Inspection on 24/10/05 for The Chestnuts

This inspection was carried out on 24th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 18/04/05

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 Sally Hall Unannounced Inspection 24th October 2005 10:00 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 DS0000024032.V254081.R01.S.doc Version 5.0 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 DS0000024032.V254081.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Chestnuts Address Wrotham Road Meopham Gravesend Kent DA13 9AH 01474 812152 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) Mr Michael Knowles Banks Mrs Patricia Banks Mrs Brenda Dorathy Turley Care Home 26 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (24) of places The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residential care for two older people with mental infirmity restricted to two people whose date of birth are 1st October1912 and 11th August 1910. 18th April 2005 Date of last inspection 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 service users’ accommodation is located on the ground and first floor, with the second floor of the home being used for administration purposes. There is a Stannah stair lift and a separate passenger lift serving the first floor. 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 DS0000024032.V254081.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection at The Chestnuts took place on 24th October 2005 and commenced at 10.00am. Time was spent looking at a conversion of the upper floor, that the owners hope to register in the future. The Inspector agreed and explained the inspection process with the Registered Manager and owners. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was also undertaken but it was not fully inspected. The focus of the inspection was to assess The Chestnuts in accordance with the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: The staff need to record more detail about the care and support they provide service users through the day. Staff training needs to be facilitated for all staff and refresher courses must be arranged as required. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 6 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 DS0000024032.V254081.R01.S.doc Version 5.0 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 DS0000024032.V254081.R01.S.doc Version 5.0 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): 1-6 Service users have the information they need to ascertain whether the home can meet their needs. Service users rights are largely protected by a written contract / statement of terms and conditions which requires some minor amendments. Prospective residents have the benefit of a trial period at the home to assess whether the home can or cannot meet their needs. EVIDENCE: The home provides the service users with their own copy of the Statement of Purpose and Service Users Guide that is presented in a in a leather folder and can be kept in their bedrooms. The manager explained that the content of these documents was currently under review, as recent changes needed to be reflected. Service users are provided with a contract/terms and conditions, these need to show details of the room number that is occupied, the fee payable to the home and by whom. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 9 The manager or her senior team visit all prospective service users before they are offered a place at the home. A pre assessment is then completed and these were seen on the files of new service users. They all contained the information necessary to make an informed judgement. The manager stated that they would only offer a place at the home if they could meet that service user’s needs. The manager explained the training staff have completed to ensure that they are able to meet the needs of the service users living at the home. Many of the service users at this home are generally self caring and need only minimal assistance. All service users are invited to the home and are encouraged to spend time with the other service users and have lunch. Families are also welcome to visit prior to any admission. The home offers all service users a 28 day trial period, at the end of which a review is held, if it is ascertained that the home can meet their needs the service user is offered a permanent place. The home does not provide intermediate care. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 10 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): 7,8,10 Service users can be assured that their health needs will be met by the home and that their privacy and dignity is respected. EVIDENCE: The home produces much of the service users’ information documentation electronically. The service users’ assessments and care plans were seen on the computer. These were discussed with the manager and it was recommended that more detail should be recorded regarding the action required by staff. The daily records also lacked detail and did not reflect the amount of support the staff provided for service users. These records do not record when service users have taken part in activities or when these have been refused. The manager stated that the care plans were reviewed monthly and have been written in consultation with the service users. All service users have their own doctor, most use the surgery in the village. The district nurses visit the service users when required. The home monitors the service users’ diet and weighs the service users regularly. Examples were seen where the staff at the home have monitored service users’ health needs. The home also facilitates visits from or to the chiropodist, optician and dentist. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 11 The service users all said that they felt the staff treated them with respect and dignity. Staff were seen and heard talking to service users about personal issues in a sensitive manner. Although medication was not fully inspected during this inspection, it was noted that the home was unaware of the certificated courses now available for staff on the administration, recording and storage of medication. The manager was advised that this training is now required for staff who administer medication in the home. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 12 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): 12-15 Service users benefit from a suitable range of activities provided by the home. Service users maintain their independence and exercise their right to choice and control and are encouraged to maintain contact with their family and friends. The dietary needs of service users are well catered for offering both variety and choice. EVIDENCE: The residents spoken with said that they have people come into the home to entertain them, but that they had other options available to them throughout the day. A person from the church visits once a month, and those who want take Holy Communion can do so. The home also welcomes children who come in from the local school at Christmas and Easter time to provide entertainment, this is appreciated by the residents. Those spoken with said that they are able to go out with their families. The manager stated that they had tried to arrange outings but that service users were often reluctant to go when the opportunity arrived. Service users said that they felt the home offered them choices throughout the day and that they could do what they wanted, whether that was spending the day in the lounge or in their own room for all or part of the day. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 13 Visitors are made welcome at any time and the resident can have visits in their bedroom if they wish, refreshments are made available as required for a small charge. The manager stated that they endeavoured to keep meal times flexible. The service users said that they could have meals in their bedrooms if they wish. All of the residents spoken with commented on the food, and said how good it was and that they had daily choices offered. Evidence was seen of the fourweek menu. staff were observed during meal- time offering the service users a choice of meal. When asked about the meals the service users said that the meals are “very nice” others said it varied, depending on what it was. The home records what each service user has eaten each day. The owner stated that the home was able to offer special diets. The food supplied is brought in already prepared so that staff can take turns to cook in the combi-steamer making it less likely for them to be short of people who can cook. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 14 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, 18 Service users know that their concerns and complaints are taken seriously. Service users are protected from the risks of abuse, however the home’s policy and procedure need to be reviewed. EVIDENCE: The home has a complaints procedure in place, the complaints file showed that there had been no complaints since the last inspection. Service users spoken with said that they felt confident that if they were not happy about anything then the staff would do their best to put things right. The home has not received a copy of the local authority adult protection protocol. The manager was advised to obtain this document and to review the home’s current policy to ensure the recent changes have been reflected. The home has a whistle blowing policy. All staff at the home need to have undertaken the adult protection training. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 15 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): These standards were not inspected during this visit. EVIDENCE: The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 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 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, 30 The numbers and skills mix of staff currently meets service users’ needs. The service users benefit from the number of staff who have comlpeted or are undertaking the NVQ award. EVIDENCE: The staffing levels in this home appear to be sufficient to meet the needs of the service users. The home is currently recruiting staff in order to ensure there is sufficient staff available to cover sickness and annual leave. The manager explained that 8 staff have an NVQ level 2 in care or above. A further 5 staff have started the NVQ award, this will give a total of 13 when they complete it. The home currently employs 26 care staff, so they will have reached the required 50 of staff with an NVQ level 2 or above. The home will need to be aware of the skills mix of staff on duty. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 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 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): 32, 36, 38 The manager is approachable to service users and staff and offers clear guidance and support. Staff would benefit from regular supervision and the required training. EVIDENCE: From talking with service users, staff and observing the interaction during the day it was evident that the home is friendly and inclusive. Service users said that they had no problem speaking up if they needed anything and that they were consulted on issues. The staff said that they felt supported by the manager and felt able to discus anything they had concerns about. The staff files showed that staff have an annual appraisal, however, it was not evident that the staff were receiving formal supervision at least six times a year. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 18 The home was able to produce many of the required maintenance certificates required. The landlord’s gas certificate was however, out of date. The owner explained that they have just had the boilers replaced and the boiler performance check is to be carried out and then the certificate would be issued. The home has a COSSH file that details all the information about chemicals used in the home. The LOLER certificate for one hoist could not be located this is being followed up by the owner. The staff training matrix was viewed, it indicated that many of the required courses are undertaken by staff at the home. It also showed that some staff were still awaiting some of this training and that infection control training needs to be facilitated. The requirements and frequency around staff training were discussed with the manager and the owners. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 19 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 2 3 3 3 N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X 2 X 2 The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP7 Regulation 15, schedule 3(1)(b) Requirement Timescale for action 31/12/05 2 OP36 18(2) 3 OP38 23,13,16, schedule 4 A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. This care and support to be detailed in the daily report. The registered person ensures 31/12/05 that the employment policies and procedures adopted by the home and training and supervision arrangements are put into practice. Supervision to be facilitated on a regular basis six times a year. The registered manager ensures 31/12/05 so far as is reasonably practicable the health, safety and welfare of service users and staff. Facilitate the staff training and ensure all maintenance certificates are kept current. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 21 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 OP2 OP18 Good Practice Recommendations Each service user is provided with a statement of terms and conditions at the point of moving into the home which shows the fee and who is responsible for the payment. Obtain a copy of the adult protection protocols and review the home’s policy and procedure to ensure they meet the changes. The Chestnuts DS0000024032.V254081.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 DS0000024032.V254081.R01.S.doc Version 5.0 Page 23 - 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. 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