Inspection on 20/03/06 for Chimera

This inspection was carried out on 20th March 2006.

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

Chimera 15/03/10

Chimera 06/01/10

Chimera 18/02/09

Chimera 26/08/08

Chimera 27/11/07

Chimera 20/07/06

Chimera 27/06/05

Chimera 09/03/05

Chimera 06/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Chimera 21 Alum Chine Road Westbourne Bournemouth Dorset BH4 8DT Lead Inspector Jo Palmer Unannounced Inspection 09:40 20 March 2006 th 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 DS0000004012.V271494.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. DS0000004012.V271494.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chimera Address 21 Alum Chine Road Westbourne Bournemouth Dorset BH4 8DT 01202 767144 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) Ms Marise Anne Lena Holden Care Home 5 Category(ies) of Old age, not falling within any other category registration, with number (5) of places DS0000004012.V271494.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Chimera is a small care home catering for five older people. All five resident rooms are on the ground floor of the home. Chimera is located in a residential area of Westbourne close to the local amenities, which includes, shops, cafes, restaurants and post office; all are within walking distance of the home. The home is a large semi detached building with three floors. Residents are accommodated on the ground floor; the first and second floors are private accommodation for the owners. All residents rooms are single, three of which have en-suite facilities. The communal areas comprise a lounge dining room and large rear garden. There is a paved area at the front of the home overlooking the street and a small sun lounge at the front of the home. Chimera is within walking distance of public transport links to the town centres of Poole and Bournemouth. DS0000004012.V271494.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection on 20th March 2006 lasted for two hours, twenty minutes. Marise Holden registered provider and manager was present and assisted with the inspection process providing necessary information and access to records. This was a brief inspection the purpose of which was to monitor progress in addressing previous requirements and recommendations and to review practices in relation to some of the National Minimum Standards. The last inspection of 27th June 2005 resulted in one requirement and two recommendations being made and the Commission’s pharmacy inspector made one requirement and three recommendations during her visit in April 2005. Not all standards were assessed and the reader is referred to the report of the last inspection dated 27th June 2005, which can be obtained either from the Commissions web site: www.csci.org.uk The inspector spoke with two residents, one member of staff briefly, and Mrs Holden, viewed the premises and examined relevant records. What the service does well: Information is available for prospective residents and their relatives detailing the care and services provided by the home. There was evidence also that residents have their needs assessed prior to moving to the home in order that they can be assured their needs can be met before agreeing to a contractual arrangement to move in. Each resident has a plan of care devised from assessment detailing their needs and how staff are to meet them. Care plans provide good, clear instructions for staff relating to all health and welfare needs of residents. Residents remain in contact with their GPs and community health care services as required and are supported with arrangements for appointments. Residents spoken with confirmed that they are treated well and are respected, residents retain contact with friends and families and are able to make choices about their daily lives in the home. Chimera has an informal, relaxed environment, which is homely, warm and comfortable, all residents have single rooms, which they are able to personalise to reflect their own tastes and to enhance their feelings of belonging. DS0000004012.V271494.R01.S.doc Version 5.0 Page 6 Staff work at the home in sufficient numbers to meet residents needs and training is provided to an acceptable level to ensure staff retain and up date their skills and knowledge in caring for the resident group. Mrs Holden manages the home on a daily basis and communication between residents and staff is good and it was evident that relationships were goodnatured Systems are in place to ensure the health and safety of residents, staff and premises is maintained. What has improved since the last inspection? What they could do better: This inspection has resulted in one requirement, which must be addressed to ensure compliance with the regulations, and that residents best interests are protected. For residents who request assistance with the management of their personal finances, Mrs Holden must ensure that recording systems are robust and all transactions are recorded and receipts held. Resident’s money must not be pooled in one account and account details and records must be available for financial audit. Three recommendations have been made where practice could be improved: • The National Minimum Standards recommend that a qualified person assess care home premises in order that suitable aids and adaptations can be made to ensure residents are able to retain their independence around the home. Results of the resident and relative surveys that have been carried out should be audited along with other aspects of the service in order that results can be made available in the form of an improvement plan. To ensure compliance with data Protection legislation, the record of accidents in the home should be held in a specified format. Each accident should be recorded separately in an indexed system with one entry per page. • • 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. DS0000004012.V271494.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 DS0000004012.V271494.