Inspection on 08/03/06 for Chilton House Nursing Home

This inspection was carried out on 8th March 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 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 House Nursing Home 20/11/06

Chilton House Nursing Home 12/10/05

Chilton House Nursing Home 09/03/05

Chilton House Nursing Home 31/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Chilton House Nursing Home Chilton Aylesbury Bucks HP18 9LR Lead Inspector Mr Guy Horwood Unannounced Inspection 8th March 2006 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 House Nursing Home DS0000019194.V267439.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. Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chilton House Nursing Home Address Chilton Aylesbury Bucks HP18 9LR 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) 01844 265200 Chilton House Limited Laura Bale Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Maxim of 45 residents Service Users receiving intermediate care 60 years of age and over (6) This includes a maximum of 10 nursing care Date of last inspection 12th October 2005 Brief Description of the Service: Chilton House is a grade two listed Manor House set in extensive landscaped grounds in the rural village of Chilton. Due to it’s location the home is isolated from shopping facilities and local amenities, and is not served by local public transport networks. However, the home possesses 2 cars for use by the activities organisers, and which are used to take residents out for meals, shopping and activities at their request. The home is registered to provide care for 45 older people, up to ten of whom may also receive nursing care. The main part of the home is utilised to provide residential care, and nursing residents are accommodated in a seperate wing where nursing care is used to provide intermediate care to older people who are recovering from surgery or illness. The home provides individual accommodation, decorated and furnished to an extremely high standard, on three floors, with reception, lounge and dining areas on the ground floor. There are extensive and well maintained grounds with large patio areas accessible to mobile residents and wheelchair users. The manager, is supported by an experienced team of nursing, care, catering and housekeeping staff. The proprietors live adjacent to the home, visit staff and residents on a frequent basis, and as a result are easily accessible. The home has an internet web-site, which accurate, easily accessible and provides information as to the services provided at Chilton House. Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the unannounced inspection carried out at Chilton House Care Home on the 8th March 2006, between the hours of 10.30am and 12.35pm. The inspector was Mr Guy Horwood. The inspection consisted of meeting with the manager, Mrs Laura Bale, touring the premises, meeting with some residents and staff and viewing a selection of records and documents pertaining to the provision of care and the running of the home. The homes manager is occasionally away from the home, (to conduct preadmission assessments for example), and so was contacted 5 days prior to the inspection to ensure that she would be present at the time of the visit. Mrs Bale met the inspector upon arrival, was present within the home throughout the inspection, and received feedback at the conclusion of the visit as to the inspector’s findings. Several residents were spoken with during the visit, all of which made comments expressing that they were, comfortable, happy to be at Chilton House and that they felt well cared for by a team of kind and caring staff. The high standards of care exhibited during the inspection are further evidenced by the fact that all standards assessed at this inspection were considered as “Standard Met”, and by the fact that no requirements or recommendations have been served. The inspector found all staff friendly and polite, and would like to thank them for their co-operation and assistance during the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. What the service does well: Residents, and their guests, are treated with respect and dignity. The Residents right to privacy is respected. Residents are presented with the opportunity to participate in various activities both in-house and in the local community. Residents are encouraged to participate in gentle exercise to promote their well-being. Residents are able to receive visitors at times convenient to them. Residents are provided with choice in relation to how they choose to spend their time. Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 6 Residents live in surroundings of a high quality, which are well maintained, well decorated and well furnished, and that provide a warm, comfortable and safe place to live. The home is clean and tidy, and has no offensive odours. Sufficient numbers of staff are employed to meet resident’s needs. The home is managed competently, with good lines of communication between services. Residents are well cared for by a team of kind and caring staff. The health and safety of residents and staff is protected and promoted. 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. Chilton House Nursing Home DS0000019194.V267439.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 Chilton House Nursing Home DS0000019194.V267439.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): EVIDENCE: These standards were not assessed at the time of this inspection, although at the last inspection, (12th October 2005), standards 3, 4 and 6 were scored as “3 - Standard Met”. Chilton House Nursing Home DS0000019194.V267439.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): 10 Residents, and their visitors, are treated with respect and dignity, and their right to privacy is respected. EVIDENCE: Staff were noted to address residents by the title of their choosing, and to knock at bedroom doors and await a reply before entering. Residents are able to receive visitors in the privacy of their bedrooms or communal areas such as the reception hall or drawing room. Throughout the visit, staff were polite and friendly in their interaction with residents. Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 10 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. Staff consult residents as to their interests and provide a choice of meaningful and stimulating activities. Residents can receive visitors at times convenient to them and in privacy. Residents are provided with choice in relation to the way they choose to live their lives. EVIDENCE: The home employs 2 staff as “Hosts”, (akin to activities organisers), for a total of 60 hours a week, covering 6 days. One of the hosts, who had been employed at the home for 5 years, was spoken with during the visit. It was established that the hosts organise and manage activities and entertainments through establishing residents preferences, interests and hobbies. The hosts have access to 2 cars, which they are able to use to take residents out to lunch, on shopping trips, to the theatre or simply for time outside of the home. Internal group activities include cards, scrabble and a book club, and on a one-to-one basis hosts may engage a resident in conversation, provide company or read to them from the paper or a book. At the time of the visit a group of residents had gathered in one of the communal rooms to participate in a movement and exercise session. Residents expressed that this was a regular event, and that they were free to Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 11 choose to take part or not - they also commented that it was a very popular weekly activity. The hosts maintain a record of activities provided and attended. This record was viewed and appeared up to date and well maintained. It was confirmed that the Host’s receive mandatory training as per care staff, including information pertaining to the Protection of Vulnerable Adults. The home operates an open visiting policy, and during the inspection some residents were noted to receive visitors. Resident’s guests were noted to be offered refreshments when visiting, and were treated with courtesy and politeness. Residents are able to receive visitors in their rooms or communal areas including lounges. Chilton House Nursing Home DS0000019194.V267439.