Inspection on 18/12/06 for Chimnies Residential Care Home

This inspection was carried out on 18th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Chimnies Residential Care Home 09/02/06

Chimnies Residential Care Home 02/08/05

Chimnies Residential Care Home 31/01/05

Chimnies Residential Care Home 02/08/04

Chimnies Residential Care Home 23/02/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Chimnies Residential Care Home Stoke Road Allhallows Rochester Kent ME3 9BL Lead Inspector Marion Weller Key Unannounced Inspection 18th December 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 Chimnies Residential Care Home DS0000029262.V324099.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. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chimnies Residential Care Home Address Stoke Road Allhallows Rochester Kent ME3 9BL 01634 270119 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) Mr Kim San Ong Mrs Marilyn Janet Ong None Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care may be provided to one older person who has a learning disability and whose identity is held at the CSCI office. 9th February 2006 Date of last inspection Brief Description of the Service: Chimnies Residential Home is registered to provide care and accommodation for up to 29 older people. The detached property is situated in a rural area on the outskirts of Allhallows Village. The home enjoys extensive views across the countryside. Accommodation is on two floors and all bedrooms offer single accommodation, two with an en-suite bathroom. A passenger lift provides access to the first floor. There is ample car parking space at the front of the premises. There is a garden area to the rear and side of the property. The Proprietors, Mr & Mrs Ong, have many years experience in the caring profession. The home employs care staff working a roster, which provides 24hour cover. Ancillary staff for catering and domestic duties are also employed. Current fees range from £336-£410 according to assessed personal need. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was conducted by Marion Weller, Regulatory Inspector between 10:30 am and 3:45 pm. During that time the inspector spoke with some residents, the proprietors and some of the staff on duty. Some judgements about the quality of life in the home were taken from observations and conversation. Some records and documents were looked at. In addition a tour of the building was undertaken. Thirteen survey responses were received prior to the inspection. Responses from residents, relatives and health professionals indicated that they were very satisfied with the standard of care the home provided. One respondent however was unhappy at having to go to a resident’s room when visiting the home and felt that some adaptation could be made to one of the lounges for the use of visitors. The same respondent felt the home did not offer sufficient activities. The remaining respondents all stated that the home always or usually offers activities to residents, which they attend if they so choose. Statements on surveys included: “Chimnies is an immaculately clean and welcoming home which provides excellent care” “The home is extremely nice with a pleasant outlook- nothing is too much trouble” “Very happy with the care my relative receives at the home. I am always made welcome by the owners/staff and kept up to date with what’s happening”. “I don’t feel it necessary to have to go to a residents room when visiting. I would not like my visitors to sit in my bedroom. Maybe one of the lounges could be a visitor’s room! “I never know what activities go on, if any!” The owners and staff gave their full cooperation throughout the visit. Chimnies Residential Care Home DS0000029262.V324099.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: Residents would benefit if their main plans of care were updated to reflect any reviews and changes that have taken place and residents or their representatives signed care plans to evidence their involvement in its formulation and agreement to the plan. Residents would benefit from improvements to procedures for infection control in the home. Some of the home’s systems of work regarding the safe administration of medication currently put residents at some risk and do not fully protect their privacy and dignity on all occasions. Residents are protected from abuse but would be further safeguarded if all staff were trained in the protection of vulnerable adults. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 7 Residents would benefit from staff having greater access to external training opportunities. The home needs to formulate a training matrix that gives a clear overview of staff training needs. Residents would benefit from the formal supervision of staff taking place at least to the minimum standard of six times a year. Residents would benefit by the owners undertaking a formal management qualification or appointing a qualified manager. The home’s policies and procedures would benefit from regular review to ensure they are up to date and that they reflect current regulation and good practice guidance. Systems and procedures must be further developed to protect the security of residents’ information held by the home. Further consideration needs to be given to best practice in the sharing of residents’ personal information with others. 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. Chimnies Residential Care Home DS0000029262.V324099.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 Chimnies Residential Care Home DS0000029262.V324099.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): 123456 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service have the information they need to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned before they move to the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide, which provide residents or their representatives with all the information they need to make a decision about moving to the home. Both documents were seen to be available for reference in residents’ bedrooms. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 10 Residents and their representatives are able to visit the home before deciding to move in and longer trial visits can be arranged with the owners. Residents have a full assessment of their needs prior to moving in to ensure their needs can be met by the home. Each resident has signed a contract with the home for their care, this outlines the terms and conditions of their stay. The home does not provide intermediate care and therefore standard 6 is not applicable. Chimnies Residential Care Home DS0000029262.V324099.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 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ health and social care needs are clearly set out in plans of care which are regularly reviewed to ensure their changing needs will be met. Residents would further benefit if the main plans of care were updated to reflect any changes that have taken place and residents or their representatives signed care plans to evidence their involvement in its formulation and agreement to it. Systems and procedures must be further developed to protect residents’ personal information held by the home. Some of the home’s systems of work regarding the safe administration of medication currently puts residents at risk and does not fully protect their privacy and dignity Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 12 EVIDENCE: Each resident has a care plan. Some were looked at in detail. Care plans were seen to be individually maintained in the home and made available to staff for guidance in their daily practice. The content of care plans was easy to understand and plans had been regularly reviewed. On occasions the home had not revised the main plan at review stage when changes had occurred. The owners stated their intention to rectify this matter. Residents’ individual care plans are currently stored on shelves by the open entrance door to the main office. Some elements of the care plans viewed held privileged and sensitive information that had no direct relevance to the individuals daily care needs and should be locked away for reasons of privacy and security. Residents’ daily records were being maintained. They were seen to be detailed, comprehensive and reflected plans of care. Entries made are now signed upon completion as recommended at the last inspection. Residents weight and nutritional records were being maintained and regularly updated. Risk assessments in care plans were seen to be in place where they were necessary. Some care planning training had been undertaken ‘in house’ with staff, which was provided by the owners. All residents felt well cared for. Residents or their representatives were said to be included in care planning formulation and at review where it was possible. Care plans however were not signed to evidence the residents’ or their representatives’ involvement with the formulation of the plan or their agreement to it. The home was not aware that this was necessary. The home is effective in keeping residents relatives and representatives informed as to the individuals changing needs and the owners spoke of the necessity to share information in a timely manner. The home could improve practice by ensuring that they have a resident’s agreement to information being shared about them and with whom. No records were available to evidence this aspect of care planning had been raised with residents upon admission or at review. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 13 Residents can use a telephone in private if they wish and said that their mail arrives unopened for them. There are locks on bedroom and bathroom doors to promote residents privacy. The home’s medication systems were audited and the mid day administration round observed in the residents’ dining room. A monitored dosage system for dispensing medication is used by the home. The care worker undertaking the round said they had received a ‘one day’ external training course and had also received medication administration guidance from the home. The home has a written medication procedure and policy. The document had not recently been reviewed. A resident’s eye drops were seen to be installed in the main dining room during the medication round. Good practice demands that this intervention should have taken place in the residents’ bedroom or other private area to protect the individual’s privacy and dignity. The owner said some residents prefer to receive treatment in the dining room, but this was not evidenced on care plans. The home’s medication administration sheets were inspected and no obvious gaps in administration were found. A recommendation was given at the last inspection for two people to sign handwritten transcriptions in medication records to ensure accuracy. A sheet of handwritten records for a respite resident was seen. Accuracy of transcription had not been confirmed by a second person checking the written detail and signing to say this had happened. The controlled drugs cabinet was a locked safe within a locked cupboard which was password protected. The controlled drugs balance was checked and found to be correct. The home does not maintain a sequentially numbered Controlled Drugs register; although a hard backed exercise book was in use, the pages were not numbered. None of the staff spoken with had undertaken comprehensive training in the safe administration of medication. Good practice demands that at least one member of staff should have proved competency in a more advanced programme of instruction to safeguard residents, especially as a manager is not currently employed by the home. Chimnies Residential Care Home DS0000029262.V324099.