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3. Standard 6 is not applicable. The home’s Service User Guide provides residents and their representatives with detail of the care and services provided in order that they can make an informed decision whether to move to the home. Prior to moving into the home, resident’s needs are assessed to enable staff at eh home to be sure they are able to meet those needs and residents are provided with a contract outlining the terms and conditions of their residency. EVIDENCE: The home’s Statement of Purpose and Service User Guide were not directly assessed during this visit although a review of the current copy of the Service User Guide held on file with the Commission confirmed that information provided is relevant and detailed and would enable prospective residents to make an informed decision about moving to the home. Mrs Holden confirmed that following a requirement of the last inspection; the Service User Guide is now available to residents and visitors in the entrance of the home. Since the last inspection, and also now available to residents is supplementary information including the charter of residents rights and the home’s philosophy of care. DS0000004012.V271494.R01.S.doc Version 5.0 Page 9 Examination of residents care files evidenced that they had been issued with contracts outlining the terms and conditions of their stay at Chimera and their rights and obligations. Where residents have assistance form a local authority with their funding arrangements, a copy of the local authority contract was available for reference. Mrs Holden confirmed that there have not been any new admissions to the home since the last inspection, however, care files examined evidenced that an assessment of need had been carried out prior to admission detailing the residents health and welfare needs, a copy of the local authority care management plan was also available for reference where appropriate, there was evidence of regular reviews of assessments identifying resident’s changing needs. DS0000004012.V271494.R01.S.doc Version 5.0 Page 10 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. Care plans provide sufficient detail for staff to be aware of resident’s health and welfare needs and how to meet them and are reviewed appropriately; resident’s access to local community health care services is maintained. Resident’s rights are respected and their right to privacy is supported through care delivery and relationships with staff. EVIDENCE: Three resident care files were examined; each held care plans detailing the person’s needs, identified through assessment and detailed instructions for staff on how those needs are to be met. Care plans addressed all areas of the resident’s health and welfare including their social and leisure interests, care records were well written and respectful and demonstrated the staff’s understanding of resident’s individuality and personal preferences. It was evident from examination of care files that residents retain contact with their GPs and other community health care professionals as required. Medication systems were not directly assessed although one requirement and three recommendations made as a result of the Commission’s pharmacy inspector’s visit were discussed and evidence was available to demonstrate DS0000004012.V271494.R01.S.doc Version 5.0 Page 11 that these issues had been resolved. Risk assessment and review of the manner in which the keys to the medication storage has resulted in safer practice, the medicines policy has been revised to include reference to the procedures for ordering, checking and returning medicines and medication errors and a maximum/minimum thermometer has been obtained to monitor medication storage in the refrigerator. A recommendation regarding use of a compliance aid for one resident has been addressed although this has resulted in a system of medication management for the resident that has taken away some of her autonomy and independence. Further consultation will be made on this issue. Five residents were accommodated at the time of inspection, of these, one was not present in the home and one was sleeping, two residents were spoken with who confirmed they were treated well and with respect, one resident was in the lounge area of the home and both Mrs Holden and the member of staff on duty were observed in their relationship with this resident being respectful, courteous and kind and responsive to her needs. DS0000004012.V271494.R01.S.doc Version 5.0 Page 12 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): None of these standards were assessed EVIDENCE: The last inspection dated 27th April 2005 reported that standards 12, 13 & 15 were met. Although not directly assessed, it was evident that staff at the home are committed to ensuring that the social care and recreational activities meet residents needs. As a small home, Mrs Holden explained that group activities were not always possible although residents are assisted to go out to local community events and socials. DS0000004012.V271494.R01.S.doc Version 5.0 Page 13 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): None of these standards were assessed. EVIDENCE: The last inspection dated 27th April 2005 reported that standards 16 & 18 were met. Not directly assessed during this visit, the complaints process was however evident as Mrs Holden confirmed that each resident had been provided with a copy of the procedure, Mrs Holden also confirmed that no complaints had been received and those residents spoken with said they had no concerns about the care and services at the home. DS0000004012.V271494.R01.S.doc Version 5.0 Page 14 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 Chimera provides a well-maintained, comfortable environment for residents and although there has been no assessment of the premises to establish the extent of any specialist equipment needed to promote resident’s independence, access around the home for the current resident group is not restricted. Bedrooms and shared areas provide comfortable surroundings where residents can enjoy a homely atmosphere. EVIDENCE: In a residential street, Chimera is situated close to the local amenities of Westbourne. The home is well maintained and recorded evidence was available demonstrating regular