Inspection on 01/02/10 for Chilworth House

This inspection was carried out on 1st February 2010.

CQC found this care home to be providing an Poor service.

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

Chilworth House 18/11/09

Chilworth House 20/01/09

Chilworth House 20/05/08

Chilworth House 14/11/07

Chilworth House 15/11/06

Chilworth House 19/12/05

Chilworth House 04/08/05

Chilworth House 13/01/05

Chilworth House 02/08/04

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 10/04/2010.

Random inspection report Care homes for older people Name: Address: Chilworth House 7 Rectory Avenue High Wycombe Buckinghamshire HP13 6HN zero star poor service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Barbara Mulligan Date: 0 1 0 2 2 0 1 0 Information about the care home Name of care home: Address: Chilworth House 7 Rectory Avenue High Wycombe Buckinghamshire HP13 6HN 01494526867 01494526140 simon@lloydscott-healthcare.co.uk www.chilworthhouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Lloyd Scott Healthcare Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 29 Number of places (if applicable): Under 65 Over 65 0 old age, not falling within any other category Conditions of registration: 0 Care home only (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 (OP) The maximum number of service users to be accommodated is 29 Care home only (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 (OP) The maximum number of service users to be accommodated is 29 Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Chilworth House is a care home providing personal care and accommodation for 29 older people. It is privately owned. The home is situated in High Wycombe and is a short drive away from the amenities that a large town can offer. The home has been owned and operated by Lloyd Scott Healthcare since 1998 and has undergone many improvements since then. It is a well-maintained Edwardian building and the improvements are in keeping with the style of the building. There are 26 single bedrooms and two double rooms, which are comfortably furnished. The home has two lounges and a pleasant conservatory. There is a sheltered outside sitting area and well-kept garden. The fees for the home range from £580 per week low dependency to £950 per week high dependency. Care Homes for Older People Page 3 of 9 What we found: A Random Focused Inspection was undertaken on the 1st February 2010 following the issue of four Statutory Requirement Notices served on the home due to failure to comply with requirements set at the previous inspection. The purpose of this inspection was to assess if the Statutory Requirement Notices have been complied with by the 30th January 2010. The inspection focused specifically on care planning, medication procedures and recruitment practices. The registered provider has recognised the seriousness of the issues and has employed an operations manager to oversee the management of the home and to ensure that the requirements from the previous inspection are complied with. The first Statutory Requirement Notice required that the home to; 1) Ensure that service users care plans are sufficiently detailed in order to provide staff with the guidance they require to ensure that service users needs are fully met. 2) Ensure that service users care plans are sufficiently detailed to include all aspects of daily living needs, their preferences and their likes and dislikes. 3) Ensure that where a service user has been prescribed (PRN) as required medicines, that the guidelines regarding the administration of this medicine are fully recorded in the service users care plan. The care plans for three people using this service were examined. These show an improvement in the detail recorded in each file. The care plans are up to date and contain sufficient detail for staff to learn about residents they support. Specific needs have been identified within the care plans and there is a detailed action plan in place to provide staff with the details of how these needs are to be managed and fully met. For example, in one file the initial needs assessment has identified that the service user suffers from anxiety and panic attacks. There is a detailed plan of care for staff to follow to support the individual in this area. Individual preferences, likes and dislikes are recorded in each of the service users files examined. At this visit we looked at the medication administration record (MAR) charts for all people using this service and the three care plans for the people whose care was being looked at as part of this visit. The operations manager informed the inspector that all service users residing in the home were to have a medication review and this would be completed by each persons doctor. Generic guidance and policies have been produced regarding the administration of as needed medicines. This covers medication such as Analgesics, Antiinflammatory medication, Sedatives, Antipsychotic medicines, Respiratory tract medicines and gastro-intestinal medicines. Following a medicatoin review for each person specific guidance has been produced for as needed medicines. This Statutory Requirement Notice is assessed as met. The second Notice requires that the home; Care Homes for Older People Page 4 of 9 1) Have a system in place to ensure that all risks to the health and welfare of service users are fully identified and documented in the service users care plan. 2) Ensure that each identified risk has a fully documented action plan as to how the risk can be minimised or eliminated. 3) Ensure that all risk assessments are reviewed and updated at least monthly. You must ensure that the risk assessments are reviewed and updated following a change in the service users needs which would impact on their health and safety. The three care plans for the people whose care was being looked at as part of this inspection were looked at and the risk assessments were examined. Risk assessments are in place covering falls, moving and handling and pressure area care. The operations manager was in the process of completing nutritional assessments for each person and these were looked at during the visit. All assessments observed are up to date, signed and dated by the person completing the assessment. Where a specific risk has been identified the care plan provides guidance for staff on how to minimise the risk. For example in one file the individual was assessed as at high risk of falls and a clear plan of care was recorded in this file. This Statutory Requirement Notice is assessed as met. The third Statutory Requirement Notice requires that the home; 1) Ensure that all handwritten entries on medication record sheets are checked for accuracy by a second person qualified to do so. 2) Ensure that there are clear written guidelines for staff regarding the administration of (PRN) as required medicines. 3) Ensure you provide clear written guidance to staff for each service users who is prescribed (PRN) as required medication, as to when to administer the medication and any triggers or indicators known that shows the medication is needed. 4) Ensure that where a service user has been prescribed (PRN) as required medicines, that the guidelines regarding the administration of this medicine are fully recorded in the service users care plan. The Medication Administration Records (MAR) were examined for all people who use this service. There were several handwritten entries on the MAR charts and these were signed by one person. The registered manager assured the inspector that she would check these charts and counter sign them on the day of the visit. The operations manager has produced a policy regarding the safe administration of as needed (PRN) medicines and she said the home has been working closely with the supplying pharmacist. There is specific guidance regarding the administration of as needed medicines and this is contained in the care plans. These include information about when to administer the medication and any triggers or indicators known that shows the medication is needed. Care Homes for Older People Page 5 of 9 This Statutory Requirement Notice is assessed as met. The fourth notice requires the home to; 1) Have a system in place to ensure that the documents specified in Schedule 2 of the Care Homes Regulations 2001 are obtained and are available for all staff before they start working in the Home. 2) Ensure that the documents specified in Schedule 2 of the Care Homes Regulations 2001 are obtained and are available for all of the existing staff. Six staff files were examined during this visit to the home, including one for a care worker new to the home. Criminal Records Bureau checks have been applied for where these were missing from files at the previous inspection. All files examined contained application forms, evidence of ID, contracts of employment, declaration statements of physical fitness and in all files except one there were two written references. Although the person with only one reference had been employed to work in the home for a substantial period the operations manager was informed to obtain a second reference for this person. The operations manager has updated the recruitment procedures and policies and implemented a recruitment checklist. The operations manager said she is now over seeing the recruitment of all new staff. This Statutory Requirement Notice is assessed as met. Overall it was felt that the provider had recognised the deficits in the home and had taken initial steps to address them. The Care Quality Commission will continue to monitor the home. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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