Inspection on 27/02/06 for The Chestnuts

This inspection was carried out on 27th February 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 19/12/06

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 Stephen French Unannounced Inspection 27th February 2006 09:15 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 DS0000006173.V285880.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. DS0000006173.V285880.R01.S.doc Version 5.1 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 DS0000006173.V285880.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate a maximum of 5 persons in category TI(E) (Terminally Ill - Older People) at any one time. 27th July 2005 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. DS0000006173.V285880.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, which took place on the 27th February 2006. The inspection was conducted over a five-hour period and included a tour of the home, examination of service users and staff records and conversations with service users and staff. Not all of the standards were assessed on this visit as most of the core standards were covered in the previous inspection. Service users spoken to said that the staff treated them with respect and were very nice. They were happy with their accommodation and they are able to exercise choice in most things they do. During the inspection it was noted that care plans did not always reflect the current health care needs of the service user, and these need to be more specific in the detail. The overall care the service users receive is of a very good standard. What the service does well: What has improved since the last inspection? The home now completes a formal pre-admission assessment on all prospective service users. DS0000006173.V285880.R01.S.doc Version 5.1 Page 6 Staff now record the stock balances on all medication brought into the home. 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. DS0000006173.V285880.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 DS0000006173.V285880.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): 3 Service users needs are assessed prior to them moving into the home. EVIDENCE: Prior to a service user being admitted to the home the home receives a Community Care Assessment, which has been completed by the service users social worker. The manager and deputy manager then visits the service user in their own home or hospital and completes a pre admission assessment. Once the assessment is completed a decision is made as to whether the home is able to meet the service users needs. At the moment the home does not write to the service user confirming that the home can meet their needs. Completed pre admission assessments were seen for two service users recently admitted to the home. DS0000006173.V285880.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): 7,9, Care plans within the home ensure that the service users physical and social needs are met, however these need to be more specific in their actions. Risk assessments were not always completed fully or reviewed. The administration of medication is carried out safely. EVIDENCE: Each service user has a care plan, which has been developed from information gathered from the community care and pre admission assessment. Staff also discuss with the service user and their relatives what support they require. Five service users care files were examined and these included such things as risk assessments for moving and handling and skin integrity. Care plans were not always developed for problems identified by the risk assessments. One file examined identified that the service users nutritional status was compromised, but the care plan, which was in place was not specific in the actions staff were to take to prevent further deterioration in the service users health. It was also noted that the home did not have a nutritional assessment in place for any of the service users. DS0000006173.V285880.R01.S.doc Version 5.1 Page 10 Service users whose skin assessments were scored high did not always have a care plan in place. A plan should be in place, which would alert staff of the need to evaluate and put into place actions to prevent further deterioration in the service users skin condition. Although moving and handling assessments were in place, some did not reflect the service users current ability to mobilise and did not direct staff in what support was required. Qualified nursing staff are responsible for the administration of medication. Service users are able to continue to self medicate, if they wish, following a risk assessment. The balances of three service users medication was checked against the medication records held by the home and the balances tallied. It was noted that a recommendation regarding the recording of stock balances of medication had been actioned following the previous inspection. DS0000006173.V285880.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Not assessed during this inspection. DS0000006173.V285880.R01.S.doc Version 5.1 Page 12 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): EVIDENCE: Not assessed during this inspection. DS0000006173.V285880.R01.S.doc Version 5.1 Page 13 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): 20,21,22,23,24,25,26 Service users live in safe, comfortable, homely surroundings, which meets their needs. The home was clean and fresh. EVIDENCE: As part of the inspection, a tour of the home was conducted and this included a number of service users bedrooms and communal lounges and the dining room. Service users bedrooms were personalised with pictures, ornaments and small pieces of furniture. Service users who are dependant on staff to meet all of their personal needs were nursed on specialist beds and mattresses. There was a variety of moving and handling equipment, which included hoists and slide sheets. Service users spoken to said that the home was very comfortable and homely and that they could choose which lounge they spend their day in. There are communal bathrooms and toilets within close proximity to service users bedrooms and lounge areas. DS0000006173.V285880.R01.S.doc Version 5.1 Page 14 The standard of cleanliness throughout the home was very good and there were no unpleasant odours detected in any part of the home. DS0000006173.V285880.R01.S.doc Version 5.1 Page 15 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): 29,30 The home has a robust recruitment and selection policy and new staff receive appropriate training to ensure they are confident and competent in their role as a carer. EVIDENCE: The manager or her deputy is responsible for the recruitment and selection of staff. Four staff details were examined and the files contained application forms, references and confirmation that checks had been made for each staff to ensure they did not appear on the criminal records bureau or the protection of vulnerable adults register. New staff receive Induction training within six weeks of employment this ensures that they are aware of the needs of the service users and the policies and procedures of the home. They also receive moving and handling, fire awareness and health and safety training. DS0000006173.V285880.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): 31,32,33,34,36,37 The home is well managed and the views of the service users and their families are acted upon. Staff receive formal supervision at least six times per year. EVIDENCE: The manager is a qualified nurse and has been employed by the home since 1999. She has commenced the Registered Managers Award and is aware of the aims and objectives of the home. She is supported in her role by a deputy manager, who also has many years experience in working with older people. The manager operates an open door policy and relatives and service users are able to discuss any issues they may have. Service users spoken to said that the manager was always available to chat to if they had any problems and they were confident that any issues they brought up would be addressed. DS0000006173.V285880.R01.S.doc Version 5.1 Page 17 The deputy manager is responsible for completing staff supervision, which they receive six times per year. The supervision session’s cover all aspects of care and the training needs of the individual is identified and outcomes are recorded. Supervision records were checked for four staff and these confirmed that staff are receiving the appropriate supervision. Records seen on the day of the inspection were up to date and stored correctly. DS0000006173.V285880.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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 3 3 x DS0000006173.V285880.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No DS0000006173.V285880.R01.S.doc Version 5.1 Page 20 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 2 Standard OP3 OP7 Regulation 14 (1)d 15(2)b Requirement The manager should confirm in writing to the service user that the home can meet their needs. Where there is an identified risk then a care plan should be in place, which should be kept under review. Timescale for action 31/05/06 31/05/06 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 Refer to Standard OP7 Good Practice Recommendations Nutritional risk assessments should be completed for all service users and should be reviewed monthly. Old notes should be removed from the care files and stored separately. The date of opening should be recorded on G.T.N sprays To ensure they are not used after 28 days of opening. The underside of the bed identified during the inspection should be repaired. 2 3 OP9 OP24 DS0000006173.V285880.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 DS0000006173.V285880.R01.S.doc Version 5.1 Page 22 - 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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