Inspection on 20/04/07 for Chiswell Residential Home

This inspection was carried out on 20th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Chiswell Residential Home 15/05/06

Chiswell Residential Home 28/09/05

Chiswell Residential Home 25/05/05

Chiswell Residential Home 28/10/04

Chiswell Residential Home 24/08/04

Chiswell Residential Home 15/03/04

Chiswell Residential Home 16/06/03

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

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

CARE HOMES FOR OLDER PEOPLE Chiswell Residential Home 193 Watford Road St. Albans Hertfordshire AL2 3HH Lead Inspector Yoke-Lan Jackson Unannounced Inspection 20th April 2007 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 Chiswell Residential Home DS0000019314.V336733.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. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chiswell Residential Home Address 193 Watford Road St. Albans Hertfordshire AL2 3HH 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) 01727 856153 01727 848472 Mrs S Dewing Mrs S Dewing Care Home 6 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (6), Old age, of places not falling within any other category (6) Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The registration category of MD(E) applies only to the service users currently resident in the home. All care staff must receive certified training in Mental Health care. The registration category MD(E) only applies to named service users and will revert back when the named service users are no longer residing in the home. 15th May 2006 Date of last inspection Brief Description of the Service: Chiswell Home, opened in 1996, is a residential care home registered for 6 residents in the Older People category. However, there are specific conditions attached to the registration in relation to 6 service users with mental health conditions. The home is located in Chiswell Green, on the outskirts of St. Albans, close to local shops and other amenities. There are some parking spaces on the front driveway and on the side road nearby. The two-storey detached house provides 2 bedrooms on the ground floor and 4 on the first floor. Each bedroom has a washbasin. The bathroom and toilet facilities are nearby. The kitchen, lounge and dining room are all on the ground floor. The small administrative office is on the first floor. There is a front lawn, and to the back of the building, there is an attractive garden with a patio. There are garden furniture and comfortable seating which are accessible to the service users. The home charges £550- £650 per week. Further information can be obtained from the home’s Statement of Purpose and the Service User Guide. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection included a site visit on 20/04/2007. The registered manager was present. There are six residents in the home. The inspection included a tour of the premises. The inspector met with all six residents. Members of staff were interviewed. Documents were examined. (Please see below for details of the inspection findings). What the service does well: What has improved since the last inspection? What they could do better: The home is currently advertising for permanent and bank carers. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 6 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. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Standard 6 is not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients have the information they need to make an informed choice about the home. Prior to an admission, a full assessment is carried out to ensure that all prospective client’s needs can be met. EVIDENCE: The home has admitted two more residents since the last inspection. The placement was arranged with the Mental Health Team, Hertfordshire Social Services. Prior to the admission of these residents, the proprietor submitted an application to vary the condition of admission to include residents with mental health problems. The two residents have settled in well in their new home. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 9 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, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect and their personal and healthcare needs are fully met. There is a written care plan for each resident. The medicines are administered in accordance with legislation. EVIDENCE: Members of staff present on the day of the inspection demonstrated their caring attitude to all the residents, who appeared content and happy. All residents have access to specialist services according to their needs. One resident is encouraged to elevate her oedematous legs daily to improve blood circulation. Her General Practitioner and the District Nurse are actively involved in her health care needs. Two residents have their blood monitored regularly by the District Nurse because of the medication prescribed. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 10 One resident has been referred to a specialist nurse in regard to the management of continence. A resident with partial sight impairment has access to sight tests and appropriate aids. The Community Psychiatric Nurse visits the home regularly and gives her support. The care plans examined have details of each resident’s care needs. Risk assessments were done where appropriate. The format for the written care plan is being revised to ensure that all aspects of the health, personal and social care needs of each resident are clearly documented and updated. The care plan is reviewed monthly and is updated to reflect the changing care needs of the resident. A trained member of staff administers the medicines to the residents. The home has installed a new drug cupboard that includes a controlled drug cupboard. The home uses the Nomad System for each resident. All medicines are clearly labelled and the opening date is written on each container. All medication records are kept in accordance with legislation. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 11 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. Residents are given choices in their daily routine and their preferences are respected. The meals provided are nutritious and wholesome and the daily activities are stimulating. Residents have close links with their family and friends. EVIDENCE: On the day of the inspection, one resident was seen knitting as part of a therapy session. Later on a member of staff was playing scrabble with some residents. It was noted on previous occasions that residents were encouraged in fun and stimulating activities that included group sessions of singing and dancing organised by an instructor. The instructor also brought along her two pet dogs. These stimulating sessions have been on-going for a number of years and are much enjoyed by the residents. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 12 Residents have their nails manicured every 2 weeks by a professional. Staff interviewed confirmed that residents have walking exercises and that they are often taken out to the local shops. Sightseeing and other day trips are usually arranged for the summer months. One resident has regular visits from her spouse. Privacy is maintained during these visits to allow the couple to spend time together. Mealtimes were observed to be pleasant and unhurried. The member of staff was readily available to offer assistance in a discreet and caring manner. The dishes presented were appealing and appetising. All the residents appeared to enjoy their fish and chips on the day of the inspection. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from the home’s robust Complaints Policy and Procedure. EVIDENCE: The home has not received any complaints since the last inspection. Staff have training on issues concerning the protection of vulnerable adults. The home follows the procedure set up by Hertfordshire Social Services. All staff have had Criminal Record Bureau (CRB) checks and clearance. Residents have access to advocacy services and are able to exercise their legal rights. The home is not involved in the financial affairs of the residents, except for their personal allowances. All transactions are appropriately recorded. Some residents have their own solicitors to assist them, whilst others are assisted by their relatives or friends. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 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 safe, homely and comfortable environment. The internal and outdoor communal facilities are kept safe and accessible to all the service users at all times. EVIDENCE: The home is well maintained. On the day of the inspection, it appeared clean and tidy. All the bedrooms had been redecorated and they reflect the lifestyle of the individual occupant. Since the last inspection, the greenhouse activity has proved unsuccessful and the proprietor hopes to remove the greenhouse to create more communal space in the garden for the residents. The garden furniture is appropriately placed, and the residents have safe access to the garden facilities. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 15 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 is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and practices comply with legislation. There is an effective and dedicated team of workers. The skill mix of the staff benefits the residents. EVIDENCE: The home has an effective staff team. The registered manager herself is a trained nurse in mental health. The home is currently recruiting for more carers, including bank carers. There is an ongoing training programme for staff. The induction programme is in line with the Skill for Care guidelines. The two new members of staff confirmed that they have had the required induction training. They said that they enjoyed looking after the residents in the home. Staff have had accredited training on mental health issues to enhance their knowledge and skills in meeting the needs of the residents in their care, some of whom have mental health problems. The accredited training programme on ‘Schizophrenia’ took place on 29/03/06. Further training sessions included ‘Depression, Anxiety and Challenging Behaviour’ which was held in the same year. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 16 It was noted that the home is well supported by the Community Psychiatric Nurse from the Hertfordshire Mental Health Team who provides regular training to the staff on topics that are relevant in order to meet the needs of the current group of residents. The in-house training included topics such as ‘The Mental Health Act’ and ‘Activities for the Elderly with Mental Health problems.’ Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37, 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standards of care and services are well maintained. The health and safety of the residents and staff are promoted and protected. EVIDENCE: The home is run in the best interests of the residents, who appeared well cared for. The members of staff interviewed confirmed that they are meeting the needs of the residents including those with a history of mental health problems. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 18 Currently the home is registered for service users in the Old Age Category. However, the proprietor, who is also the registered manager, hopes to include registration in the Mental Health Category. She is an experienced and trained nurse in mental health. The registered manager ensures the health and safety of the residents and the staff. There is an effective quality monitoring system. Records for the protection and effective management of the home are kept up to date. The Registration Certificate and the Liability Insurance Certificate are on display in the dining room. There is a business and financial plan that is readily available for inspection. The home is not involved in the financial affairs of the service users except for their personal allowances. All transactions are appropriately documented. Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Chiswell Residential Home DS0000019314.V336733.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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