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): EVIDENCE: These standards were not assessed at the time of this inspection, although at the last inspection, (12th October 2005), standards 16 and 18 were scored as “3 - Standard Met”. Chilton House Nursing Home DS0000019194.V267439.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, 20, 21, 22, 23, 24, 25 & 26. Residents live in pleasant surroundings, which are clean, warm, comfortable, well maintained and safe. EVIDENCE: Chilton House is a grade two listed Manor House set in the rural village of Chilton. The home sits in extensive landscaped grounds, much of which is accessible to mobile residents and wheelchair users. The home is isolated in its location, but possesses 2 cars, which are utilised by the activities organisers to transport residents if required. A number of communal areas exist within the home including a dining room, drawing room and reception hall. Some corridors are sufficiently wide to accommodate furnishings, including seating and tables, without obstructing the passageways. All bedrooms provide single accommodation and some include separate private lounge space. Resident’s rooms hold personal belongings and appear to reflect the character and interests of the occupant. All private and communal spaces are decorated to an extremely high standard, and are Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 14 furnished to reflect the age, period and character of the home and its image as a grand country house. At the time of the visit one vacant room was in the process of being redecorated and fitted with a new carpet. It was also apparent that kitchenettes on the residential and convalescence wings had been refurbished. The home employs someone for in-house maintenance, but will use external contractors for large or specialist jobs. Bedrooms possess en-suite facilities and additional bathrooms on all floors enable assisted bathing where required. Assisted bathing facilities include 3 specialist baths and walk-in showers. Additional toilets are situated close to communal areas. The home possesses hoisting equipment for the safe moving and handling of residents and height adjustable beds. At the time of the inspectors visit the home was extremely clean and tidy, and no unpleasant odours were noted. Housekeeping staff were noted hard at work throughout the visit, and were seen to be mindful of working in accordance with relevant health and safety guidelines. Hand washing facilities for staff are present throughout the home. Window restrictors are fitted to first floor windows. Two through-floor lifts enable access to all levels of the home for disabled residents, and recent work has enable better access to the main houses lift for all residents. Residents are able to have personal phone lines. All rooms possess a nurse call bell. No door wedges were seen in use, and doors are fitted with automatic closures, which activate when the fire alarm sounds. Those doors tested by the inspector were found to close to their stops. The home has purchased emergency evacuation chairs. Chilton House Nursing Home DS0000019194.V267439.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 Sufficient numbers of staff are employed in order to meet resident’s needs. EVIDENCE: At the time of the inspection the home appeared to be staffed sufficiently to meet residents needs. Mrs Bales hours are supernumary to the staff rota. From rotas viewed, staffing levels average at around 2 nurses and 4 care staff on an early shift, 1 nurse and 3 carers on a late shift and 1 nurse and 2 carers on a night shift. Given the current dependency levels within the home, Mrs Bale stated that staffing levels appear satisfactory, and indicated that a process of review as to staffing takes place on a frequent basis. The inspector was informed that no agency staff have been utilised by the home for over 12 months. In addition to care staff, a team of activities organisers, physiotherapists, catering, housekeeping and maintenance staff are employed within the home. These staff teams appear to work well in conjunction with one another to the benefit of residents. One member of housekeeping staff was in the process of changing role to work as a carer. It was established that this staff member had attended the week long Induction and Foundation training being provided by Buckinghamshire County Council, which they reported as having been very useful. Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 16 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, 35 & 38. Residents live in a home that is run in a manner beneficial to them, that is managed by a person competent to do so, and are cared for by a kind and caring staff team. No personal money is handled by staff for, or on the behalf of, residents. Suitable systems are in place to protect residents and staff from the risk of fire within the home, and staff are provided with training in fire safety. EVIDENCE: The manager, Mrs Bale, is a registered nurse and is registered as the homes manager as required under the Care Standards Act 2000. Mrs Bale, and those staff members spoken with, did not appear unduly concerned at the presence of the inspector, and were co-operative and friendly throughout the visit. The manager and staff appeared caring and kind in their dealings with residents, and residents commented freely on this quality. Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 17 The inspector has recently been informed that Mrs Bale has handed in her notice at Chilton House in order to pursue a career development opportunity. The inspector has liased with the registered persons, and has been informed that steps are in hand to find a replacement for Mrs Bale. It appears that in the transitional period, robust systems have been established and are in place, which will minimise the impact this change will have on the running of the home and the provision of care. The manager stated that it is not policy to handle finances on behalf of residents, and as such no personal money is held for residents. Those rooms providing convalescence care are equipped with an individual safe. The home holds a fire action plan, which has been drawn up through liaison with a safety representative of Buckinghamshire Fire and Rescue Service. The fire logbook was viewed, and was found to hold up to date records pertaining to the testing and maintenance of fire detection systems, fire drills and equipment testing. At the time of the visit staff were receiving fire safety training. Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 18 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 3 Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Chilton House Nursing Home DS0000019194.V267439.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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