Inspection on 24/02/06 for The Chestnuts

This inspection was carried out on 24th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 26/04/07

The Chestnuts 02/11/06

The Chestnuts 22/09/05

The Chestnuts 02/03/05

The Chestnuts 25/08/04

The Chestnuts 04/03/04

The Chestnuts 13/08/03

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE The Chestnuts 29 Station Road Ruskington Lincs NG34 9DR Lead Inspector Mr Toby Payne Unannounced Inspection 24th February 2006 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 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 DS0000002439.V283685.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Chestnuts Address 29 Station Road Ruskington Lincs NG34 9DR 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) 01526 832174 Mr George Eric Stafford Mrs Sheila Stafford, Mr Graham David Stafford Mr George Eric Stafford Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1), Old age, not falling within any other category (12) The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: The Chestnuts Care Home is family owned and has been adapted and extended from a former domestic house to provide the present accommodation. The home is provides personal care for up to 14 people over he age of 65. On the day of the inspection the home was fully occupied. The home is a detached two storey building with a stair lift serving the first floor. All the rooms provide single accommodation but none of them are en-suite. Communal rooms consist of 3 separate sitting areas as well as a dining room adjacent to the kitchen. There is a small car parking area to the front of the home with more car parking space at the rear. There is a garden area at the rear of the home. The home is situated close to the village of Ruskington, which contains a range of community facilities including shops, Post Office and churches. There are also rail and bus services close by. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and started at 8.30 a.m. It took place over 4 hours. The inspector spoke to 9 residents, 3 visitors, 3 staff, as well as the acting manager. The main method of the inspection was called “case tracking”. This involved selecting one newly admitted resident and tracking the care they received through the checking of records, discussion with them and the care staff. The inspector also observed how care was delivered and how staff responded to other residents living in the home. A pre-inspection questionnaire had been completed by the home prior to the inspection and the information was used when planning the inspection. Comment cards were received from one resident. Comments were, “”I am happy to be in a home with such a loving caring staff”. Comment cards were also received from 2 relatives/visitors. Comments were, “very impressed with the loving care my mother receives. Nothing seems too much trouble. I feel free to contact them or visit at any time. As much a home from home as possible”. What the service does well: What has improved since the last inspection? One bedroom has been redecorated and recarpeted. A new commercial washing machine has been purchased which has improved the quality of washing. New dining room chairs are to be provided in the future and new flooring for the dining room. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 6 Residents receive information to enable them to make a choice as to whether or not they wish to come to this home. . EVIDENCE: There is a detailed statement of purpose and service user’s guide and a copy of the service user’s guide is given to each person when being admitted to the home. The statement of purpose was reviewed on the 17/3/2005. The home does not provide intermediate care. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 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 the following standard(s): 7,8 and 11 Resident’s care, health and welfare needs are met by staff who know the resident’s needs. Medication is safely administered. Where required residents can receive attention from their GP and Community Nurse. EVIDENCE: All residents had detailed and up to date care plans. The care plans included an information sheet about the person’s personal care, mental health and physical intervention, a care plan identifying medical, individuality, independence and mental health and a daily report. Where required, risk assessments are also included. There was evidence to show that wherever possible residents had been involved in their care. Their signatures showed this. There was evidence to show that the care plans had also been reviewed. Where required service users can be referred to GPs, Community Nurse, Continence Nurse, Infection Control Nurse, Community Psychiatric Nurse, Chiropodist, Dentist, Optician and other professionals. Nursing care is provided by the Community Nursing Service. On the day of the inspection there was one person who required this service. Residents commented, “staff are very kind and considerate” and “I am very happy”. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Social activities provide stimulation for residents living in the home. Meals are nutritious and offer a healthy and varied diet. Visitors are welcome in the home. EVIDENCE: Staff members are responsible for activities. The home does not have a written programme of activities. However activities are provided including outside entertainers. Since the last inspection activities have increased. The home receives a visit by Pets as Therapy (PAT) and residents go on trips into town. Activities are provided on nearly every day. A very successful valentine party took place with a singer, cream tea attended by 41 people. Residents are encouraged to maintain their interests and one resident had a model railway, which gave a great deal of pleasure to him. People also attend local churches or go into the village, which is close to the home. Residents were offered a choice of well-balanced and wholesome meals. Resident’s comments were, “the cook and food is wonderful” and “I can do what I wish to do”. Visitors commented, “the staff are so helpful”, “I always receive a warm friendly welcome whenever I visit” and “the staff are brilliant”. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Residents know that any concerns they have are taken seriously and acted upon. Residents rights are protected. EVIDENCE: Each resident is given a complaints procedure when they are admitted to the home. No complaints have been received by the home and the CSCI since the last inspection. Where required, advocacy services and legal services could be obtained by the home. Service users are also encouraged to vote at elections The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24 and 25 Residents live in clean, safe and comfortable surroundings with accessible gardens. EVIDENCE: Records kept by the Commission shows that there is sufficient communal space (4.1 square metres per person) for the 14 people living in the home. There are 3 sitting areas with a dining area adjacent to the kitchen. There are 5 toilets on the ground floor including those in the bathroom and shower room. On the first floor there are 2 toilets one in the bathroom on this floor. All these facilities have locks. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 13 The homes’ entrance is by way of a gravel drive up a slight ramp through 2 doors to the hallway. There are no handrails in the corridors but handrails in toilets, bathrooms and shower room. There is a stair lift to the first floor. The home has 1 mobile hoist, 1 stand assisted hoist and an electric bath seat in the first floor bathroom. The home also has slide sheets, alternating pressure matresses, turntable and raised toilet seats. Where required, advice can be obtained from an Occupational and Physiotherapists. People coming into the home are encouraged to bring into the home small items of furniture, television, video recorder, pictures and personal items. Rooms were personal. Radiator covers have been installed throughout the home following a risk assessment. The 3 boilers which control the hot water system have thermostatic controls installed to give guaranteed water temperatures at hot water taps not exceeding 43º Centigrade. The home monitors the temperatures every month and adjustments are made where required. Records examined showed that they were within safe limits. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 There is a trained, knowledgeable and competent staff team. The numbers of staff are sufficient to meet the needs of the residents. Staff are correctly recruited EVIDENCE: The last new member of staff was recruited in 2001 and there is a stable and established team of staff. All residents who spoke to the inspector were satisfied with the level of staff in the home. Comments were, “nothing is too much for the staff” and “we are well looked after”. On the day of the inspection, the home had no staff vacancies. The inspector examined the duty rota and could see between 06.00 and 09.00 hours there were 2 care staff, from 09.00 to 13.00 hours there were 3 care staff, from 13.00 to 22.00 hours there were 2 care staff and between 22.00 and 06.00 hours there were 2 (one on wakeful duty and one asleep but available if required in the home). The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 15 The home has a written recruitment and equal opportunities procedure. All new staff are recruited in line with the regulations. This includes application form, 2 references, photograph, birth certificate and a check by the Criminal Records Bureau (CRB). All staff have been checked by the CRB. No new staff have been recruited since the 26/7/2004. However where this occurred the home was aware that both a CRB and POVA check would be required to be undertaken. Since the last inspection training has included moving and handling, catheter care, dementia awareness and loss and bereavement. Future training will cover bowel management and abuse prevention. These have also included the use of videos backed up by multiple-choice questions to check staff knowledge. All training provided is recorded. 30 of staff have achieved a qualification in care (NVQ level 2). However although 6 further staff want to study for the same qualification there has been a delay in obtaining funding. This has been outside the home’s control. This is to be pursued by the home. Comments from staff were, “we treat the residents like our family” and “we all work as one team”. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 36, 37 and 38 People living in this home have confidence in the staff and management and are consulted about any changes taking place. Residents are asked their opinion about the home. EVIDENCE: The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 Page 17 The home is family run with the registered providers having an active role in the management of the home. They have 17 years experience in managing and providing care in the home. A number of roles are delegated to the care manager and representative of the providers who achieved a management qualification and intends to apply to the CSCI to be the registered manager. She is studying for a care qualification (NVQ level 4). Comments from residents were, “fantastic” and “the manager and staff are very attentive”. Visitors commented, “the home arranged a lovely party for my mother and when she arrived in the home there were fresh flowers in her room”. The home with the resident’s permission handles their monies. Signatures are obtained and receipts issued where required. Records examined on the day of the inspection, were found to be well maintained with evidence of review. Records examined, concerned care, medication administration, fire prevention and equipment maintenance. Essential equipment showed evidence of regular maintenance. The home had a detailed health and safety policy, which includes Substances Hazardous to Health (COSHH). Window restrictors have been installed to all first floor windows. Staff have also received first aid training. A formal fire risk assessment had been undertaken following advice from the Lincolnshire Fire and Rescue Service. This was reviewed on the 1/2/2006. The last fire safety inspection was on the 5/12/2005. There were no major concerns. The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 4 17 3 18 x 3 3 3 3 3 3 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 3 3 3 The Chestnuts DS0000002439.V283685.R01.S.doc Version 5.1 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. 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 DS0000002439.V283685.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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