Inspection on 25/03/09 for The Chesters

This inspection was carried out on 25th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

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Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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 Chesters 418 Durham Road Durham Road Low Fell Gateshead Tyne & Wear NE9 5AJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janet Thompson     Date: 2 5 0 3 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 26 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Chesters 418 Durham Road Durham Road Low Fell Gateshead Tyne & Wear NE9 5AJ 01914910750 01914878926 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Parkside Northern Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: The maximum number of users who can be accommodated is 29 The registered person may provide the following category of service only Care Hom only Code - PC To service users of the following gneder - Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, maximum number of places 24 Mental Disorder, excluding learning disability or dementia - Code MD, maximum number of places 1 Old age not falling within any other category - Code OP, maximum number of places 29 Physical disability - Code PD, Care Homes for Older People Page 4 of 26 Over 65 0 0 29 0 0 24 1 0 9 7 maximum number of places 9 Sensory impariment - Code SI, maximum number of places 7 Date of last inspection Brief description of the care home The Chesters provides personal care for 29 older people some of who have dementia. The home is situated off a main road in Low Fell. The building consists of an older part which has been adapted for purpose, and a newer purpose built extention. The main lounge, dining areas, kitchen and ancillary facilities are located on the ground floor. There is a passenger lift providing access to the first floor. Outside the home are pleasant landscaped gardens and sitting areas. Fees for the home vary and are available on request from the manager. Further information about the home can be found in the service users guide which is located in the main foyer. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home 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: This was an unannounced inspection. The manager and provider were present at the inspection. This inspection was carried out by two inspectors. It took a combined time of nine hours to complete. Before the visit we looked at information we have received since the last inspection visit, including how the service dealt with any complaints or concerns. We also looked at any changes to how the home is run and asked for the managers views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is usually given to us in the form of questionnaires. At the time of writing this report we had received ten responses from staff, eight residents and one professionals questionnaires. During the unannounced visit we talked with people who use the service and some of Care Homes for Older People Page 6 of 26 the staff. We looked at the information about people who use the service and how well their needs are met. We looked at other records the home is required to keep and checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building to make sure it was clean, comfortable and safe, and we checked what improvements had been made since the last inspection visit. Feedback was given to the manager at the end of the visit. What the care home does well: What has improved since the last inspection? What they could do better: We thought the excellent care was not fully reflected in the care plans and we made some recommendations about how this should be done. We have asked that all residents, not just the more dependant, have a range of risk assessments in place that Care Homes for Older People Page 8 of 26 are evaluated monthly. Some of the waste bins in the home were not foot operated, this is essential to contain waste and help prevent cross contamination. Similarly the sinks where staff wash their hands need to have regulators on the hot water taps. This means staff can practice good hand washing technique under running water. Some of the internal health and safety checks were not properly recorded. This has since been remedied by the manager. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. Evidence: Pre admission assessments contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals and carers was included in the assessment. Following the assessment a letter is sent to the prospective resident informing them that their assessment has indicated that the home can meet their care needs and offering them a place. In questionnaires relatives and residents said that they were given true and factual information before admission. They said everything was explained in detail and they had visited the home. Relatives told us that prior to admission, they had looked around the home and were impressed by the atmosphere, they said they were greeted warmly by staff who made every effort to answer their questions. Care Homes for Older People Page 11 of 26 Evidence: The manager told us that she visits all prospective residents to assess their needs. Sometimes she visits more than once and takes other members of staff with her. Care Homes for Older People Page 12 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. Evidence: Two care plans were examined and case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. Both case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. Peoples preferences in relation to routine, personal care, diet and staff gender were recorded. Care plans were very personal with good in depth information about social and emotional care as well as physical. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. Each resident had a plan of care for every need but the evaluations for these were done as a collective instead of individually. Staff had assessed some residents as at risk of falls, pressure damage or requiring moving and handling interventions but not all. We discussed this with the manager and it was apparent that staff knew the residents very well, they were Care Homes for Older People Page 13 of 26 Evidence: therefore not documenting risk assessments that they were actually carrying out in practice. We thought the actual care of people was very good. We received questionnaires from residents and relatives that were full of positive comments about the care. Residents said they were well looked after. Relatives said the care was second to none and an example of how a care home should be. They said all of the staff, without exception, were excellent. Residents told us that if they are ill they are seen by a Doctor the same day. A Doctor also attends the home on a weekly basis to carry out more routine checks. Residents told us that they are regularly seen by opticians, nurses, chiropodists and medical staff. They described the care given as exceptional. We noticed that residents looked clean and well cared for. The men were clean shaven and some of the women had on jewellery and accessories. Medication ordering, administration, storage and disposal were examined. The officer in charge told us that she and the manager check medication every month. She confirmed that all staff with responsibility for medication had received training. All medicines were accounted for and all those administered were signed for. Two amounts of controlled drug were checked and were correct. The storage areas, though small, were well organised. We noticed that staff worked hard to protect residents privacy and dignity during the routine of the day and when giving personal care. Staff knocked on doors before entering bedrooms and they ensured that personal care was given in private in the residents bedroom. In questionnaires a relative told us care and kindness was always shown by staff and that dignity was always respected. Care Homes for Older People Page 14 of 26 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. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. Evidence: Residents appeared to be generally happy and we noted that they were free to move around the home as they wished. Residents and relatives told us that they thought the activities provided were sufficient and they were pleased that this was being developed further. Residents told us that they could join in things if they wished. They said that they enjoyed special entertainment like singers and themed events such as red nose day. Residents told us that they have control of their lives in simple but important ways such as when to get up, what and when to eat and how they spend their day. In questionnaires relatives told us that they can visit at any reasonable time of day and that they were made to feel welcome by staff. Residents can entertain their visitors in their own rooms, a small lounge or use the larger, busier lounges. We ate the food at the home. It was very well cooked and well presented. The braised steak was tender enough to cut without a knife and served with mash, carrots, and Care Homes for Older People Page 15 of 26 Evidence: sprouts. The pudding was Eves pudding and custard, which residents seemed to enjoy. The dining tables were nicely set and lunch was seen as a social occasion. Hot and cold drinks were readily available. We noticed that people who needed assistance to eat were given this discreetly by a carer sitting next to them. When we arrived at the home the morning coffee was being given out. There was fresh fruit, chopped on plates, on the trolley for any resident who wanted it. Residents told us that the food was always good. They said if you wanted anything different you got it without a problem. They said they got enough to eat and told us that the Cook makes a Birthday cake for each resident and home cooks all of the cakes. Care Homes for Older People Page 16 of 26 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 use the service are protected from harm through thorough policies, procedures and staff training. Evidence: Staff follow the homes policies and procedures relating to the management of complaints and allegations of abuse. Staff are kept up to date with information and training on safeguarding adults. The manager and some staff have just completed training in deprivation of liberty, there were leaflets on this subject in the home for other staff to read. An appointed person has just been identified by the Local Authority to communicate with the home about any safeguarding issues. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. In questionnaires relatives and residents said they knew how to complain. They said they were very happy with the care but they would feel confident about using the complaints process if they had to. Staff said they would pass on any concerns to the manager and they appeared clear about the process. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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 live in a safe comfortable home that is generally pleasant and clean. Evidence: The home was generally clean and free from odours. In questionnaires residents and relatives told us that the home was always clean and always smelled fresh. One relative said the home was immaculate, another said it was always very clean and very tidy. We observed that the general state of the decor was good. Residents bedrooms were well personalised, they had matching curtains and duvet covers and a good standard of furnishings. Bathrooms and toilets were a little old fashioned but were clean and tidy. There are two assisted baths and a wheel in shower for residents to use. Some of the bins in the home do not have lids that are operated by foot. This is essential to limit contamination and the spread of infection. We washed our hands at a staff hand washing sink and found the water to be too hot to practice good hand washing technique. This requires hands to be washed and rinsed under running water. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and protected through staff numbers, skill and ability. Evidence: There were sufficient amounts of staff on duty in the home. The staffing for the home was: Five care staff through the day until 3pm Three care staff from 3-10pm. Two care staff overnight. In addition to this the manager was on duty with a trainee carer, the Cook, two domestics, a laundry assistant and the handyman. Staff records showed that staff are properly screened before employment . They each contained two references, evidence of any past employment, and identity checks. Staff training records were examined. They showed that staff receive a good level of training both mandatory and related to care of the elderly. The manager has a training plan which indicates when refresher training is due. Staff also have individual training profiles. Most of the staff have attained NVQ level two and above. Ancillary staff have undertaken NVQ in their specialist area to support their work. The management team Care Homes for Older People Page 19 of 26 Evidence: have received training provided by the Alzheimers Society, this will be cascaded to all staff to enable them to understand and support people with Dementia. In questionnaires relatives and residents made positive comments about staff. They said all of the staff were supportive, they described staff as really good or excellent. They said staff were kind and supportive. Relatives said staff communication was good and they were kept up to date with events. Staff told us that they received good training and inductions. They said they felt supported and educated enough to carry out their job with confidence. Care Homes for Older People Page 20 of 26 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. People using this service are protected through reflective management taking account of the diverse needs of the service. Evidence: The manager is experienced and qualified to run the home. She has and continues to update her skills with regular training. The manager has been assessed by us as fit to run the home. There are clear lines of accountability in the home as the manager has two officers in charge who have supervisory and some management responsibilities. This means that the home should function well in the absence of the manager. We received very positive comments about the management of the home from residents, relatives and staff. Relatives describe their relationship with the management as friendly and co-operative. A relative said that relatives, staff and management work together for the good of the resident. Relatives said the home was a true example of how care homes should be run and described the service as five star. Staff said the managers door is always open, they feel supported and are Care Homes for Older People Page 21 of 26 Evidence: confident that confidentiality is maintained. There are good quality assurance systems in place that seek the views of residents and relatives. Regular staff, residents and relatives meetings are held. The minutes of these were available on the notice board for anyone who did not attend. Surveys are sent to users of the service every six months. We looked at the results of the last one which were very positive. Any negative remarks or questions were answered by the manager, in writing. The manager has a monitoring system that enables her to keep track of when health and safety checks, staff supervisions and care plan reviews are due. Residents monies are well accounted for. Each resident has an individual account. Receipts are kept for monies spent. We checked three amounts of money and found them to be correct. Some residents control their own money which they keep in a locked drawer in their bedroom. Staff supervisions were up to date. Staff are formally supervised on all aspects of care and practice relative to the home. Fire safety is the responsibility of one of the officers in charge. Records showed staff were up to date with training and drills. Fire checks and tests of equipment were also up to date. Other internal health and safety checks were not up to date. These are the responsibility of the handyman and cover such things as hot water checks and window restrictors. There were no records to show any checks for 2009 and the handyman stated that he had destroyed the records for the previous year. There was no evidence that checks were made to ensure that water was delivered at below 43oC in residents washing areas, staff hand wash sinks or before residents took a bath or shower. The absence of these checks was not known to the manager and we have recommended a more robust auditing system. External checks on lifts, hoists, electricity and gas safety were up to date. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 13 All waste bins must be foot operated. Water at staff hand washing sinks should be regulated to 43oC This helps to limit cross infection and promote good infection control practice. 01/05/2009 2 38 13 Ensure that hot water is delvered from taps at no more than 43oC. Record regular checks on the hot water system. Ensure all internal health and safety checks are up to date. This helps to promote safety for residents and other users of the building. 01/05/2009 Care Homes for Older People Page 24 of 26 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 1 9 Care plans should show a separate evaluation for each area of planned care. All residents should have a written assessment for tissue viability, falls and moving and handling. 2 38 Ensure that work delegated to others is audited. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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