Inspection on 09/11/06 for Chyngton Rise

This inspection was carried out on 9th November 2006.

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

Other inspections for this house

Chyngton Rise 22/10/08

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Chyngton Rise South Way Seaford East Sussex BN25 4JG Lead Inspector Nigel Thompson Key Unannounced Inspection 9th November 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chyngton Rise DS0000021418.V304698.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. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chyngton Rise Address South Way Seaford East Sussex BN25 4JG 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) 01323 897937 Mr Jack DuVivier Mrs Elli DuVivier Mrs Elli DuVivier Care Home 6 Category(ies) of Dementia (6) registration, with number of places Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is six (6). Service users must be older people aged sixty-five (65) years or over on admission. 16th January 2006 Date of last inspection Brief Description of the Service: 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. 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 User’s 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 9 November 2006, is £350 - £550. Additional charges, not included in the fees, include hairdressing, chiropody, newspapers and toiletries. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours in November 2006. It found that the majority of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. On the day of the inspection there were four service users living at the home. The inspection involved a tour of the premises, examination of the homes records, discussion with the manager and proprietor and consultation with two service users and two relatives. The focus of the inspection was on the quality of life for people who live at the home. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the service does well: What has improved since the last inspection? Since the previous inspection, the manager has completed the Registered Manager’s Award (RMA). Also since the last inspection, as required, the manager and staff have undertaken relevant training relating to the protection of vulnerable adults. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 6 What they could do better: 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. Chyngton Rise DS0000021418.V304698.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 Chyngton Rise DS0000021418.V304698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. 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 service users have the opportunity to visit the home and know that it is able to meet their individual care and support needs. EVIDENCE: Following a referral to the home, the manager confirmed that she or her husband carries out a thorough pre-admission assessment including all personal care and support needs, any mental health and mobility issues, social and cultural needs and family involvement. It was noted that one service user had been admitted to the home since the previous inspection and there was documentary evidence of a full and comprehensive needs assessment having been carried out. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 9 The manager confirmed that the admission process has been extended to provide prospective service users with the opportunity to visit the home, before moving in and have the opportunity to look around and meet with existing service users and staff. Having moved into the home, there is an initial four week trial period, of continual assessment, during which time the suitability of the service and the compatibility of the service user can be established. Individual records showed that the manager properly assesses each service user prior to moving in. Assessments from social workers or other health professionals are requested before admission in order that the home has a clear understanding of what medical and personal care is required. The manager also carries out an assessment after admission and completes an initial care plan involving the family. Positive comments received from service users and their relatives support this process: ‘We looked around a number of other homes but this one stood out. It is very comfortable and homely here and the manager is so kind and helpful.’ The manager confirmed that emergency or unplanned admissions are avoided and intermediate care is not provided at Chyngton Rise. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 10 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 in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users’ health care needs are met and individual care plans enable staff to meet their assessed needs in a structured and consistent manner. The systems for service user consultation and participation are good and service users are treated with respect and, where appropriate, are encouraged to make decisions about their day-to-day living. EVIDENCE: The home develops an initial care plan for each resident on admission, including all aspects of health, personal, psychological and social care needs, and this is evaluated and updated monthly. General risk assessments, including moving and handling, are carried out in respect of each service user and are held on their individual file. In addition it was noted that six monthly monitoring reviews are held and depending on the level of need and support required will involve the service user, their relative or representative, a community psychiatric nurse, a social worker and the manager and key-worker from the home. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 11 As part of their induction programme, the manager confirmed that all staff receive instruction on the principles of dignity and respect. This was evident, through discussion during the inspection, and from direct observation of staff interacting sensitively and professionally with service users. Service users and relatives spoken to during the inspection were also able to confirm the care, sensitivity and respect shown by the manager and staff: ‘Staff are so kind in all they do for me’. ‘She is wonderful and can’t do enough for the people here. The place would not be the same without her’. Satisfactory policies and procedures are in place for the control, storage, safe administering and recording of medication. All service users continue to be registered with local GPs and have access to other health care professionals, via the surgeries. It was evident, in care plans that were examined, that all visits or appointments with doctors or other health care professionals are recorded. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 12 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 in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are enabled and supported to maintain contact with family and friends as they wish. Opportunities for appropriate recreational and leisure activities are limited however service users benefit from menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The manager confirmed that, in accordance with the wishes of the service users, visitors to the home are welcome, at any reasonable time. However, they are asked to respect mealtimes. Service users may see friends or relatives in the lounge, conservatory or in the privacy of their own room. Service users’ social and recreational interests and preferences are now recorded, as part of the pre admission assessment process. The manager confirmed that one staff member continues to take responsibility for organising activities, reflecting the wishes and capacity of individual residents, including skittles, quizzes and music. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 13 As part of a four week rolling menu, service users are provided with a varied, wholesome and nutritious diet. At lunchtime a choice of main meal is available and special diets are catered for. ‘Even where someone cannot express a preference, everyone here makes it very clear if they do not like a particular meal – and an alternative is always available. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 14 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The open and inclusive atmosphere within the home enables service users, staff and visitors to express any concerns, confident that they will be listened to and acted upon. Service users are safeguarded from abuse through relevant staff training and robust policies and procedures. EVIDENCE: An up to date copy of the complaints procedure is in place in the main lounge, for the benefit of service users and visitors to the home. However, following discussion with the manager, it is recommended that the procedure be reviewed and amended to include details of relevant timescales. Service users, relatives and members of staff spoken to described how the manager operates an ‘open door policy’ and is clearly considered to be very approachable and understanding. They confirmed that they would have no hesitation in speaking to her or making a complaint if necessary and each person was confident that they would be listened to: ‘I wouldn’t hesitate to discuss any concerns that I had with her’. Since the previous inspection, as required, the manager and staff have undertaken relevant training relating to the protection of vulnerable adults. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 15 Specific areas covered in the training included: ‘Recognising signs of abuse’; ‘Current legislation’; Staff roles and responsibilities’ and ‘Procedures for reporting abuse’. This was evidenced from discussion with the manager and through training records examined during the inspection. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 16 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, 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. Service users benefit from accommodation that is safe, comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: There has been little change in the physical environment since the previous inspection and with the generally well maintained décor and good quality furniture and furnishings it continues to provide a comfortable, safe and homely environment for service users. Despite previous requirements to remove unsightly vehicles from the front of the building, this has still not been addressed and the requirement therefore remains outstanding. The manager confirmed that independence continues to be promoted within the home, as far as is practicable, and this is evident from the personalising of Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 17 service users’ rooms, which reflects individual tastes, preferences and interests. Communal areas in the home consist of a spacious lounge, dining room a separate seating area and a conservatory. The home also has a large wellmaintained and accessible rear garden. A maintenance book is kept which details all work undertaken to maintain and improve the home. The home meets the requirements of the local fire service and the local environmental health department. Infection control procedures are in place and levels of cleanliness remain generally high throughout. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 18 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 in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There are sufficient trained and competent staff on duty at all times to meet the assessed needs of the service users. Robust recruitment procedures and appropriate staff training help to ensure the safety and protection of service users. EVIDENCE: The stable and dedicated staff team clearly remain able to meet the assessed, individual and collective needs of service users within the home. A clear and updated duty rota is in place and staffing levels were found to be adequate. Although the manager confirmed that there have been no care staff appointed since the previous inspection, there was documentary evidence of thorough recruitment procedures in place. The manager stated that appropriate induction, foundation and core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was supported by training records examined. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 19 Staff files that were examined were found to be well maintained, containing necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 20 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, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from sound management and improved quality assurance systems within the home and adequate arrangements are in place for the provision of formal staff supervision. Satisfactory health and safety policies and procedures, within the home, help to ensure the protection of service users and staff. EVIDENCE: The manager is qualified both as a general nurse and as a psychiatric nurse and has many years’ experience of managing a care home. She undertakes training from time to time to update her knowledge. Since the previous inspection, she has completed the Registered Manager’s Award (RMA). Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 21 Records inspected showed that, as required, all care staff receive regular formal recorded supervision. The home continues to operate effective quality monitoring systems, including satisfaction questionnaires for both service users and their relatives. Although there was evidently a limited response to the most recent survey and some notable reluctance, positive comments from relatives indicate a high level of satisfaction with the home and the care provided: ‘…was lucky to find such a comfortable, homely and caring place. It’s such a relief’. ‘If we weren’t happy with what you are doing – my sister would not be there!’ The manager confirmed that the health, safety and welfare of service users and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 22 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 X 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 X X 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 X 3 X X 3 X 3 Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23(2) Requirement It is required that the outside areas of the home must be cleared and made safe. (Previous timescales of 30/9/05 and 31/05/06 not met). Timescale for action 31/12/06 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. Refer to Standard OP16 Good Practice Recommendations It is recommended that the home’s complaints procedure be reviewed and amended, as discussed, to include details of relevant timescales. Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Chyngton Rise DS0000021418.V304698.R01.S.doc Version 5.2 Page 25 - 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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