Inspection on 28/01/09 for The Chapel House

This inspection was carried out on 28th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Chapel House 17/01/07

The Chapel House 28/02/06

The Chapel House 04/10/05

The Chapel House 16/02/05

The Chapel House 05/08/04

The Chapel House 11/02/04

The Chapel House 04/11/03

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Chapel House Chapel House Lane Puddington South Wirral CH64 5SW     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: Joan Adam     Date: 2 8 0 1 2 0 0 9 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. that people have said are important to them: They reflect the things 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 22 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 22 Information about the care home Name of care home: Address: The Chapel House Chapel House Lane Puddington South Wirral CH64 5SW 01513362123 01513363833 cathrina.moore@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Imelda Moore Name of registered manager (if applicable) Cathrina Moore Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The home is registered for a maximum of 35 service users to be accommodated in the category DE(E) (Dementia over the age of 65 years) Within the overall number of service users to be accommodated, 2 named service users may be accommodated in the category DE (Dementia under the age of 65 years) Date of last inspection Brief description of the care home The Chapel House is located in the village of Puddington to the north west of Chester, and is surrounded by farmland and countryside. The home is a family business, with the proprietors involved in the day-to-day running of the home. The building is a three storey detached country house which has been extended and adapted by the present owners. The home has two lounges each providing access to conservatories that are used as dining rooms and for social activities. There is a passenger lift providing access to all three floors, however six of the bedrooms can only be accessed by a short flight of steps on the first floor. There are enclosed and secure gardens with access for ambulant residents and wheelchair users. The home is registered to provide nursing Care Homes for Older People Page 4 of 22 care home 35 Over 65 35 2 Brief description of the care home care for 35 older people with dementia related needs and also provides day care services for up to three people. At all times there is a registered nurse and care staff on duty. Care Homes for Older People Page 5 of 22 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: We made an unannounced visit to The Chapel House on 28th January 2009. During the visit we spoke to the manager, some staff members and some residents. Before the visit the manager was asked to complete a questionare called an Annual Quality Assurrance Assessment (AQAA) to provide us with up to date information about the home. Some of the comments we received and the information is detailed in this report. Care Homes for Older People Page 6 of 22 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 7 of 22 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 8 of 22 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. People have a full assessment of their needs before they go to live at the Chapel House so they know their needs can be met there. Evidence: Two people had come to live in the home within the last few months. We looked at their records and this showed that information about their needs had been obtained by the manager before they came to live at the Chapel House so she would know if the home could meet their needs. Information from professionals at the hospital had also been provided. A initial care plan had been written based on this information. Care Homes for Older People Page 9 of 22 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. The health care needs of the people living at The Chapel House are well managed to ensure they receive the care they need. Evidence: Each resident has a care plan that details their needs and gives information and guidance to staff about how their needs should be met. We looked at four care plans and found that these were detailed and gave good guidance so that staff would know what to do for the people in their care. However the wording of these was written in medical terms and may not be fully understood by care staff and families. This was discussed with the manager. Care plans had been evaluated and this was detailed so that staff knew what had happened during the month. Daily records were also well written with any changes in behavior fully documented and records of one to one intervention by care staff was written on a separate sheet. Visits from other health care professionals such as GPs, opticians was also recorded. The atmosphere in the home was warm and welcoming. Staff were observed to speak to and care for people in a kind and sensitive way. People spoken with said I like it here the staff are Care Homes for Older People Page 10 of 22 Evidence: really nice Medication management was looked at. All medicine administration sheets had been appropriately signed, medicines had been signed in and any carried forward from the previous month were added to the total so staff would know how many tablets were in the trolley. Storage of medicines was satisfactory. Care Homes for Older People Page 11 of 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities on offer need to improve so that people who live at the Chapel House can take part in stimulating and meaningful activities of their choice. Evidence: We looked at the AQAA that was sent to us. This said that activities were going to improve over the next twelve months by asking residents and relatives for more information. We saw that all relatives have been asked to complete an activities planner for their family member so that activities are more individual. Some of these planners have been returned so that staff are more aware of what type of things the people who live in the home would like to do. The home employs an activity coordinator who shares her time between the Chapel House and the sister home next door. Activities are on offer and she was seen giving personal time to people who live at the home. However there were some people who were sat in the lounge for long periods of time with little stimulation apart from