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 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and stimulation are provided in the home and as much as possible ensure daily variation and interest for residents. Residents are enabled to maintain contact with friends and family who are made welcome in the home. Wherever possible residents are given opportunities to make choices, therefore allowing for some level of control over their lives. The meals in this home offer both choice and variety and cater for residents’ particular needs. EVIDENCE: The home states that it offers an activities programme, which ensures social activities and stimulation are provided in the home and as much as possible offers daily variation and interest for residents. Notice boards viewed on the day of the inspection displayed ‘in house’ and local events for residents that were due to take place and to which they had access. Residents spoken with Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 15 said they were happy with the activities offered in the home. Most said that it was difficult to please everyone, but they felt that the home did its best to meet their individual and collective needs. One survey respondent was less than enthusiastic about the content of the home’s activities programme and stated that they were unaware what activities, if any, took place in the home. One survey respondent spoke of their dislike at having to go to a resident’s bedroom when visiting and asked if one of the lounges could be a turned into a visitor’s room. Both quality of service issues need to be discussed by the owners with residents and their representatives to see if the points raised could be further explained or possible changes made. Residents meetings regularly take place in the home. There are two main lounges and a separate dining room for residents. All communal rooms are comfortable and well decorated. Residents’ friends and family felt welcome and knew they could visit the home at any reasonable time. The home advises against visiting at meal times so as not to distract residents. One survey respondent thought this to be good practice, which ensured residents were able to enjoy their meals in peace and privacy. The kitchen staff understood residents’ dietary needs well and were used to cooking for older people. Survey respondents spoke well of the food offered to them and said that the menus always gave an alternative choice of meal. It was evident from speaking with residents that the home meets their individual needs and all spoken with reported that they were very happy and contented. There didn’t appear to be any routines in the home that residents did not agree with. Some individuals spoke of getting up and going to bed when they liked. They could bathe when they liked, although realised that staff had to make sure everyone was assisted with bathing and that took time. Residents spoke highly of staff and they appeared to get on well with each other. Games/ papers/ magazines/books/ TV & Radio were in evidence for residents use. One resident spoke of how she used to play the church organ. The vicar still visits her and she is enabled to visit the local Church. The home is two minutes walking distance from the local Church. Chimnies was originally the church rectory. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 16 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 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know how to make a complaint and know that their concerns will be taken seriously and acted upon. Residents are protected from abuse but would be further safeguarded if staff were all trained in the protection of vulnerable adults. EVIDENCE: The home has a clear complaints procedure and residents have been issued with a copy for their reference. Residents spoken with said they knew how to make a complaint if they needed to and felt comfortable in doing so. The owner had dealt with one formal complaint since the last inspection within the published timescale and the outcome fully satisfied the complainant. Any minor concerns or requests were seen to have been addressed appropriately through residents meetings. The owner said they have very few complaints. They strive to maintain good relationships with residents’ relatives and listen carefully and act quickly on residents concerns. Residents said they Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 17 felt safe and secure in the home. A number said they wouldn’t want to live anywhere else and trusted the owners and the staff to care for them. No residents or their representatives raised any concerns about the home’s management of finances. Relatives/representatives and Care Managers usually take responsibility for the management of residents’ finances. The home maintains accurate and up to date residents allowance records. A policy for the protection of vulnerable adults is in place and staff are made aware of the content through induction and supervision. The Home could evidence possession of the lead agencies updated policy and procedure document on adult protection. The home’s own adult protection policy needs review to reflect current good practice and legislation but content was seen to be comprehensive in its approach to the subject. The home’s owner explained the actions the home would take if there were any suspicion of abuse. The staff notice board had a current information document on view about protecting vulnerable adults and whistle blowing. Residents’ rights are promoted in the home. Since the last inspection the owner has accessed two places for staff members to receive training in Adult Protection during 2007. Accessing training for all staff in adult protection has been an outstanding requirement from the last inspection and thus this issue must now be resolved to ensure residents are fully protected from potential harm. There have been no referrals under the POVA scheme. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 18 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 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and well-maintained home. They have plenty of private and communal space and access to sufficient bathroom facilities. Whilst the home meets the needs of residents they would benefit from improvements to the home’s procedures for infection control. EVIDENCE: Residents all have single bedrooms, which have been personalised to reflect, their individual tastes and interests. All residents have access to sufficient bathroom and toilet facilities, including assisted baths. There is a mobile hoist Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 19 and a fixed ceiling hoist for use by residents. All of the home’s equipment is regularly serviced and maintained. Residents have access to two large lounges and a spacious dining room. All areas of the home are well decorated and furnished to a good standard. All radiators in communal areas and residents bedrooms were guarded. The owner undertakes all handyman duties in the home including redecoration. A new extension to the home was built fairly recently which has made the home considerably larger to maintain. The home’s laundry was clean, well organised and maintained. The home’s industrial laundry machines are of good quality. The home has a red bag system for foul laundry to protect staff and residents. Two chest freezers for the storage of food were housed in the laundry area. The owner stated that the Environmental Health Officer had noted this on a recent visit and requested that these are rehoused elsewhere in the home to ensure food hygiene standards are not compromised. The owners were intending to comply with the request as soon as alternative arrangements could be made. The home was very clean and hygienic. Residents spoken with and survey respondents said the home is always pleasant, clean and fresh. Communal toilets evidenced domestic cotton hand towels in situ although there were also liquid soap and paper towels in evidence as well in some toilets/ bathrooms. It is recommended that paper towels be solely used for staff and residents use in communal bathrooms and toilets to ensure that the home’s infection control procedures are not compromised. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 20 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 30 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents are supported by sufficient numbers of staff on duty to meet residents’ needs. Residents would benefit from staff having greater access to external training opportunities and the home formulating a training matrix that gives a clear overview of staff training needs. EVIDENCE: There were sufficient staff on duty to meet the needs of the residents on the day of the inspection and it was stated that there is always a senior carer on shift. Residents and survey respondents spoke highly of the care staff and said they were caring and respectful. They also confirmed that staff responded quickly to call bells and are always understanding and accommodating of their needs. Staff spoken with are aware of their roles and responsibilities. There are clear lines of accountability in the home. Staff appeared happy working in the home and felt they had the necessary skills to meet the requirements of their role. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 21 Over 50 of care staff have achieved or are working toward their NVQ award. Most staff had completed training in areas of health and safety and senior staff had undertaken one day training in medication administration. It is recommended that at least one member of the senior staff should complete a more comprehensive course of instruction in the safe administration of medication. It also remains a recommendation that the owner introduces a training matrix to provide the home with a clear overview of staff training completed, training planned and update training required for staff. It is further required that all staff undertake training in adult protection. The home has an induction programme for new staff. The owners were advised of the need to revise the existing induction programme and to provide foundation training for any new staff. All new members of staff are to receive foundation training to NTO specifications within the first six months of their appointment. The owners were given information on accessing the Skills for Care website to inform and guide their future practice. Staff records were inspected. CRB and POVA checks were seen in all files viewed. The home now realises that this precautionary measure is an absolute necessity to protect residents. Recruitment processes were seen to be sound on this inspection. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 22 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 32 33 35 36 37 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a home run by experienced owners, but would further gain by the owners undertaking a formal management qualification or appointing a qualified manager. Residents are regularly consulted on their views of the home and their financial interests are protected. Residents’ welfare is promoted through regular maintenance and equipment safety checks. The home’s policies and procedures would benefit from regular review to ensure they are up to date and reflect current regulation and good practice guidance. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 23 Residents would benefit from the formal supervision of staff taking place at least to the minimum standard of six times a year. EVIDENCE: The owners manage the home between them on a daily basis. Staff and survey respondents said both were experienced, supportive and resident focussed. Neither of the owners had undertaken the appropriate management qualifications yet. This must be arranged if they plan to continue to manage the home without employing a qualified manager. Mr Ong stated that he had recently advertised for a trained manager to relieve them both of the need to undertake any further formal management training. There appeared to be some confusion about what the home should notify the Commission about. To date the home only notifies of residents deaths. They were unaware of the need to notify of anything that may affect a resident’s welfare. Records such as accident reports are however maintained in the home. Access to guidance on the scope of notifications necessary to meet the demands of regulation can be obtained via the Commissions website as can the changes made to the inspection process since the introduction of Inspecting for Better Lives 2. The changes to regulation and the inspection process were discussed with the owners. Residents’ financial records are maintained and two people now sign entries. The balance of a resident’s money kept at the home was checked and found to be