Inspection on 18/04/05 for The Chestnuts

This inspection was carried out on 18th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Chestnuts 15/03/07

The Chestnuts 24/10/05

The Chestnuts 09/11/04

The Chestnuts 04/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Chestnuts Wrotham Road Meopham Gravesend Kent DA13 9AH Lead Inspector Fiona Holdaway Unannounced 18 April 2005 10:00 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 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. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Chesnuts Address Wrotham Road Meopham Gravesend Kent DA13 9AH 01474 812152 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Michael Knowles Banks Mrs Brenda Dorathy Turley Care Home 26 Category(ies) of Dementia (2) registration, with number Old Age (24) of places The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residential care for two older people with mental infirmity restricted to two whose date of birth are 1st October 1912 and 11th August 1910. Date of last inspection 9 November 2004 Brief Description of the Service: The Chestnuts is a large detached property standing in its own grounds. It is registered for twenty-six residents who are over 65 years of age. The accommodation is on the ground and first floor, with the third floor being used for administration purposes. There is a Stannah chair lift to the first floor and a separate passenger lift. The home is situated in the village of Meopham and seeks to meet the needs of the local population. The house is close to the shops and post office and is on the main bus route. There is a main line station in the village. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection was carried out by Fiona Holdaway between 10:00 am and 1.30pm. A tour of the home took place and the Inspector spent 2 hours talking with 10 service users (individually and in small groups) the Inspector also joined the staff on their tea break. The Manager was present in the home throughout the Inspection. Some care records and staff files were inspected. There have been no complaints received by CSCI about this home. What the service does well: What has improved since the last inspection? What they could do better: The Manager could consult with service users more frequently about the range and frequency of activities offered to ensure that all the service users wishes in this respect are agreed and met. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 6 Although the Inspector has seen good care plans on the homes computer system at previous inspections these were not available on this occasion. The manager needs to ensure that these are accessible to all staff. The use of a complaints book is required to evidence that a record of all complaints made by service users (or their representatives or relatives) is kept. Any action that has been taken by the registered person in response to a complaint is recorded. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 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 standard(s) 3, 4, and 5 Prospective service users have the information they need to make a choice about living in the home. There are enough appropriately qualified and experienced staff employed at the home. EVIDENCE: Service users and their relatives are encouraged to visit the home before the person moves in and the first month of stay is a trial period for both parties. Service users needs are assessed prior to being offered a place at the home to ensure that the home is able to meet the needs of the individual. Three service users that had recently moved into the home told the Inspector that they and their relatives had visited the home and been provided with sufficient information to make the decision to move in. Pre admissions assessments for the same 3 service users were seen, these have been improved upon since the last inspection. The manager stated she undertakes the assessment of prospective service users within their current environment and with the involvement of relatives where appropriate. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, and 10 Service users personal, social and health care is provided according to service users needs and wishes. Service users receive a high standard of personal care and are treated with respect and their privacy is maintained at all times. EVIDENCE: The Inspector spent 2 hours talking with 10 service users (individually and in small groups). The judgement for these standards is largely based on their views about it and their comments included: “the staff are always very kind”, “no one tells you what to do”, “staff will always help you, you’ve only got to ask”, “I am very happy and satisfied with the service” “every single one of the staff are kind”. Service users confirmed that staff always knock on doors and support them with bathing and personal care in a manner that maintains their privacy and dignity. With regard to record keeping, the home operates a computerised care plan system and the staff record the significant events of the day for each service user by using a simple hand held computerised log. The information recorded was shown to the Inspector. The manager stated that a print out can be obtained for service users should they request it. However the manager was not able on this occasion to show the details of service users individual care plans to the Inspector, although these were seen at the last announced The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 10 inspection and met the standard required. The Inspector was concerned that the Care Plans were not easily accessible for all staff, particularly new staff who may need to spend time familiarising themselves with the care plans. With regard to environmental factors that apply to privacy and dignity, locks and bell calls are fitted in all bedrooms, bathrooms and toilets. A visitor’s lounge is available upstairs and there are two designated overnight guest rooms. Some service users have their own telephones in their bedrooms these are on private lines. There are no shared bedrooms at the Chestnuts. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, Service users are encouraged to make choices about all aspects of their daily routine and their choices are respected. Service users are supported to maintain contact with family, friends and the wider community and this provides stimulation, opportunities to go out and emotional support. Some service users would like more activities throughout the day as there are long periods in which they feel bored. EVIDENCE: The home employs activities workers for 4 hours per week and the service users stated that a variety of entertainers are brought in on a regular basis. The homes timetable of activities was viewed, this is prominently displayed for all service users. Activities included quizzes, word games, cards, puzzles, bingo, poetry reading, and reminiscence activities. However these activities were limited to one activity a day. Some service users would like more activities throughout the day as there are long periods in which they feel bored and days when there are no activities at all on offer. For the month of February there was a planned activity every day but for the month of March there were 9 weekdays where there were no activities on offer. There is no record kept of the details of who has participated in activities or how else service users have spent their time. Service users comments included: The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 12 “the only thing I don’t like is there isn’t anything to do.” “I wish we had something more to do to pass the time away.” “its boring, there isn’t anything to do, unless your family take you out.” “there are activities but I would still like to do more”. A member of staff stated that service users are consulted about any significant events and how they wish to mark the occasion, such as wartime anniversaries, royal weddings, celebrations, special days and holidays etc. The local vicar visits the home and a communion service is offered monthly. In house entertainment is provided on a regular basis and this is much appreciated by service users. Minutes of a residents meeting held in Dec 04 that evidenced service users had been consulted about activities on offer and asked for any suggestions for improvements. The manager stated that 2 service users go to a day centre (they are collected by bus) and this can now be offered to other service users but they will have to pay to go. There is no vehicle allocated to the home and service users are dependent on their families and friends for trips out. One service user said she goes for a long walk every day. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 The home has a clear complaints procedure and service users and relatives are aware of how to complain. EVIDENCE: The home has a clear complaints procedure and a copy was displayed in the entrance hall. Service users spoken with were well aware of their right to complain and generally presented as very satisfied and happy with the service provided. However the home did not have a record of any complaints and it was clear from one service user that a complaint had been made recently. It is a requirement that all complaints are documented and the complaints procedure is followed, this was discussed with the manager. Service users told the Inspector that they would either vote by post or go to a polling station. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25, and 26. Service users live in a safe, well-maintained and clean environment. The décor, furnishing and fittings are of a high standard providing a homely and pleasant living environment. EVIDENCE: Service users occupy spacious single bedrooms. All but 3 rooms have en-suite facilities and where these are not included a suitable bathroom is located nearby. Service users said that they had been able to bring some of their own furniture and ornaments, pictures etc. All the service users spoken with expressed satisfaction with their rooms, except for one (which was discussed with the manager). The home has a large lounge / diner, separate dining room, and a small quiet room, all are fully furnished. On the day of the inspection the home was found to be clean, bright, airy, warm and well lit. The home is accessible to service users throughout and a new passenger lift has been installed. Service users said they enjoyed the large garden and patio areas when the weather was The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 15 warmer. The home has sufficient toilet and bathroom facilities for the number of service users and hoists are provided in the two main bathrooms. The kitchen and separate laundry room were viewed both were well maintained, and clean. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 and 29 The home employs sufficient numbers of staff to provide the level of care needed. A high number of staff are working towards NVQ’s in care ensuring that the staff team have the knowledge and skills required. The home has a good recruitment procedure which supports and protects service users. EVIDENCE: Four staff files were seen including a new member of staffs’. Staff files included application forms, written references, proof of identity, and CRB (Criminal Record Bureau) checks. Staff are provided with a handbook with information about working at the home and the key policies of the home. 9 staff have enrolled on NVQ courses at levels 2 and 3. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 37 The atmosphere of the home is friendly and welcoming. The manager is approachable to service users and staff and offers clear guidance and support. EVIDENCE: Staff and service users spoke with high regard of the Manager one service user said “the Manager is very easy to talk to, you can tell her anything”. The Manager demonstrated through discussion, a clear understanding of the needs of the service users and any current issues. Health and safety is monitored within the home by using the new computer system. The Manager has achieved her NVQ 4 qualification in management and has completed several courses in care. She is currently seeking confirmation from West Kent College that these, are equivalent to an NVQ at level 4. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 x 3 3 3 x x x 3 x The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? 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 16 Regulation 17(2) Requirement Schedule 4 Other records to be kept in a care home. 11. A record of all complaints made by service users or representatives or relatives of service users or by persons working at the care home about the operation of the care home, and the action taken by the registered person in respect of any such complaint. Timescale for action 18 April 2005 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. 2. Refer to Standard 7 12 Good Practice Recommendations Ensure that care plans are easily accessible to all staff. Ensure that service users are continually consulted about the range and frequency of activities offered. Keep records about activities offered and which service users participated to evidence that this standard is met. The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 The Chestnuts H56-H06 S24032 The Chestnuts V218583 180405 Stage 4.doc Version 1.30 Page 21 - 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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