servicing and maintenance of equipment and of the electrical and gas installations. Chimera has a contract with a local company for the disposal of waste and has guidelines available for staff on effective infection control procedures. The décor, furnishings and floor coverings were satisfactory. A lounge room with two areas separated by a dividing wall provides comfortable space for residents; the lounge is homely and domestic with a range of furnishings from high back chairs and comfortable sofas. Two resident bedrooms have en-suite facilities; other rooms have access to nearby DS0000004012.V271494.R01.S.doc Version 5.0 Page 15 toilets and bathrooms. Bathrooms are provided with hoists and aids to mobility to assist residents when bathing. A recommendation of the last inspection is repeated that Mrs Holden obtains the services of a qualified occupational therapist to undertake and assessment of the premises to establish the extent of the disability equipment required. As a pre-existing care home (registered prior to April 2002), Chimera provides the same useable floor space for residents as it did at that date in the two rooms that were registered at that time. The National Minimum Standards specification of 12 ² metres applies to the three bedrooms that were registered in 2005, although not measured during this visit, these room have not been altered since the 2005 variation to registration and therefore meet the standards for spatial requirements. All residents are accommodated in single rooms on the ground floor, bedrooms are comfortable and appropriately furnished and residents are able to personalise their rooms with pictures, ornaments and some furniture items. The home was a suitable temperature for the time of year, was appropriately lit and ventilated and hot surfaces had been guarded with low surface temperature covers to guard against accidental scalding. Water temperatures were not measured during this visit. DS0000004012.V271494.R01.S.doc Version 5.0 Page 16 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 & 30 The numbers of staff on duty and the training they receive ensures that resident’s needs are met and staff are able and experienced. EVIDENCE: At the time of inspection, four residents were accommodated, Mr & Mrs Holden were present in the home along with two members of staff whose roles include care, catering and domestic duties. Rotas were not examined although Mrs Holden confirmed that she had a stable staff group. Records of training provided demonstrated that all staff undertake a period of induction some of which is taught internally by Mrs Holden and some external by a local training provider including moving and handling, medication management, personal hygiene and care practices. The record indicated that the external training provider covered all units of the Skills for Care (formerly TOPSS) training specifications. DS0000004012.V271494.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 The management arrangements for the home support good practice. Being a small, family home communication between staff, management, residents and relatives is good although would benefit from more formalised systems of quality assurance. Methods of managing residents personal money were designed to assist residents although potentially place their financial interests at risk. The health and safety of the residents, staff and premises are safeguarded. EVIDENCE: Mrs Holden is the registered provider at Chimera and also manages the home on a daily basis; Mrs Holden is currently studying for an NVQ level 4 award in management and care which she hopes to complete by July 2006. DS0000004012.V271494.R01.S.doc Version 5.0 Page 18 The last inspection dated 27th June 2006 reported that Mrs Holden had provided residents and relatives with questionnaires in order to obtain their views on the services and care provided at the home although results of these had not been collated. Mrs Holden confirmed that to date, she has not completed an audit of results and developed an improvement plan for the home. A recommendation of the last inspection is repeated and Mrs Holden has been provided with an anonymised sample copy of a quality audit undertaken by another registered care service. Mrs Holden manages the personal finances of two residents. Mrs Holden confirmed that for these residents, their money is held in her personal account from which she pays for their hairdressing, chiropody, and other purchases. There are no records of income, expenses and balances held and money is not held separately or accessibly for each resident. Appropriate checks and maintenance of equipment are in place in accordance with health and safety expectations. All staff have received moving and handling training and infection control procedures are in place. Any accidents in the home are reported appropriately although the format used is not in accordance with Data Protection legislation. DS0000004012.V271494.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 2 3 3 3 X STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 1 X 2 3 DS0000004012.V271494.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Where residents request assistance with management of their personal finances, robust records detailing income, expenditure and balances must be held and all money must be held securely or banked for them individually in an interest bearing account. Timescale for action 1 OP35 17 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP22 OP33 Good Practice Recommendations The registered person should arrange for an assessment of the premises and facilities by suitably qualified persons including a qualified occupational therapist. The registered person should publish the results of the survey undertaken making it available for prospective residents and other interested parties. The record of accidents in the home should be held in accordance with Data Protection legislation, advice on recording formats is available form the Health and Safety Executive. 3 OP37 DS0000004012.V271494.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000004012.V271494.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!