Inspection on 22/10/08 for Chyngton Rise

This inspection was carried out on 22nd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chyngton Rise 09/11/06

Chyngton Rise 16/01/06

Chyngton Rise 08/06/05

Chyngton Rise 17/08/04

Chyngton Rise 26/04/04

Similar services:

Deepdene Care Centre

Ferndale Residential Care Home

David Gresham House

Elizabeth House

Elvy Court Nursing Home

Fontenay Nursing Home

Clairmont Residential Home

Cornford House

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 older people Name: Address: Chyngton Rise South Way Seaford East Sussex BN25 4JG     The quality rating for this care home is:   two star good 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: Melanie Freeman     Date: 2 2 1 0 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 Older People 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 Older People Page 2 of 27 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 Older People Page 3 of 27 Information about the care home Name of care home: Address: Chyngton Rise South Way Seaford East Sussex BN25 4JG 01323897937 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elli DuVivier Type of registration: Number of places registered: Mrs Elli DuVivier,Mr Jack DuVivier care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Service users must be older people aged sixty-five (65) years or over on admission. The maximum number of service users to be accommodated is six (6). Date of last inspection Brief description of the care home Chyngton Rise is a large detached property situated in a quiet residential area of Seaford backing onto open downland. The town centre, with local shops, amenities and access to buses and trains, is approximately one mile away. The home is registered to provide residential care and support for six older people who have a dementia type illness and aims to provide a happy, relaxed atmosphere within a homely and secure environment. Mrs DuVivier has confirmed that the occupancy of the home will now not exceed two residents. It is her intention to have a smaller home, and to follow the Fire Safety Officers advise to limit the occupancy of the home to no more than two residents, to ensure the fire precautions are appropriate. If however Mrs DuVivier decides in the future that she wants to accomodate more residents, she has assured the Commission that suitable fire precautions would be established in accordance with Care Homes for Older People Page 4 of 27 6 Over 65 0 Brief description of the care home a fire risk assessment, and cosultation with the local Fire Brigade. The home does not provide nursing care. On the ground floor there is a comfortable and spacious lounge and dining room, and a bright conservatory. Residents accommodation is provided on two floors. The home does not have a lift. Outside there is a large garden where residents can walk, relax and entertain visitors. Meals can be taken in the residents own room or in the conservatory. Visiting is unrestricted and there is ample car parking space at the front of the house. Information about the service, including the Statement of Purpose, Service Users Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The range of weekly fees, as of October 2008, is 550 pounds - 650 pounds depending on the individual needs of residents . Additional charges, not included in the fees, include hairdressing, chiropody, newspapers and toiletries. Care Homes for Older People Page 5 of 27 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Chyngton Rise Care Home will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and follow up contact with two residents representatives. The allocated inspector spent approximately four hours in the home and was able to discuss matters with Mrs DuVivier the registered owner and manager. The focus of the inspection was the quality of life for the resident living in the home. Care Homes for Older People Page 6 of 27 During the inspection visit time was spent with the resident in the communal area where the interaction between her and Mr and Mrs DuVivier was observed along with care practices followed. A tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, pre-admission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff recruitment files and quality assurance systems. The home’s health and safety procedures and checks were also discussed with Mrs DuVivier. The care documentation relating to the resident was also reviewed in depth. 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 Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 provides prospective residents and relatives, with a suitable level of information about the home, its facilities, services and the costs involved. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents have the opportunity to visit the home and know that it is able to meet their individual care, and support needs. Evidence: The home has a service users guide and statement of purpose held within the homes policies and procedures manual. Although the home has all the required information that should be held within these documents, they are not readily available to anyone wanting to have access. This was discussed with the manager, Mrs DuVivier, who Care Homes for Older People Page 10 of 27 Evidence: agreed to ensure that these documents are reviewed, updated, and in a format that ensures all the required information is readily available to any interested parties. There have been no recent admissions to Chyngton Rise and Mrs DuVivier was able to demonstrate that all residents admitted to the home had been visited, and assessed prior to their admission, to ensure their specific care needs could be met by the home. She also confirmed that following the assessment the residents representative was advised in writing, that Chyngton Rise was an appropriate placement for those individual needs. She advised that once contacted about any future possible admission, the family and prospective resident would be invited to visit the home. During this time they would be fully