Inspection on 19/08/08 for Chipstead Lake Cheshire Home

This inspection was carried out on 19th August 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chipstead Lake Cheshire Home 16/08/06

Chipstead Lake Cheshire Home 05/12/05

Chipstead Lake Cheshire Home 06/12/04

Chipstead Lake Cheshire Home 29/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Chipstead Lake Cheshire Home Chevening Road Chipstead Sevenoaks Kent TN13 2SD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Mills     Date: 1 9 0 8 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Chipstead Lake Cheshire Home Chevening Road Chipstead Sevenoaks Kent TN13 2SD 01732459510 01732741059 chipstead@lc-uk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Leonard Cheshire Disability care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Care of two Service Users who are over 65 years of age is restricted to two persons whose date of birth is 08/08/1931 and 28/12/1936 Date of last inspection Brief description of the care home Chipstead Lake Cheshire home is a purpose built service for people aged 18 to 65 with a physical disability. It is one of the Leonard Cheshire Homes and was built in 1977. The home is in the village of Chipstead that is very close to the town of Sevenoaks and can be accessed easily by the M25, there is a local bus service. The home can accommodate 22 people in single rooms. Eleven of the rooms have en-suite facilities; there is one dedicated respite room. Service users have access to the day activities facility on site and there are large attractive grounds. Local facilities are available in the town of Sevenoaks. 22 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This visit is called a Key Inspection and was unannounced. It was carried out by Wendy Mills, link inspector for the home, and lasted seven hours. During this time eight service users were spoken to, some in private and some whilst they were taking part in activities in the home. Three members of staff were spoken to in private and others were spoken to throughout the day. there was in depth discussion about all aspects of the home with the registered manager. Feedback was sought, prior to the visit, from health and social care professionals associated with the home and the inspection record of the home since the last inspection, was reviewed. The visit forms part of the inspection process of the Commission for Social Care Inspection (CSCI). Evidence gathered during this visit as well as information we have Care Homes for Adults (18-65 years) Page 5 of 26 received about the home, such as notifications, compliments and complaints and feedback from relatives and supporters of the home, have been used when compiling this report. The home is given a star rating as the result of this Key inspection What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home gives prospective service users the information they need to make a decision about moving into the home. Appropriate pre-admission assessments are made. This ensures that only those people suitable for the home and whose needs can be met by the home are offered a place. Evidence: The home has a comprehensive and up to date statement of purpose and service user guide. There is plenty of information about what is going on in the home. There are regular service user meetings, notice boards around the home and regular newsletters. Inspection of care plans showed that appropriate pre-admission assessments are made before a place is offered at the home. Service users said that they had been able to visit the home prior to admission. Care Homes for Adults (18-65 years) Page 9 of 26 Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes informed decision making and responsible risk taking. This means that the service users can maintain as much independence as possible Evidence: There is very good evidence that the home values equality and diversity. Individual needs and choices are recorded in the care plans. The service users said that they can always choose how they spend their day and that there is plenty to choose from. Some said they preferred to spend time in their rooms, listening to music, reading or watching television whilst others said they are busy everyday and enjoy going out and about. Appropriate risk assessments are in place for activities and decision-making. Discussion with the registered manager confirmed that the service users are consulted properly and that they are encouraged to try out new things. Care Homes for Adults (18-65 years) Page 11 of 26 Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a wide variety of opportunities for the service users. Evidence: There is a very wide range of activities available. There a day centre in the grounds of the home. The centre offers a wide range of activity including gardening, cooking, arts and crafts and computers. There is a separate room for computer work and keyboards and controls are specially adapted for ease of use. The home is situated in beautiful grounds and is near a lake where there is a sailing club. The club has welcomed service users and some have been able to have e a go at sailing and join in the clubs general activities. The home has its own transport and there are frequent outings. The home employs a Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: driver but there is also a large bank of volunteers, some of whom act as drivers for various outings. Good use is made of local community facilities in the nearby town of Sevenoaks. A volunteer co-ordinator is employed by the home. The role of volunteer co-ordinator involves ensuring that volunteers are properly vetted and that their talents are use in the best way. The environment of the home gives wheelchair access to all areas. This means that the service users can go anywhere they wish in the home and grounds. Wheelchairs are well maintained and there is a system to ensure electric wheelchairs are charged. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home positively promotes the health and well being of the service suers Evidence: A sample of care plans was examined. There is a written plan of support for each service user. These are important documents. This is because they form one of the means by which the service users and their supporters can be tell that they will be supported in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. Care plans were tracked to other records, including medication records, and service users views. The care plans are comprehensive, up-to-date and in good order. Service users are aware of their care plans and said they are involved in the care planning process. There was good evidence that service users are consulted on a regular basis. There are regular care reviews, residents meetings and residents know that the manager has an open door policy. