Inspection on 07/06/05 for The Chestnuts

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 24/05/07

The Chestnuts 13/11/06

The Chestnuts 25/05/06

The Chestnuts 16/01/06

The Chestnuts 30/09/04

The Chestnuts 21/07/04

The Chestnuts 08/03/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 The Chestnuts (Welcome House) Watts Avenue (10) Rochester Kent ME1 1RX Lead Inspector Sarah Montgomery Unannounced 7 June 2005 11.15am 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Chestnuts (Welcome House) Address Watts Avenue (10) Rochester Kent ME1 1RX 01634 842084 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dr Toqeer Aslam Care Home only 15 Category(ies) of MD Mental Disorder (15) registration, with number of places The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 September 2004 Brief Description of the Service: The Chestnuts is a registered care home for adults with mental health problems. It has registration for 15. A staff team consisting of a Home manager, Deputy Manager, and a support worker, supports Service users. The home is a large detached property with accommodation over two floors. Communal areas include a large lounge, a dining room and kitchen. The home is close to Rochester town centre and has a selection of local shops and services nearby. The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on June 7th 2005. The inspection focussed on service user assessment, staffing hours, and recruitment and selection. What the service does well: What has improved since the last inspection? What they could do better: Service users would benefit if the home increased staffing numbers. Individual and collective needs of service users are not being met due to insufficient staffing. Current recruitment practice is poor and does not protect service users. The home must ensure that they are in receipt of acceptable references and a CRB check prior to staff taking up employment. The home must also ensure that all staff receive a thorough induction. Service user care and support would be enhanced if the home ensured that pre assessment documentation was completed thoroughly. The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 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 (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2. Service users cannot be confident that their individual aspirations and needs are assessed. EVIDENCE: The inspector spoke with a service user who had recently moved to the home. With the service user’s permission, the inspector and service user looked at the pre assessment information the home had gathered prior to admission. Although the home had clearly gathered some information, large gaps on the pre assessment documentation were present; There was no photograph of the service user, notable events (anniversaries, hobbies, previous work) had not been filled in, nor had the summary sheet of care needs been written. A general risk assessment had been completed, but gave little indication as to the risk. No description accompanied the answer of ‘yes’, and staff and other professionals would be unable to know any triggers or proposed actions in response to managing risk. To enable the process of care planning, and determining the placement will meet individual service users needs, it is imperative to have an assessment procedure which is thorough and fully records all information. The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 34. Service users cannot be confident that they will be supported by a competent or effective staff team. Service users are not supported or protected by the homes current recruitment practices. EVIDENCE: “We are very short staffed. There are only two staff looking after us. Usually there are four. Staff don’t stay long”. This is a direct quote from a service user. The rota was inspected. The home is inadequately staffed to meet the needs of service users. During the week two members of staff are on duty between the hours of 9am and 5pm (one being the registered manager). From 5pm until 9am the following morning, one member of staff is on duty. At weekends only one member of staff is on duty. The home is significantly understaffed. There are two vacancies. At present, just three members of staff work at the home. A file of the most recently employed member of staff was inspected. This staff member is also the ‘live in’, and undertakes sleep in duties every night. The file had significant shortfalls, in that, large gaps in employment were unexplained, with no indication that the employers had sought clarity on this The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 15 issue. There were no references on file, and no indication (letters) that any references had been sought. There was no CRB. This member of staff had no experience of working with people with mental health problems, yet she received no induction, and from the first day of work (30th May 2005) she had worked alone on every shift, including sleeping in. Her total hours for the first week were 53. On the second week of work this staff member was on the rota every day and sleeping in every night. The home has failed in the first instance to protect service users by not ensuring references and a CRB check were sought. The home has further failed to protect service users by allowing a member of staff to work alone without any induction or training, or allow for any time spent with service users. The registered manager and registered provider must ensure that these shortfalls are attended to without delay. The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 1 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x 1 1 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Chestnuts (Welcome House) Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 18 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. 1. 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. 1. Refer to Standard Good Practice Recommendations The Chestnuts (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 19 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane, Maidstone Kent. 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 (Welcome House) H56-H06 S28336 The Chestnuts V224124 070605 Stage 2.doc Version 1.30 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!