Inspection on 18/05/06 for Chippendayle Lodge.

This inspection was carried out on 18th May 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

Chippendayle Lodge. 06/06/07

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 Chippendayle Lodge 10 Chippendayle Drive Harrietsham Maidstone Kent ME17 1AD Lead Inspector Lynnette Gajjar Key Unannounced Inspection 18th May 2006 10:00 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 Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 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. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chippendayle Lodge Address 10 Chippendayle Drive Harrietsham Maidstone Kent ME17 1AD 01622 859230 01622 859230 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) Charing Dale Ltd Ms Sandra Margaret Pearce - Tamsett Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 6 people with a diagnosis of dementia can be accommodated. 25Th January 2006 Date of last inspection Brief Description of the Service: Chippendayle Lodge is one of 18 care homes managed by Charing Health Care under the company name Charing Dale Ltd. Chippendayle Lodge is a detached property on the outskirts of Harrietsham village and sits within approximately one acre of grounds. The home is located approximately a quarter of a mile from the village centre. There is good access to facilities within the village and to public transport. The home is registered for 21 people including 6 with a diagnosis of dementia. Accommodation comprises 21 single bedrooms located on the ground and first floor. 14 bedrooms have en-suite facilities. The home has a large lounge and an attractive sun lounge that combines the residents dining area. The home has two stair lifts and a platform lift. There is a car park to the front and side of the building. There are a number of areas in the attractively laid out garden where residents may sit. 24 hour staffing is provided with waking night staff. Current fees range from £407 to £428 per week. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2006 to March 31st 2007. The visit lasted from 10:00am to 16:30pm. The homes previous private owners on 14th March 2006 sold the home to a company Charing Health Care (CHC) and registered the home as Charing Dale Ltd. Residents, staff and families were unaware of the sale until it had been completed. This has caused increased anxiety to those living and working at the home over the past two months. The home currently has 18 residents and is running with three vacancies. The visit was spent talking directly with residents, both privately and collectively, with staff, visiting relatives and the registered manager. Due to the nature of the service and short-term memory loss experienced by some residents, it is difficult to reliably incorporate accurate reflections in the report. Some judgements about quality of life and choices were taken from direct conversation with residents, and direct observation followed by discussion with care staff and evidencing records held at the home. A tour of the premises was undertaken, with time spent assessing various records. Information was also gathered through a pre inspection questionnaire completed by the manager. A number of CSCI “comment cards” (completed questionnaires) were received from 13x relatives/visitors; 5x GP’s. Feedback included: “Staff are good at maintaining a happy and caring environment. Very satisfied” “ On the whole we are quite happy” “Quality of food has fallen since new owners taken over, possibly due to the inexperience of the chef(s). Fruit not always offered at tea time.” “I do feel the standard of the catering is not quite what it was, I think that is down to the supplier (mainly) rather than lack of experience in the kitchen.” “There are times additional foods is required.” “We are very satisfied with the care our mother is receiving and hope this will not be adversely affected by the new ownership. Staff coped very well with the difficult period of change of ownership; which was not handle well by the outgoing owners. Residents were unsettled. The meeting of relatives called by the new owners was useful and allayed a number of concerns.” Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 6 “ Excellent home with dedicated carers run by an extremely knowledgeable and dedicated manageress. Pleased to visit there for my visits.” “No concerns at all” 13 residents also completed ‘Have your say about Chippendayle lodge’ questionnaires and discussion today directly gave the following comments. “Everything is good, the home is very good.” “I couldn’t be in a better place” “The staff are very caring, lovely girls” “Lovely home, I am very happy here” “I wouldn’t use the word happy, content is far more appropriate” “Quality of food has gone down hill, very poor, no fresh fruit any more” I agree the food is not good, (name of previous cook) was a corden bleu chef, that’s hard to follow” “ Food is not so good, it’s not the cooks they try hard, it’s the quality if their ingredients, the bread and wheetabix are like cardboard, the prunes are hard to chew, the fruit juice is disgusting but you tolerate it” “I couldn’t be happier here, I just hope I don’t become a number rather than a person in a big company” “ Sandra and the girls are marvellous” What the service does well: Residents benefit from a staff team who work well together, promote a happy and familiar support for individual residents. Staff know the individuals well and communicate effectively with them. Residents presented as feeling safe and comfortable at the home. Residents have a happy and fulfilled lifestyle with good two-way relationships and contact with their families and local community. Residents like the home and believe the care and facilities are excellent. They continue to consider the staff work hard. Many feel that staff go out of their way to ensure all residents are treated with dignity and respect, particularly with the changes recently. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 7 Residents particularly liked the gardens and appreciated all the work and thought that goes into making their home so comfortable. Residents consider there to be sufficient staff on duty to meet their needs. Residents and staff benefit from the open, approachable and strong leadership of the manager. What has improved since the last inspection? What they could do better: Residents would benefit greatly from a full review of current food suppliers, menu planning and dietary needs through Charing Healthcare listening to the preferences, expectations and nutritional care needs of those living at Chippendale Lodge. Resident’s rights to take risks must be underpinned by the introduction of comprehensive risk assessments, which detail the action to be taken to eliminate, reduce or manage the risk. Pharmaceutical standards continue to improve to meet good practice guidelines and will be further enhanced when staff that administer medication have all completed suitable training. Residents would benefit from staff having clear guidelines and information regarding when to administer PRN medication. The risks of cross infection would be reduced if disposable hand drying facilities were put in communal toilet/bathrooms and private rooms were personal care is supported. Good infection control management would be improved through the installation of a sluicing facility for cleaning commodes and laundry facilities to enable effective division of clean and dirty items. Resident’s health and safety would be improved if toilet frames were fixed to the floor and cupboards housing electrical fuse boxes and shelving by the lift is not used to store combustible items. Residents and staff would have a better understanding of what to do in the event of a fire alarms sounding with occasional fire drills being completed and recorded in line with current fire regulations. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 8 Residents would benefit from having the two-bathroom/shower rooms fit for purpose and in full working order. To ensure consistent care and support to residents, current and relevant information is transferred into Charing Healthcare care plan formats. Staff can develop further the daily records by ensuring accurate details of the support and care given, how the residents have felt, been involved etc, to reflect the guidelines and assessed plan of care. 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. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 9 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 Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 10 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): 1,2,3,4,5,6 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service and reflecting current changes of ownership and documentation to be used. Residents and representatives have access to the information needed in making a decision if the home can best meet their needs. Residents are protected by a written agreement for living at the home with the previous owners being honoured by Charing Dale Ltd. Residents would feel less anxiety through the transferring of the above information to documents from Charing Dale Ltd. EVIDENCE: The home is still currently working to the previous statement of purpose and service users guide, where information pertaining to owners ship is incorrect but the remainder remains unchanged. Charing Dale Ltd have not developed Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 11 or submitted either document to the commission as part of the registration but stated this was to follow due the speed of the sale. The manager talked though a very comprehensive pre admission process including all new residents being required have a day visit arranged before making a final decision to choose to live at the home. This is good practice and allows both staff and resident to make further assessment as to whether the home can meet their needs. A prospective new resident was visiting the home today and was supported by fellow residents and staff in getting to know each other and get around the home. This was managed in a very relaxed and caring manner. Charing Health Care admission paperwork was being introduced as part of this. The manager continues to demonstrate a clear understanding regarding the category and needs of the resident that the home could meet. Her knowledge and experience of the homes capacity to meet individual needs is commendable. Residents spoke of the support and assistance they had received in helping them to settle in. Those spoken with were fully aware that the initial period is a trial stay to ensure that it is the right home for them. Chippendayle continues to offer periods of respite care to individuals when a room is available. A few said this was how they became familiar with the home and had then decided to return when a room of their choice became available on a permanent basis. Contracts seen are with the previous owners but residents and relatives today stated Charing Dale Ltd had said they would honour these at the emergency meeting held after the sale. New residents will be issued with Charing Dale Ltd contracts. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 12 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 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service and reflecting current changes of ownership and documentation to be used. Care plans, risk assessments and guidelines need to develop with more detailed information to ensure consistent support by staff to meet the individual health and social care needs of residents and to track the care provided. Residents are treated with genuine respect and dignity by the manager and care staff. Residents and representatives feel confident staff support them in every day decisions, in taking risks, being part off aspects of their lives they feel are important (except the current food being offered), whilst maintaining their confidence. EVIDENCE: Four care plans were assessed and care tracked. However it was acknowledged that the staff was in the process of transferring to Charing Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 13 Health Care formats and inappropriate to assess fully today. Staff have not yet received formal training by the company in completing these. Those seen today require more information to make them personal to the individual and ensure consistent support. Care plans