Inspection on 26/04/07 for The Chestnuts

This inspection was carried out on 26th April 2007.

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 02/11/06

The Chestnuts 24/02/06

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 Key Unannounced Inspection 26th April 2007 08:25 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.V335225.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 DS0000002439.V335225.R01.S.doc Version 5.2 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 Mr Graham David Stafford Mr George Eric Stafford Mr Graham David 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.V335225.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2006 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 fees at the inspection on the 26/4/2007 ranged from £335 to £402 each week. Extras are for hairdressing which ranged from £7 to £23.50, chiropody £10, personal toiletries and magazines. Newspapers and external activities are included in the fees. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.25 am. It was undertaken using a review of all the information available to the inspector about The Chestnuts Care Home. It took place over 5 hours. The inspector spoke to 7 residents, 4 staff and the acting manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. All comments from residents were positive about the home and the standard of care. The acting manager was present throughout and assisted the inspector. She was given general feedback about the outcomes of the inspection at the end of the visit. An unannounced random inspection visit took place on the 9/1/2007 to follow up concerns regarding care records and medication as a result of the last key inspection visit on the 2/11/2006. At the random inspection improvements had been seen and outstanding requirements addressed. What the service does well: What has improved since the last inspection? All requirements from the last key inspection have been addressed. Improvements have taken place in the way care is recorded and medication practices in the home. Staff had received training to have the skills to write care records and administer medication safely. The outside of the home has been repainted and the roof of the home replaced. In addition, a programme of redecoration and refurbishment of the lounge was taking place. This will include new chairs, carpeting and a large widescreen television. An extensive training programme had taken place to enhance the skills of the staff. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 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.V335225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. EVIDENCE: The home had a statement of purpose and service user’s guide. A copy was given to each resident when coming into the home. There was an admission procedure, which described the needs of residents coming into the home. All residents were assessed before entering the home and written confirmation was sent to them that the home was able to meet their needs The home did not provide intermediate care The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans had improved since the last inspection and there was now good care planning in this home, which helps ensure that the general health and welfare of residents is addressed. Medication has also improved and is safely given by staff who know what they are doing. EVIDENCE: As part of the inspection process the inspector tracked 2 resident’s care plans. There were clear records outlining their care and welfare needs. Efforts have been made to include residents wherever possible in identifying their care needs and being involved in reviews of their care. This was shown by their signatures. There was evidence to show that care plans were up to date and reviewed. There was sufficient information to enable staff to know how to care and support each person. The two residents felt staff knew about their needs and were satisfied with the care and approach of staff. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 10 Staff were seen to have evident pride in their work and attended to people promptly and with little fuss. Residents were satisfied with the way staff cared for them and had confidence in the staff. Comments were, “If I need something, they attend to me quickly”, “People are always asking do I like it here and I reply I am content, staff are good, I am comfortable and the food is very nice” and “The staff are always there when we seem to want them which is very good”. Since the last key inspection improvements have been made in the medication in the home and this was evident at both this inspection and the previous random inspection. The home had introduced the Monitored Dosage System and all staff responsible for medication had received training on the administration of medication. Eleven staff out of 14 have received this training. The storage and recording had also improved greatly. Records were well maintained. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s social and cultural needs are met at the home. They were encouraged to maintain family and community links. They enjoyed a well balanced diet that reflected individual preference and specific dietary needs. . EVIDENCE: There was no written activities programme. There was a varied programme of activities which included extend exercises, Bingo, a person coming into play the organ and outings and shopping in Ruskington or a visit to the local pub twice a week. Some residents were encouraged to continue with interests and hobbies. Residents were able to see visitors in their own rooms if they wished. Changes to staff sleep-in arrangements had provided a ‘quiet lounge’, and more choice for residents. There was a cordless phone for resident’s use. This was used as a speakerphone when residents took calls in their rooms. Close links continued to be maintained with the local community by visits from local schools, clubs for older people, Brownie groups and members of the local church. On the day of the inspection there were students from a local school gaining experience with supervision in the home. They spoke of “enjoying the experience”. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 12 There was set menu with an alternative if requested and the menu was displayed in the dining area off from the kitchen. During the inspection residents spoke of having had a hot breakfast consisting of eggs, toast and cereal and were very satisfied with the food served. Comments were, “The meals are very good and we have a very good choice” and “ the meals are nicely served and hot.” The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to make a complaint and feel that staff will listen to their views. Staff are aware of how to respond to a complaint or an adult protection allegation EVIDENCE: Each person received a copy of the complaints procedure, which was in service user’s guide. Since the last inspection the complaints procedure had been reviewed. No complaints had been received by the home or the commission since the last inspection. In addition visitors books had been introduced and there were signs requesting visitors signed in and out. A sign had been put on the front of the door indicating the door was locked and asking visitors to ring the bell and a member of staff would come and see them. None of the residents or staff had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a resident. All staff were correctly recruited including a check by the criminal records bureau (CRB). Staff also received adult protection training during the induction and this was expanded in the new comprehensive induction standards for all new care workers. Staff confirmed this information and knew what abuse was and what they should do if abuse was suspected. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 14 Indirect observation made by the inspector on the day of the inspection noted that staff were polite and respectful when talking to or undertaking care duties with residents. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards.19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have taken place since the last inspection to the decoration and people lived in comfortable, clean and safe accommodation EVIDENCE: Since the last key inspection a major redecoration programme has started. This has included a new roof, outside repainting, 1 bedroom repainted and an extensive redecoration, recarpeting and new furniture and widescreen TV in the lounge (this was in progress at the inspection). A recommendation was made at the last key inspection about the provision of a sluice as commodes were being emptied in the toilet. An old WC has had a change of use to being used only for this purpose. A letter had been sent to the Environmental Health Officer with this proposal in April 2007. No reply had yet been received. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 16 There were gloves and aprons in evidence. The home was clean, tidy and odour free throughout. Residents were satisfied with the accommodation and cleanliness of the home. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 17 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the training of staff to meet the needs of the people living in the home. Staff were educated to meet and support people living in the home. EVIDENCE: The duty rotas were examined. Residents did not express any worries about the level or availability of staff. During the inspection staff were seen to promptly attend to residents needs. Staff confirmed that they were able to meet residents’ needs and spend social time with them. Night care was provided by one member of staff awake and one member of staff asleep in the home but awake if required. Training since November 2006 had included Moving and handling, Health and safety, Fire training, Adult protection, Infection control, Medication administration, Making food safe, Care planning, Dementia care and a very comprehensive First steps in induction programme. In addition, 7 staff had achieved a care qualification (National Vocational Qualifications) level 2 out of 13 care staff. In addition, 4 staff will start NVQ level 2 in the future and 4 care staff will start NVQ level 3. There had been a great deal of training taking place and staff spoke of the benefit they had gained. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 18 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): Standards 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been seen in records, policies and procedures and management systems. These show that residents’ health and general welfare and safety are promoted. The home ensures that the residents, relatives and professional visitors have the opportunity to voice their views and opinions and feedback from questionnaires. EVIDENCE: The acting manager had been in post for some years and had applied to the commission to be registered. She had a great deal of experience in delivering care to older people and was knowledgeable about age related issues. She had obtained a diploma in management and was to start NVQ level 4 in care in the future. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 19 Staff confirmed they received supervision every 6 weeks. Staff were confident and residents were full of praise for the staff, care, food and services provided by the home. Improvements had taken place with the aid of an outside consultant to the way the home was being managed. New policies and procedures had been introduced. The annual quality assurance survey was sent out in January 2007 to all residents, visitors/relatives and professional visitors. 100 response was received and a detailed report was shown to the inspector. Questions covered decoration, general appearance, meals and staff. Residents and relatives rated the appearance 84 to 92 and meals 88 to 96 . Professionals rated the appearance 70 , how they were greeted 85 and the staff 85 to 90 . A senior care assistant also monitored the medication every month. The home was to receive a quality assurance visit by Lincolnshire County Council’s quality assurance Dept. on the 5/7/2007. There was to be a training course on equality and diversity on the 22/5/2007. The manager showed knowledge of the subject. There were no communication problems or issues of concern. The manager wanted to further develop the communication throughout the home. Since the last key inspection improvements had also taken place in the way resident’s money was being handled. Formal records were now being kept. The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 20 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 3 x x N/A 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 2 x 3 x 3 x x 3 The Chestnuts DS0000002439.V335225.R01.S.doc Version 5.2 Page 21 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.V335225.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000002439.V335225.R01.S.doc Version 5.2 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. 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