advised about the homes services, and terms and conditions of residency. Following admission there is an initial four-week trial period, of continual assessment, during which time the suitability of the service, and the compatibility of the resident can be established. Care Homes for Older People Page 11 of 27 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst residents needs are being met and individual plans of care are devised these need to be reflective of the care provided, and take into account individual risk assessments that cover all areas of risk. Residents health care needs are responded to with an emphasis on individualised care that promotes a persons dignity and individuality. On the whole the homes practice ensure residents medicines are administered safely. Evidence: There is only one resident living in the home and her care documentation was reviewed as part of the inspection process. This confirmed that individual plans of care are devised and record the residents health, social and psychological needs. These reflected the basic care needs, which are reviewed and evaluated along with identified risks on a monthly basis. The monthly Care Homes for Older People Page 12 of 27 Evidence: reviews contain up to date information about the changing needs of the resident, these however are not routinely reflected in the plans of care. Although individual risk assessments are completed and evaluated, these also need to be updated to reflect the current risks, and what measures are being taken to minimise this risk. The generic risk assessment used also needs to be improved to cover all risks around the home. In addition nutritional screening should be completed on all residents routinely and used to monitor any nutritional needs. Specialist advice including the Dietitian can then be sought as necessary and recorded in the plan of care. Residents are weighed regularly and one residents weight loss, when identified has been discussed with the Doctor. The homes care documentation takes into account the mental capacity of residents and consent issues. Care interventions are recorded and discussed with the resident if possible and or relative/ representative if more appropriate. Medicines are stored in a small room off the kitchen, which contains metal storage cupboards and a suitable controlled drugs cupboard. The controlled drug cupboard is not however available for use, as it is currently being used for the storage of personal items of the homeowners. Mrs DuVivier was reminded that a recent change in legislation requires all care homes to have suitable storage arrangements that comply with current legislation. Further information on this matter is available on the CSCI Internet ,within the guidance document The safe management of controlled drugs in care homes. The medicine administration charts relating to the current resident were reviewed and were found to be accurate, clear, and to include a photograph for identity purposes. Observation during the inspection visit confirmed that the resident lives in the care home as a family member, with the homeowners spending time with her as if she is a relative. The communal spaces are used by the resident and homeowners and in this way the resident is rarely alone. The homeowners were attentive to the residents needs, knowing when she wanted help and encouraging her as necessary. She was seen to be dressed according to her preferences, and to look like care had been taken in her presentation. Two residents representatives were contacted following the inspection visits to the home and both confirmed that they were more than happy with the care that was provided. They particularly praised the relationship that the manager had with the residents Care Homes for Older People Page 13 of 27 Evidence: saying that she genuinely cares and there is a family atmosphere in the home and how very caring she was and how the care is individual and fantastic. Care Homes for Older People Page 14 of 27 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Residents are helped in maintaining links with friends, relatives and the community, and benefit from activity relating to daily life. Residents receive a wholesome and appealing diet, and are provided with choice. Evidence: Residents social needs are reflected in the plan of care. The current resident particularly enjoys spending time out of the home going for a meal or coffee and shopping. Due to the occupancy of the home Mrs DuVivier is able to spend a great deal of individual time with the residents and takes them out regularly. The day before this inspection visit she was out with the resident all day. All family activities and events include any resident living in the home, and family friends and relatives are always welcome at the home. On relative said that she often just popped into the home when she was passing and felt able to do this at any time. Meals are individual and the main meal is eaten around 13.00 and was seen to look attractive and suitable. It included lamb casserole, carrots, peas and potatoes. Choices wherever possible are encouraged, and Mrs DuVivier was able to demonstrate a deep understanding of the current residents needs and wishes. Care Homes for Older People Page 15 of 27 Evidence: Care Homes for Older People Page 16 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 open and inclusive atmosphere within the home enables residents and visitors to express any concerns, confident that they will be listened to. The management arrangements and information in the home would ensure any allegation or suspicion of abuse would be responded to appropriately. Evidence: The home has a full complaints procedure that is displayed in the homes sitting room. Mrs DuVivier has excellent communication skills that are used to maintain good links with residents, and all their representatives. In this way any problems or matters causing concern are resolved. There have been no complaints recorded since the last key inspection. There is a complaints book that would be used to record any complaint when received. The home has an Adult Protection procedure in place this, however needs to be updated to reflect the new local policies and procedures on Safeguarding Vulnerable Adults and to clearly reflect that the home does not investigate any allegation or suspicion of abuse, until this is discussed with either social services, who are the lead authority, or the police to decide what investigation is appropriate. Care Homes for Older People Page 17 of 27 Evidence: Staff training on Safeguarding Vulnerable Adults has not been completed since 2006 and this was discussed with Mrs DuVivier who agreed that she would attend an update. Care Homes for Older People Page 18 of 27 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, 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. 