the TV. Staff members spoke to them when they were passing through the room or when they were giving them drinks or taking them to the toilet and dining room. The interaction was good and reassurance was given by all staff observed. Two people who were walking around the home said they were bored. A staff member found them some Care Homes for Older People Page 12 of 22 Evidence: thing to do .The activities co-ordinator was spoken with and she said monthly entertainers were provided and people enjoyed this. A suggestion from relatives as to taking photographs of residents taking part in activities was to be commenced and a digital picture frame was to be purchased. We looked at the menus and these were varied and residents are helped to choose what they want to eat at each meal. Lunch was seen and this looked nicely presented. People who needed assistance with eating their meal were helped in a discreet way. People who live in the home were spoken with and they said the food is lovely you get plenty to eat. Care Homes for Older People Page 13 of 22 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. People who live at the Chapel House are confident that their complaints are listened to and staff have received training so that they know what to do to protect people. Evidence: There is a complaints procedure at the Chapel House and no complaints have been made to the home or CSCI. People could be confident that their complaints would be listened to. Staff have received training about safeguarding people from abuse so that they know how to deal with any incident or suspicion of abuse. Care Homes for Older People Page 14 of 22 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. The home is well maintained so that residents live in comfortable, clean and homely surroundings Evidence: During our visit we walked round the home and saw that all areas had been cleaned to a high standard. All bedrooms looked at were well personalised with photos and ornaments brought in by the residents and their families. The garden was pleasant and accessible for people who live in the home and has access if a wheelchair was needed. The stairs in the main entrance hall were blocked from access by two arm chairs. This area should be risk assessed and if necessary a more permanent safe structure should be provided to maintain the safety of people living in the home. Care Homes for Older People Page 15 of 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment procedures of staff need to be more thorough to ensure that suitable staff are employed to safeguard the people who live there. Evidence: Staff rotas showed that enough nurses and care staff are provided to ensure the needs of the people living in the home are met. The percentage of staff holding a National Vocational qualification (NVQ) level 2 is 99 . The home does not use agency staff which means the residents have continuity of care from the homes regular staff. Regular training is provided for staff to ensure that they know how to work safely and make sure residents are safe. The personnel files of four newly appointed staff were looked at. Three of these contained a Protection of Vulnerable Adults check,(POVA 1st) a Criminal Bureau check and a full employment history. However, one staff file did not contain a POVA first or CRB check. This means that it was not known if this person was suitable to work with elderly people.The manager applied for this at the time of the visit and agreed to suspend the staff member until the POVA first was returned. Care Homes for Older People Page 16 of 22 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 Chapel House is well managed so that it is run with the best interest of people who live there. Evidence: The manager has been in post for some time and is a registered nurse. She is registered with CSCI and has completed the National Examination in supervisory management and the registered manager award. She has recently completed her Bsc in professional practice. The home has a quality monitoring system in place to check if medications were being managed well and to highlight any problems so that they could be acted upon quickly. The AQAA said this was to be developed to other areas within the next twelve months. The fire alarm systems and emergency lights were checked on a monthly basis and this is recorded. The recruitment process must be more robust so that all safety checks are completed on all staff members before they work at the home so that the manager is sure they are safe to work with elderly people. The home does not manage any monies for the people living there. Comment cards are sent out Care Homes for Older People Page 17 of 22 Evidence: to relatives every twelve months to gain their views on the care their relative receives at the Chapel House. Regular meetings take place and minutes are taken but relatives felt that they could raise any issues in a less formal way whenever they need to and said the staff are supportive. The AQAA told us that all relevant safe checks are carried out on items such as lifts and hoists within the home. The stairs in the main entrance hall were blocked from access by two arm chairs. This area should be risk assessed and if necessary a more permanent safe structure should be provided to maintain the safety of people living in the home. Care Homes for Older People Page 18 of 22 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 19 of 22 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 12 16 An individual social activities 28/02/2009 programme must be made available for all people living at the home. So that people living in the home can take place in stimulating meaningful activities and are not bored. 2 29 19 All staff must have a POVA first and CRB check before they commence work at the home So that people living in the home are safeguarded. 15/02/2009 3 38 13 The stairs in the main 28/02/2009 entrance hall where armchairs are being used as a barrier must be risk assessed and if necessary a more permanent safe barrier be put in to place. So that people who live in the home are safe from harm. Care Homes for Older People Page 20 of 22 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 21 of 22 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 © (2009) 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. 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