Inspection on 19/12/06 for The Chestnuts

This inspection was carried out on 19th December 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 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 27/02/09

The Chestnuts 27/02/06

The Chestnuts 27/07/05

The Chestnuts 17/02/05

The Chestnuts 22/11/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Chestnuts 72 Church Road Altofts Normanton West Yorks WF6 2QG Lead Inspector Mr Tony Brindle Unannounced Inspection 19th December 2006 14:00 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 The Chestnuts DS0000006173.V325205.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. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Chestnuts Address 72 Church Road Altofts Normanton West Yorks WF6 2QG 01924 220019 01924 223460 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) Bond Care Ltd Mrs Anne Bradley Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To accommodate a maximum of 5 persons in category TI(E) (Terminally Ill - Older People) at any one time. Can accommodate one named service user under 65 years of age in PD category 27th February 2006 Date of last inspection Brief Description of the Service: The Chestnuts provides personal and nursing care for 41 older people. Set back in its own grounds the home is situated in a residential part of Altofts between Wakefield and Castleford. There is car parking provided to the front and a large garden and patio area to the rear. Through the main entrance to the front there is a large hallway, which leads to all areas including lounges to the front and left, dining room to the right and a passenger lift to bedrooms on the first and ground floors. All bedrooms provided by the home are single accommodation and there are assisted baths with hoists for those who require it. There are qualified nurses on duty at all times. The home is close to local shops, churches and public houses and the M62/A1 link roads are close by. The current fees for December 2006 range from £378 per week per person. The service provider ensures that information about the service is available to prospective service users and the current service users by way of the home’s Statement of Purpose, the Service User Guide and through CSCI inspection reports, which are available in the home and upon request. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this full inspection, a visit to the home took place Whilst at the home, key documents such as care assessments, care plans, daily records and the home’s policies were looked at, and so were some of the rooms. 6 service users were spoken with. 5 members of staff were spoken with, along with the acting manager. Comments received during the inspection included, The staff are nice and help me. They make sure I am comfortable.” “They really know how to look after you and go out of their way to make sure I am alright What the service does well: • Each person considering moving to The Chestnuts has their needs assessed, and is given information about the home by the manager, before admission. • The admission process ensures that those new to the home know what to expect of the service from the outset. • Individual care needs are set out in individual care plans. • The ethos of the home is to make sure that residents’ needs comes first, resulting in residents feeling they are treated with respect and their right to privacy and dignity is upheld. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 6 • The home’s medication policies and procedures promote and support the best interests and healthcare needs of the service user. • Service users are happy living in the home, and benefit from the development of various activities programmes based on their interests and hobbies. • Service users enjoy getting out into the local community. The meals provided at the home are of a very high standard. • The home’s policies and procedures for dealing with complaints or suspected abuse were found to be satisfactory with appropriate record keeping. • The home is well maintained and people like the décor and surroundings. • The home is keep clean. • Service users needs are met by sufficient numbers of staff. • The home’s recruitment policies and procedures safeguard people living in the home. • Attention is paid to ensuring that staff receive the right level of periodic training. • There are good systems in place that are to be used to monitor the quality of the care provided by the acting manager and staff. • Service users financial interests are promoted by good systems. • The health and welfare of people living and working at the home are promoted. What has improved since the last inspection? • The home has had its Investors in People Award renewed. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 7 • The home’s care of people with terminal illness and palliative care needs has been developed and recognised by external professionals. • The manager and staff have worked well to ensure the requirements and recommendations made at the last inspection have been met. 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. The summary of this inspection report can be made available in other formats on request. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 8 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 The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The home doesn’t provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person considering moving to The Chestnuts has their needs assessed, and is given information about the home by the manager, before admission. The admission process ensures that those new to the home know what to expect of the service from the outset. EVIDENCE: The registered manager described the admission process, stating that she visits each prospective resident to assess their needs. The records show that the manager considers the available information from the social worker, talks to the prospective resident and completes assessment documentation. If the prospective resident is privately funded, the manager said that most of the information is gained through liaison with family members. She added that the resident or their relatives could visit the home at any time to have a look around. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 10 The manager said that prospective residents are offered an introductory visit, may stay for a meal or come in for a full day to meet people. During this time further assessment may take place if required. She added the resident and their relatives are given a copy of Statement of Purpose and Service Users’ Guide. One person living at the home confirmed this. Discussions took place with one resident new to the home. They said, The staff are nice and help me. They make sure I am comfortable. They really know how to look after you and go out of their way to make sure I am alright Records showed that a pre-admission assessment form is completed that contains the headings of basic details, medication, physical health, allergies, eyesight, hearing, sleep pattern, mental health and religion. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 11 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. 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. Individual care needs are set out in individual care plans. The ethos of the home is to make sure that residents’ needs comes first, resulting in residents feeling they are treated with respect and their right to privacy and dignity is upheld. The home’s medication policies and procedures promote and support the best interests and healthcare needs of the service user. EVIDENCE: The records show that care plans reflect the needs of residents, which along with good communication systems, ensure that those needs are met. The registered manager said each person has a plan that has been agreed with him or her. The records confirmed this. She added that residents have right of access to health and remedial services and the home’s policies, procedures and practice guidance strongly support this. The records show that the health care needs of those people too frail to leave the home are managed by visits from local health care services. The registered manager said that residents have The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 12 individual health care plans that give an overview of their general health and acts as an indicator to changing health needs. The records confirmed this. The records show that induction training for staff covers a number of area including healthcare, respect, privacy and dignity. The records show that the home has clear and robust practices for the care of residents who are dying. One of the home’s nurses explained that she and other staff at the home had worked closely with the local palliative care team to develop a person centred pathway for people with terminal illnesses. The paper work relating to this was seen and found to be of a very high standard. The registered manager explained that the pathway is soon to be accredited externally, for which the staff at the home are to be commended. The records show that staff in the home support the family and the home’s other residents during the bereavement process. A recent medication audit was examined which indicated that the systems operated by the home in relation to medication promote the health and welfare of people living at the home. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 13 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. 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 happy living in the home, and benefit from the development of various activities programmes based on their interests and hobbies. Service users enjoy getting out into the local community. The meals provided at the home are of a very high standard. EVIDENCE: Discussion with some of the staff showed that they are aware of the need to plan the routines and activities of the home in a way which meets the choice and wishes of the people living there. Observation of care practices, and the way people are supported shows that the staff are flexible and attempts to provide a service which is as individual. People living in the home say that are spoken with as to how they would like to spend their time, and how they would like to be cared for. The home’s activities organiser was spoken with, who explained that a number of activities are provided for people to get involved with. A record of these activities was looked at and was found to offer a variety of activities based on the needs and interests of people living at the home. One service user who was spoken with explained that they really enjoy the The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 14 activities and said that they like the variety on offer. The home has open visiting arrangements and one person said that they could entertain their family/or friends in their own room. The records confirmed this. The registered manager explained that uunless there are legal reasons for people not to do so, they can carry out their own financial, legal and other personal business at a time that suits them. She added that people can decide who should know about, and have access to, their personal business. The records show that people can keep and control their money and their personal belongings, unless their individual circumstances mean that specific legal arrangements have been made. A check of the records and money held by the registered manager found no discrepancies. It is clear from visiting people’s bedrooms, that people are able to have personal possessions in their room. People at the home said that the food in the home is of good quality, well presented and meets the dietary needs of the people living at the home. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 15 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. 