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. Residents benefit from a homelike environment that is clean and comfortable. Evidence: Chyngton Rise reflects a family home, and is used by residents and the owners as such. During the inspection visit it was noted that some window repair is needed in the one occupied room and the manager said that this matter was in hand. General redecoration is also now needed throughout the home in order to maintain a high standard and this should be planned within a general annual program. The homeowners are in the process of moving some furniture, other belongings and paper work abroad and therefore some areas in the home are cluttered. Mrs DuVivier the manager advised that all excess items, furniture and paperwork will be removed by the end of the year. Following the last inspection when it was required that the outside areas of the home be cleared and made safe, some clearing has taken place, although further is needed, to ensure any possible risk to the safety of residents, staff and visitors is removed. The home was found to be clean and hygienic throughout and the laundry room was found to be suitably equipped for the number of residents. Care Homes for Older People Page 19 of 27 Evidence: The home has been recently inspected by a Fire Safety Officer who has advised, within a notice of deficiencies that if the occupancy of the home is increased over two that the whole home will need to be upgraded to meet the current fire standards based on a fire risk assessment. Mrs DuVivier confirmed that she and her husband have taken the decision to limit the homes occupancy to two residents. They may consider increasing in the future, following a fire risk assessment and appropriate upgrading of the fire precautions would be completed as necessary. Care Homes for Older People Page 20 of 27 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. The staffing arrangements are appropriate to meet the needs of the resident living in the home. Recruitment practice in the past has been full and robust. Evidence: As the occupancy of the home has recently been reduced to one resident, the home is being staffed by the homeowners. Both are in the home during the day most of the time with Mrs DuVivier providing most of the direct care. She explained that once she goes to bed which is around 1 am, her husband is on call and is in a bedroom close to the residents accommodation, so that he can respond to any movement. In addition Mrs DuVivier checks on the resident regularly through the night, and gets up early in the morning. No one has been recruited recently and the recruitment file for one staff member was checked and confirmed that it contained all the required information, apart from a recent photograph. Mrs DuVivier said that this shortfall would be addressed. Over recent months a duty rota has not been maintained and it was also noted that staff and the homeowners had not been attending statutory health and safety training. Mrs DuVivier confirmed that suitable duty rotas would be maintained in the future, and suitable training would be progressed. Care Homes for Older People Page 21 of 27 Evidence: Care Homes for Older People Page 22 of 27 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 management arrangements provide clear leadership and an appropriate management structure. Systems for monitoring the quality of care take account of residents views. Residents financial interests are safeguarded. The health, safety and welfare of residents are generally promoted and protected. Evidence: Mrs DuVivier is qualified both as a general nurse and as a psychiatric nurse and has many years experience of managing a care home. She has very good interpersonal skills and comments received about the management of the home reflect that she is well liked and shows a very caring attitude to residents. As the occupancy of the home is so low quality monitoring is maintained at a very personal level with regular contact with the residents representatives. Formal Quality Assurance measures are not currently recorded. Care Homes for Older People Page 23 of 27 Evidence: The home does not hold any money on behalf of residents, and if any money is spent during any outings or on any specific toiletries, this is accounted for within the monthly fees. The homeowners are fully aware of the required checks to be completed to ensure that the home meets all health and safety standards, and confirmed that these are completed. Care Homes for Older People Page 24 of 27 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 Older People Page 25 of 27 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 1 8 14 That the registered person 01/12/2008 ensures that appropriate risk assessments are in place to cover all areas of risk and are responded to. These should cover all environmental risks, and those associated with nutrition and skin damage. This will ensure any possible risk is identified and minimised as far as possible. 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 Older People Page 26 of 27 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 Older People Page 27 of 27 - 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!