steps to improve the way the service is run if that is required. This is so that peoples rights are protected and so they have some control over their lives. Chilton Care Centre DS0000067881.V374540.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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