accurate. The home’s policies and procedures were available for inspection however; they did not all evidence current review dates. A number were seen to have been formulated in 2003/4. The inspector was therefore unable to confirm that the home’s policies and procedures have all been reviewed and revised to reflect current legislation and good practice demands. The owner stated his intention to review all information, policy and procedural documents used in the home. Mr Ong stated that he undertakes quality assurance exercises. He does not publish the results although he confirmed that feedback from stakeholders in the service continues to be good. Residents and survey respondents felt the home was run with the residents best interests at heart. A local GP responded to the Commission that he found Chimnies to be a well-managed residential home. Residents’ welfare is promoted through regular maintenance and equipment safety checks within the home. Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 24 Staff supervision records were seen in staff files, which were securely held in the home. From the dates on staff supervision records it was evident that formal staff supervision and appraisal does not take place as often as six times a year, which the standard requires. Residents’ information was not securely kept in all instances, some sensitive and privileged information was available to all staff in care plan files. The home was advised to separate such information from operational care plans and keep it securely locked away. Permission to share resident information with relatives/ representatives had not been formally secured in care plans either. It was however common practice for personal or health details to be given to relatives without the resident’s prior consent. Most individuals in the home have the capacity to make their views known on the sharing of their personal information. The owner stated that they were of the opinion that they were required to share all information, regardless of the residents view, with relatives and this was in the standards. The need to formally gain a residents permission to share privileged information made known to the home and recording the agreement was discussed as best practice demands. Chimnies Residential Care Home DS0000029262.V324099.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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 2 2 2 Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Timescale for action The registered person shall make 01/04/07 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. In that: • The home’s medication administration policy and procedures are to be reviewed to ensure content meets current legislation and good practice. • Hand written transcriptions on administration records must be accurately transcribed from the medicine label and checked by a second person to verify accuracy administration records must evidence the procedure takes place. • Staff must receive suitable training and be regularly assessed for competency to administer and manage medicines. The registered person shall make 01/04/07 DS0000029262.V324099.R01.S.doc Version 5.2 Page 27 Requirement 2. OP18 13(6) Chimnies Residential Care Home arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. In that: All staff must undertake training in the protection of vulnerable adults. A plan to address this must be provided to the Commission by the timescale indicated. (Previous timescale of 31/05/06 not met) 3. OP36 18 (2) The registered person shall 01/03/07 ensure that persons working at the care home are appropriately supervised. In that: Care staff are to receive formal supervision, which includes identification of training needs at least 6 times a year. The registered person shall make 01/03/07 suitable arrangements to ensure the care home is conducted in a manner, which respects the privacy and dignity of service users. In that: Residents personal and sensitive information must be kept confidential and stored securely. The registered person shall make 01/03/07 suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home. In that: The use of cotton domestic hand towels must be eliminated from communal areas. 4 OP37 12 (4) (a) 5. OP38 OP26 13(3) Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 28 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 OP7 OP7 Good Practice Recommendations It is recommended that a resident’s main plan of care be updated to reflect any changes that have taken place at review. • It is strongly recommended that residents or their representative’s sign their care plan to evidence both their involvement with the documents formulation and their agreement to the plan. • It is further recommended that the home establishes a process for formally discussing with and gaining if necessary, a resident’s permission to share their personal information, and to whom this agreement relates and extends. The decision should be recorded in their care plan and regularly reviewed with the individual. It is recommended that the receipt, administration and disposal of Controlled Drugs are recorded in a Controlled Drugs register. It is recommended that eye drops be instilled in a resident’s own room or other private area to protect the individuals privacy and dignity. It is recommended a training matrix be used to readily identify staff training needs. It is recommended that staff induction be to the standard of the National Training Organisation (currently Skills for Care) and new staff receive Foundation Training. It is most strongly recommended that the owners complete an NVQ level 4 in Management if a qualified manager is not appointed to the home. It is most strongly recommended that the home’s information documents and policies and procedures be reviewed regularly in light of changing legislation and good practice advice. 3. 4. 5 6. 7. OP9 OP10 OP30 OP30 OP31 8 OP33 Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Chimnies Residential Care Home DS0000029262.V324099.R01.S.doc Version 5.2 Page 30 - 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. 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