seen have no risk assessment in moving and handling, where needed or other forms of individual risk assessment such as those pertaining to falls, behaviour, or PRN Medication. Daily records did not always link to accident/incident records and action taken. Daily records do not reflect the commendable care and support directly observed as being given by staff today. Life histories completed were detailed and well presented. The manager has downloaded Charing Healthcare risk assessment tool but has not yet begun to use this. Staff evidenced a clear and practical understanding of residents needs and residents themselves were confident that their care needs were being fully met (except in relation to their food). Staff continue to use a communication book and handover to ensure continuity of care. Records show continued good liaison with specialist and local health care professionals in supporting residents with their health care needs. The home has made some improvements to good practice in relation to medication management; a new medication trolley has been purchased. Cold storage continues to be stored in a domestic fridge. The manager stated a medication fridge has been ordered but still has not been delivered. Medication that is to be destroyed after 28 days should have date of opening written on the bottle/tube for monitoring purposes. Gaps identified in Mar sheet today were pertaining to medication prescribed for three times a day but on discussion is only given PRN. Such information should be confirmed with the GP and prescription changed to reflect actual doses to be given. Two staff should record and sign any verbal agreement and changes. The home currently holds one controlled drugs and is logged in the register and signed by two staff. Some staff has received ‘ Safe Handling of Medicines’ training. A number of staff that are currently designated to administer medication have not had such training. Any residents who self medicate should be assessed as to their understanding of medication, when and times to be taken on regularly basis to ensure safe administration is occurring. Those who self medicate must have lockable storage to hold such medication. Residents are treated with the greatest respect and always with consideration for their dignity and privacy. Toilet and bathroom doors are lockable. Residents could make and receive phone calls in private. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality on this outcome area is poor. This judgement has been made using available evidence including a visit to the service and reflecting current changes of ownership and documentation to be used. Residents currently feel that new menus and food provided by Charing Dale Ltd do not offer the quality, nutritional value and healthy fresh products they are accustomed to. Thus leaving them feeling the right to exercise choice and control over their diet has been taken away. Residents are given encouragement and support to make choices about a range of local social and recreational interests at a pace suitable to them. EVIDENCE: Good contact and support is promoted with family and friends. Excellent relationships have developed between staff and the families, with open familiarity and relaxed observations made today. The home has effective working relationship with the local health and social care professionals, supporting residents in their health and social care needs. Care plans seen recorded regular contact both at the home and their local practices/work place. Reviews with care managers take place. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 15 Residents felt that the home not only met their social expectations but also exceeded them in some instances. One resident said “she wouldn’t use the word happy, content is far more appropriate”. Residents were aware that some routines had to exist to aid the smooth running of the home, but all were satisfied that the home gave them choices and opportunity to spend their leisure and recreational time as they wished. Entertainers are booked by the home during the course of the year and social evenings arranged. Most people were seen to be enjoying their newspapers or books, watching television in their bedrooms or talking together in the lounge and sunroom. Some residents enjoyed walking in the gardens. A hairdresser continues to visit the home regularly. Those who wish to visit church do so with support from local church volunteers in transporting them there, with communion at the home monthly too. Some residents attend activities in the village, such as coffee mornings, which are popular and enjoyable in meeting local friends from the village. Discussion took place with residents regarding the food provided at the home. This was the main and most over powering theme in every discussion today as the one area that has deteriorated since the new owners had taken over. Residents felt strongly that the quality of the food had dropped. Comments included “the wheetabix and bread are like cardboard”, “the juice is disgusting”, “we used to have fresh fruit on the table every day not any more”, “stopped the prunes, brought in some when I complained but they were awful, hard to chew and nasty, so we don’t have them any more”, “ why did they have to change the supplier, what we had was very good, this is horrible”, “it’s not the cooks fault it the ingredients they have to work with”. Staff also confirmed the quality in their opinion had gone down and where they had eaten at work when working long day shift they now do not and bring food in. Menus supplied as part of the pre-inspection information had a four-week menu but this had another Charing Healthcare home name on top and had been replaced with Chippendayle. Suppliers with the local butcher, green grocers and Supermarkets have been stopped with deliveries from a catering company used by Charing Healthcare and a small amount of petty cash to purchase items locally. Whilst the commission acknowledges the company is trying to offer consistency amongst its services, the commission questions where the individual home, location, community interaction, resident choices, preferences and special dietary needs get consideration. Each homes menu should reflect the nutritional care needs of its own residents, collective preference and choices. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service and reflecting current changes of ownership and documentation to be used. Residents and relatives feel confident to raise concerns or complain to the manager, as they feel they are listened too, however reservation are present as to whether action will taken by the company to resolve them. Protection from abuse is promoted through staff training and understanding of the support and actions they may need to take. EVIDENCE: Residents and relatives spoken with knew who to talk to if they had a concern or wished to make a compliant; this included their relative, the manager, and their care manager. However due to the change of ownership and anxieties this has raised, all spoke of reservations as to whether action will be taken by the new company. Relatives felt confident in raising any concern with staff and the manager as they felt they were always so open and approachable. Two comment cards received from relatives stated they were unaware of the homes complaint procedure Staff who have been spoken shared a good understanding of how to protect and prevent abuse. Reporting under local procedures. Recruitment practices are robust and offer further protection from potential abuse. Agency staff are not used in the home and residents felt always having someone they knew personally care for them was a further safeguard to their protection. There are no current adult protection alerts relating to this home. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 17 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 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service and reflecting current changes of ownership and documentation to be used. Residents live in a comfortable and homely environment, which would be enhanced further by better odour control in a bedroom, adequate laundry and sluicing facilities, and the refurbishment and replacement of two bathrooms to be fit for purpose. EVIDENCE: Chippendayle Lodge is centred in a large domestic house with later extensions. It is in close proximity to other domestic properties and retains the features of its original use. Redecoration takes place when a room becomes vacant. Resident’s rooms have good natural light, are highly personalised and have emergency lighting and smoke alarms in place for safety. Residents have use of a large lounge with TV. Different style chairs offer a choice of seating. Each has a small occasional table placed beside it to put a drink down on. There is a large bright sunroom with direct access to the gardens, which are a feature of Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 18 the home, having level walkways to seating areas and areas laid to lawn with flowerbeds. Bedrooms in the new wing to the rear of the property are larger and have individual doors that lead to a patio area. Some residents have chosen to install their own patio sets, planters and bird tables. A main line railway runs across the bottom of the garden and residents said they liked watching for the Orient Express to go past, which it did at lunchtime. There is access to bathing and toilet facilities with equipment available to maximise resident’s independence. Both toilets off the dining room can be locked but cannot be opened from the outside in an emergency. Two bathroom/shower rooms are not used and are not fit for purpose, requiring action by the new owners. The majority of the bedrooms are en-suite; additional appropriate storage is needed here due to toiletries and personal pads being stored on the floor in many cases. All rooms were clean, one had an unpleasant odour, which the manager and cleaners were working hard to try to address. Toiletries were kept hygienically. Toilet frames are not fixed to the floor, some rooms had toilet floors that were carpeted and are not conducive to good infection control and cleaning. The home has adequate storage areas for pieces of equipment and wheelchairs. It was noted however combustible items were stored in shelving by lift and a cupboard housing an electrical fuse box, which is a fire hazard. The manager stated this would be removed immediately. Radiator covers are in place to protect residents from the risk of accidental burns. Systems are in place to reduce the risks of scalds from hot water. The home had an environmental health officer visit 21/11/2005 that was satisfactory and a fire officer visit 20/05/2005. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 19 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): 27,28,29,30 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service and reflecting current changes of ownership and documentation to be used. Residents benefit from the support and care of competent and skilled staff, resulting in good morale and commitment to improve their quality of life. Recruitment processes have been robust and offered protection to people living at the home. EVIDENCE: The home employs care staff working a roster, which gives 24-hour cover. Domestic and catering staff are employed assisted by care staff that do some laundering, supper preparation and serving. The staff roster identifies which senior is leading the shift and who is on-call. Residents considered there was sufficient staff on duty to meet their needs and to answer calls for assistance. Staff were seen to be relaxed and unhurried when working with residents, offering time to listen. The home has a small and committed staff team. They have continued to work through a difficult few months not only with the change ownership but coping with the death of two colleagues by managing their own grief but also supporting residents who have loss two well respected carers. Staff files tracked confirmed that CRB and POVA, reference checks are made for all staff before they commence employment to ensure that the home Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 20 employs staff that has been properly vetted. The manager is becoming familiar with Charing Healthcare recruitment procedures. Contract of employment are with previous owners but staff understood Charing Dale Ltd was honouring these and new contracts will be discussed in the future. A staff-training matrix is maintained that gives a clear overview of training completed, events that are planned and updates required. 