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: The home has a head of care who takes overall responsibility for ensuring the health and well being of the service users is promoted. Staff and residents praised her for the quality of her work, her kindness and her diligence. Staff said she is an excellent role model and motivates them in their work. The home consults well with a number of health and social care professionals such as district nurses, therapists and care managers. Good relationships are maintained with external advisors and their visits are well recorded in the care plans. The care plans also record that the advice given has been followed. All the service users have complex needs and some have needed hospital admission due to their medical conditions. It is a cause for concern that some service users have developed pressure sores whilst in hospital and that their nutrition has appeared to have been neglected. It is strongly recommended that the registered manager lodge a formal complaint with the hospitals concerned to raise their awareness of potential neglect. It was good to note that records show that the condition of those discharged from hospital with pressure sores is now improving due to the careful and diligent care given by the home and the support given by the district nurses. The processes and recording for managing medicines in the home were examined. There are sound policies and procedures for the management and administration of medicines. Medicines are stored in line with the recommendations for the Royal Pharmaceutical Society of Great Britain. Time was spent with the member of staff who has the main responsibility for ensuring medicines are ordered, stored and returned correctly. She was very knowledgeable about the way medicines should be managed and administered and is commended for her diligence. The medicines administration sheets (MARs) are up to date and in good order. Staff files show that those administering medicines have all received appropriate training. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sound polices and procedures for the management of complaints and for safeguarding vulnerable people. The home listens to the ideas and concerns of the residents and their supporters and acts upon them. Evidence: The home has sound policies and procedures for the handling of concerns and complaints. There have been no formal complaints since the last inspection. The registered manager operates and open door policy and day-to-day concerns are acted upon immediately. There are regular residents meetings where any concerns and ideas can be aired. The service users said that their ideas and concerns are listened to and acted upon. Staff receive training in the policies and procedures for the protection of vulnerable adults. Those spoken to were well aware of the action they would need to take if they ever have any concerns about any form of abuse. They said they would have no hesitation whatsoever, in reporting any concerns directly to the manager if necessary. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is homely and clean but some work is now required in order to bring the home up to current standards. Evidence: The home was purpose built some twenty-five years ago. It is set in secluded grounds near a lake. The grounds are well maintained and some of the service users enjoy helping with gardening. The home employs a maintenance person, cleaners and a laundry assistant. The home is clean and maintained in as good as condition as possible, however, it is now in need of some modernisation to bring it up to current standards. The service users are all accommodated on the ground floor and have good access throughout the home and grounds. Their rooms are personalised and homely and there is plenty of light and airy communal space. Wheelchairs have to be stored in alcoves in the corridor, and this gives the corridors a rather cluttered appearance, better storage for wheelchairs is recommended. The decor is very tired, carpets are stained and paintwork is scuffed. Whilst it is accepted that it is difficult to maintain the environments where in a home with a large proportion of wheelchair users, it is strongly recommended that the redecoration and refurbishment programme is given high priority and begins as soon as possible. It Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: should be noted that these concerns were also highlighted at a previous inspection in 2006. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, staff training and staff morale are all good. This means that the service users are cared for by a well qualified and cheerful staff team Evidence: Staff rosters show that there are sufficient staff allocated to each shift. The staff say that staffing levels enable them to meet the needs of the service users. A sample of staff files was examined. These showed good evidence that staff receive plenty of training to enable them to carry out their roles. Staff were very positive about the training they receive and said that they get good specialist training such as diabetes and multiple sclerosis, as well as the mandatory areas such as moving and handling and fire training. There is a good gender, age and ethnic mix amongst the staff team that reflects the age and gender mix of the service users. Staff spoken to were very enthusiastic about their jobs and said that they really loved working in the home. They said that they get plenty of training and that their induction had been very thorough. The service users said that they staff are kind and helpful and given them the support they need. One service user described the staff as marvelous, saying that they are Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: always supportive and helpful. There are sound policies and procedures for the recruitment of new staff and for voluntary workers. Examination of staff files showed that application forms and health checks are completed; at least two references are obtained and checked as well as Criminal Records Bureau (CRB) checks. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, the views of the service users and their supporters are listened to. This means that the home is run in the best interests of the service users. Evidence: The home is well run and has a very welcoming atmosphere is welcoming. The registered manager is well qualified and holds the registered managers Award (RMA) and the national Vocational Qualification at lever four (NVQ IV). Discussion showed her to be knowledgeable about good care practice and the needs of the service users Service users said that they can be involved in decision making about service if they wish. They told us that there are regular house meetings and that the manager runs an open door policy. They also said that there are good choices, with lots of options as to how they spend their time. Records are held securely in the staff or administrative offices and those seen were up Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: to date. There are sound policies and procedures for ensuring the health and safety of the service users, staff and visitors. There are regular maintenance and safety checks and fire practices. The home has a valid insurance certificate and this is displayed in accordance with regulations. No health and safety hazards were noted during a tour of the home. There are good quality assurance systems in place, these include an annual stakeholder survey, and regular visits by key professionals and the area manager and regular service user meetings. There was good evidence that the results of these visits and surveys are acted upon. Service users gave examples of how they had been able to influence the way the home is run. They said that they had told the manager that they thought the quality of food had gone down and this has now improved dramatically. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!