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 home’s policies and procedures for dealing with complaints or suspected abuse were found to be satisfactory with appropriate record keeping. EVIDENCE: The records show that the service has a complaints procedure, which is available within the home. 3 people were spoken with who all said that they understood how to make a complaint and who to go to. One complaint has been received since the last inspection and the registered manager explained that how this had been dealt with. The records show that the complaint had been recorded properly, and the right people had been notified and spoken to at the right time. The Commission awaits the outcome of the investigation relating to this complaint. The policies and procedures regarding the safeguarding of residents are satisfactory. Within the policy there is clear information as to when incidents need external input and who to refer the incident to. Discussion with 2 staff members showed that they had an awareness of the content of the policy and would know what immediate action to take and when and who to refer any incident on to. The records show that one adult protection referral has been made in the past 12 months. A group of people living at the home said that they feel safe. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 16 The training records show that the staff team have received training in the area of safeguarding vulnerable adults from abuse. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and people like the décor and surroundings. The home is keep clean. EVIDENCE: Observations of the home found that building has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. It was noted that the shared areas provide a choice of communal space with opportunities to meet relatives and friends in privacy or in their own rooms. Two people living at the home said that there is a choice of bathing facilities, both assisted and unassisted, showers and baths and there are a number of toilets strategically placed around the home. The records show that the management has a good infection control policy, and observations made on the day found this policy being put into practice. The Chestnuts DS0000006173.V325205.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. 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. Service users needs are met by sufficient numbers of staff. The home’s recruitment policies and procedures safeguard people living in the home. Attention is paid to ensuring that staff receive the right level of periodic training EVIDENCE: The registered manager said that because people’s needs may change over time and because every person living in the care home will have their own changing needs, she makes sure that that the management and staffing arrangements are always sufficient to meet those needs. Discussion with people living at the home shows that they have confidence in the staff that care for them. The records show that the service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications. The rota showed that there is a satisfactory mix of qualified and unqualified staff working at the home, appropriate to the assessed needs of the service users, the size, layout and purpose of the home. The records show that domestic and catering staff are employed in sufficient numbers to ensure that standards relating to food, meals and nutrition are fully met, and the home is maintained in a clean and hygienic state. Two people living in the home said that they are confident that the staff providing their support and care have the knowledge and skills gained from the experience of working with people whose needs are similar to their own, and that when new staff start, they are given The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 19 appropriate training to gain experience as part of a planned training programme. The registered manager explained that the home had recently received the Investors in People Award, an award the home has had for a number of years. The records confirmed this. Discussion with people living at the home indicated that they are confident that all the staff use methods that reflect up-to-date knowledge and best-practice guidance, and that the management team continuously striving to improve practice. The records show that a good level of training is offered to the staff team. The records show that two written references are obtained before appointing a member of staff, and any gaps in employment records are explored. The registered manager said that new staff are confirmed in post only following completion of a satisfactory CRB check, and satisfactory check of the Protection of Vulnerable Adults and NMC registers (where appropriate). The records confirmed this. The Chestnuts DS0000006173.V325205.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place that are to be used to monitor the quality of the care provided by the acting manager and staff. Service users financial interests are promoted by good systems. The health and welfare of people living and working at the home are promoted. EVIDENCE: The records show that the registered manager and staff make sure that so far as is reasonably practicable, the health, safety and welfare of service users and staff is promoted. The records show that this is done by way of staff training, fire safety system testing, risk assessment and safety system monitoring. The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 21 Staff explained that they take part in fire drills, and have received fire safety training, along with health and safety training. The records supported this. The records show that the home has satisfactory insurance cover, with certificates on display. The systems relating to the safekeeping of people’s monies and valuables were found to be in good order. The staff said that they receive formal supervision, and the records confirmed this. The company has developed a quality assurance scheme. This involves obtaining feedback from service users, their families and professionals. Once feedback is received, than a report on the quality of care will be published with an accompanying action plan (if required). The Commission awaits this. Monthly management visits take place on behalf of the service provider. The Chestnuts DS0000006173.V325205.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 X 3 X X X 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 3 17 X 18 3 3 X X X X X X 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 3 X X 3 The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Chestnuts DS0000006173.V325205.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 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 © 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 DS0000006173.V325205.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!