3 staff hold NVQ 2 or 3 qualifications in care. The home has experienced difficulty in obtaining external verification of 2 NVQ Qualifications, with staff having completed their work but cannot get this verified due to changes in the courses and not being compatible, which has been disheartening to them and others wishing to undertake this training. The deputy manager is planning to qualify as an internal NVQ assessor so that the home can meet NVQ targets. Staff are in need of undertaking moving and handling updated training, fire awareness and health and safety awareness training with in good practice timescales. The manager has transferred all documentation pertaining to training into Charing Healthcare preferred format. Comments received prior to the inspection also spoke highly of the staff, as detailed in the summary. New uniforms have been implemented by Charing Dale Ltd, which staff have chosen. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 21 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): 31,33,35,38 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service and reflecting current changes of ownership and documentation to be used. The home benefits from a manager who is accessible and has high expectations of the service to be delivered. Minor shortfalls in current arrangements do not fully protect the health, safety and welfare of clients. Residents and relatives question whether the changes to food suppliers and meals currently being offered are in their best interest or the company’s management. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 22 EVIDENCE: The manager is competent and has many years experience in working with older people, including successfully running her own care home for many years. The manager holds a relevant qualification in care and management, which will enable further competency to be proven for the Registered Managers Award. The manager stated the intention of registering for the award within the timescale required by regulation. Residents feel the manager continues to be accessible, a ready listener and with expected high standards, which they hope will not be affected by the new owners. Throughout the inspection, the manager continued to demonstrated commendable honesty and understanding of where shortfalls currently existed in best practice and the improvements to be made. Residents felt the home was run in their best interests for which they voiced their appreciation, except in relation to the food currently being offered. Residents’ records and information maintained by the home are appropriately stored in lockable facilities. The office is locked if unoccupied, which preserves residents confidentiality. Resident’s interests were protected with families dealing with their finances. The home safely holds small amounts of petty cash and keeps appropriate records. Neither residents nor their relatives expressed any concerns about the homes management of monies or valuables held on a resident’s behalf. Spot checks on money held showed totals balancing with money held and recipes for each transaction. Staff receive regular informal and formal supervision. Records of supervision sessions are recorded. The manager is currently transferring policies and procedures to Charing Healthcare and staff are working through these reading them. Records of maintenance and repair have been transferred into format preferred by Charing Healthcare. Work required is undertaken within reasonable timescales. Records seen indicated that the home staff require refresher fire training and to participated in fire drills to meet fire regulation. The manager is working through Charing Healthcare F ire risk assessment tool and has identified a number of areas that need addressing. It was noted that combustible items are stored where electrical fuse boxes / electrics are also housed. The manager recognised the dangers in this and would address this immediately. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 23 Staff require moving and handling training yearly and refresher training in Basic Food Hygiene. The manager stated a number of core training courses is planned in the coming months to address the deficits already identified. Provision of paper towels in communal bathrooms and areas where personal care is provided, to prevent the spread of infection have been purchased but not yet installed. Toilet frames are not currently fixed to the floor. This issue should be addressed as a matter of priority to safeguard resident’s welfare. Accident/ incidences are recorded using format providing data protection. However a clear tracking and auditing tool is required to monitor accidents, patterns forming and action taken. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 1 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 X 3 3 2 3 3 3 3 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 3 3 2 X 3 3 3 2 Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 25 NA Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4&5 Requirement The registered person shall compile in relation to the care home a written statement of purpose and Service User Guide, detailing the homes aims and objectives and containing information as detailed in schedule 1. Full submission to the Commission by the timescale date. ‘The Registered Person shall ensure that any activities in which service users participate are so far as reasonably practicable free from avoidable risk, and unnecessary risks to the health and safety of service users are identified and so far as possible eliminated.’ In that: Risk assessments within care plans must be developed to include the nature of the risk and the actions and outcomes agreed to reduce or manage the risk. This is now a priority to resolve. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 26 Timescale for action 30/06/06 2 OP7 13 (4) (b) (c) 30/06/06 The commission acknowledges new risk assessments are to be introduced by Charing Healthcare. Action plan to be submitted to the Commission by timescale date. The Registered person shall make arrangements for the recording, safekeeping, safe administration and disposal of medicines received into the care home’. In that: 1) Direction for administration recorded on MAR sheets is correct. 2) Medication fridge is installed. 3) Guidelines for administration of PRN medication are clearly written to ensure consistency of administration. To be completed by timescale date 4 OP15 12(3) The registered person shall, for the purposes of providing care to service users and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. In that: Concerns raised regarding the quality of food provided by the home are reviewed and appropriate action taken to take into account residents current Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 27 3 OP99 13 (2) 30/06/06 30/06/06 nutritional care needs, feelings and wishes to exercise choice and control over their diets. Action plan to be submitted to the Commission by timescale date. The registered person hall 30/06/06 having regard to the number and needs of residents ensure that the premises to be used are kept in good state of repair and fit for purpose. In that: The two bathrooms currently not in use are refurbished to meet the needs of current residents. Action plan to be submitted to the Commission by timescale date. The registered person shall 30/06/06 having regard to the number and needs of the service users ensure that any necessary sluicing facilities are provided. Action plan to be submitted to the Commission by timescale date. The Registered Person ensures so far as reasonably practicable the health, safety and welfare of service users. In that: Freestanding support frames that go over the toilet seat be fixed to the floor. To be completed by timescale date. The registered person shall after consultation with the fire authority take adequate DS0000067120.V293096.R01.S.doc 5 OP21 23(2)(b)(j ) 6 OP26 23(2)(l) 7 OP38 12(1)13 (4)(a,b,c) 30/06/06 8 OP19 23(4)(a)( e) 30/06/06 Chippendayle Lodge Version 5.1 Page 28 precautions against the risk of fire and ensure, by means of fire drills and practises at suitable intervals, that persons working at the care home and so far as practicable, service users, are aware if the procedures to be followed in the event of a fire, including the procedure to save life. In that: 1) Combustible items should not be stored where electrical wiring/engineering are housed. 2) Regular fire drills are undertaken and recorded. 3) Areas identified in the new fire risk assessment currently being assessed are implemented as a matter of urgency. Action plan to be submitted to the Commission by timescale date. 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 OP2 OP7 Good Practice Recommendations It is recommended that contracts be reviewed with residents and families, and confirmed in writing directly between Charing Healthcare and the resident or advocate. It is recommended that staff continue to transfer care plans to Charing Healthcare formats, ensuring clear detailed personal information is held to offer consistent and individual care. DS0000067120.V293096.R01.S.doc Version 5.1 Page 29 Chippendayle Lodge 3 4 5 OP7 OP7 OP8 Staff receive formal training in using this new tool. Daily write ups are more detailed in actual support and care given. Giving a clear audt trail for accidents/ incidents also. Care Plans clearly detail nutritional and fluid requirements to meet individual care needs (i.e. management of bowel movement) as well as personal preferences. Care plans are developed to include clear risk assessments in particular relating to managing falls and moving and handling. Staff receive formal training in using this new tool. It is strongly recommended that all staff handling or administering medication receive appropriate training and are competent to administer and manage medicines. It is strongly recommended any medication that is required for disposal after 28 days, has the date of opening written on the bottle/ tube for monitoring purposes. It is recommended dietician advice be sought and implemented in care plans in relation to nutritional and fluid requirements of individuals. It is recommended that the complaints procedure is replaced with Charing Healthcare formats and circulated to all residents and representatives. It is recommended that lock be installed to bathrooms and lavatories that can be opened in an emergency from the outside. It is strongly recommended alternative laundry facilities be explored to offer good infection control management and safe separation of clean and dirty laundry. It is recommended that advice regarding the laundry and sluicing facilities be sought from Infection Control Nurses based at Kent and Medway Infection Control Unit. It is recommended en-suite are regularly reviewed and monitored to the appropriateness of carpet being fitted in relation to infection control and cleaning management. It is strongly recommended that the offensive odour located in one bedroom is closely monitored and alternatives continue to be explored by staff to reduce this as quickly as possible. It is strongly recommended paper towels dispensers purchased are installed. It is recommended consideration to employing a handy person be explored to assist with minor repairs and maintenance. DS0000067120.V293096.R01.S.doc Version 5.1 Page 30 6 7 OP9 OP9 8 9 10 11 12 13 14 OP15 OP16 OP21 OP26 OP26 OP26 OP26 15 16 OP26 OP27 Chippendayle Lodge 17 18 19 20 OP30 OP30 OP31 OP38 It is strongly recommended staff undertake refresher training required to meet health and safety good practice guidelines. It is recommended 50 of the care staff team achieved NVQ 2 in Care qualifications. It is recommended that the manager is registered for and working towards completion of the R M A qualification by September 30th 2007 It is strongly recommended a formal tracking and auditing system is introduced for the accident / incident file. Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 31 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Chippendayle Lodge DS0000067120.V293096.R01.S.doc Version 5.1 Page 32 - 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. 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