Inspection on 07/09/07 for The Chestnuts Care Home

This inspection was carried out on 7th September 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 Care Home 09/05/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Chestnuts Care Home St Peters Road Arnesby Leicestershire LE8 5WJ Lead Inspector Kim Cowley Unannounced Inspection 7th September 2007 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 Care Home DS0000064773.V342061.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 Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Chestnuts Care Home Address St Peters Road Arnesby Leicestershire LE8 5WJ 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) 0116 247 8672 F/P 0116 247 8672 Chestnuts (Arnesby) Limited Mrs Priscilla Hazel Squires Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Where there are 15 people accommodated in the home within the category of OP, no further persons may be admitted under this category. 9th May 2006 Date of last inspection Brief Description of the Service: The Chestnuts is a 15-bedded home for older people situated in the village of Arnesby. The accommodation is a detached period property. On the ground floor there is a large beamed L-shaped lounge and dining room. There are 11 single bedrooms and two doubles on the ground and first floors. The home overlooks Arnesby village green and is close to the local post office. Patio gardens with seating areas surround the home. Weekly buses run through Arnesby to Leicester and Market Harborough. Current fee levels at the home range from £325 to £455 per week depending on care needs. Inspection reports are available at the home, or can be accessed via the CSCI website: www.csci.org.uk. Further information about the home is available from the Registered Manager. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, the inspector spent half a day reviewing information relating to the home. During the course of the inspection, which lasted four hours, the inspector checked the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means the inspector looked at the care provided to three residents living at the home by meeting them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were examined. The inspector also met four other residents, one visitor, the Manager, and two members of the care staff team. What the service does well: The Chestnuts provides a homely environment for residents. It is well run and has a family atmosphere. Relationships between residents and staff are excellent. All residents interviewed praised the home and said they were happy living there. One resident said, This home is fantastic - nothing could be improved on, another commented, This place feels very homely, theres a lovely atmosphere. The Chesnuts provides exceptionally homely and comfortable accomodation in a detached period property. All residents interviewed said they like their bedrooms. One said, The rooms are lovely and a good size, another commented, ‘My bedroom is beautiful and very cosy. The staff keep it very clean.’ One resident, who was sitting outside during the inspection, said how pleasant the gardens were. Residents are offered a range of recreational and social activities including, armchiar exercise classes, old time sing-a-longs, bingo, coffee mornings, and shopping trips. Families and friends are encouraged to visit at any time and to have meals with residents if they wish. One visitor said, Im made very welcome here. I always get offered a piece of cake and a cup of tea when I arrive. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 6 The home has a full-time cook who has worked at the home for 15 years. Healthy eating is encouraged and most food served is homemade. Shopping is done in the village and at local supermarkets and includes local produce. A resident commented, The meals are ever so good. A visitor said, Since my relatives been here hes put on weight and looks good. The Chestnuts has a friendly and welcoming atmosphere and the staff are caring and professional. All residents interviewed praised the staff team and the following comments were made, The staff are very nice, if you want help they help you, The staff are so kind - theyd do anything for you, and, ‘The staff look after us ever so well. They couldnt look after us better. What has improved since the last inspection? Parts of the premises have been redecorated and ‘Environment’) and new equipment has been purchased. refurbished (see Staff have successfully completed NVQ Awards in Care and other relevant courses. Over 50 of staff are now tranined to NVQ Level 2 or above. 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 Care Home DS0000064773.V342061.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 Care Home DS0000064773.V342061.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): Quality in this outcome area is good. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. This judgement has been made using available evidence including a visit to this service. (Standard 3 was inspected.) EVIDENCE: The Manager or her Deputy assesses all potential residents in their own homes or in hospital. Assessments are recorded and include the views of residents, their families, and any other carers. Visits to the home are encouraged and residents can come for a meal or stay overnight, depending on their wishes. Some come for respite prior to moving in. Three assessments were examined and found to contain all the necessary information. The assessment process helps to ensure the home is suitable for particular residents and that staff can care for them properly. Residents’ comments on choosing the home included: The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 9 My doctor put me on to this home. I went round looking at homes with my relatives and found this one. When I looked round the staff were happy to show us everything. A visitor said, What I like about this home was when we phoned up to look round the staff said Come any time you like - other homes told us to make an appointment. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Staff in the home, and in the wider community, meet residents’ health and personal care needs. Some care plans are in need of improvement. Medication is safely managed and administered. Residents are treated with respect. This judgement has been made using available evidence including a visit to this service. (Standards 7, 8, 9, and 10 were inspected.) EVIDENCE: Three residents’ care records were inspected in detail. They included useful information about residents, for example their likes and dislikes, and the level of their family’s involvement. Good detailed risk assessments were also in place, and all information had been regularly reviewed. Care plans are in need of improvement. Those inspected were basic and in some cases instructions to staff were vague. One resident suffering from confusion did not have a care plan in place for this. Care plans must be rewritten where necessary to provide more detailed information as to how care should be given. Particular attention must be paid to high-risk areas, for example mobilising. This will help staff to provide the best possible care to the residents accommodated at the home.are plans are in need of improvement. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 11 Those inspected were basic and in some cases instructions to staff were vague. One resident suffering from confusion did not have a care plan in place for this. Care plans must be re-written where necessary to provide more detailed information as to how care should be given. Particular attention must be paid to high-risk areas, for example mobilising. This will help staff to provide the best possible care to the residents accommodated at the home. Care records showed that residents’ care health needs are monitored and there is input from GPs, District Nurses, and other health care personnel where necessary. GPs hold a surgery opposite the home once a week. Private chiropody is available in the home for £8.00 per session. Senior carers who have been trained in-house by the Manager or Deputy administer medication. There are written procedures for staff to follow when carrying out this task. The home’s contract pharmacist provides advice and training to the staff on request. At present no residents self-medicate. Staff attitudes towards residents were excellent. Staff were respectful to residents, and patient and professional when requests were made to them. The routine in the home is flexible and residents choose when they get up, go to bed, or have their meals. One resident commented, I say when I want to go to bed. Sometimes I stay up late to watch televison. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents have the opportunity to take part in a range of activities. Visitors are made welcome at the home and residents are pleased with the food provided. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 14, and 15 were inspected.) EVIDENCE: Residents are offered a range of recreational and social activities including: Armchair aerobics Old time sing-a-longs Bingo Coffee mornings Shopping trips Visits to local fetes Individual activites (for example crochet and music) Church attendance Aromotherapy All residents interviewed said they were satisfied with the activities provided. Comments included, I like it when the organist comes to entertain us, ‘There’s The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 13 lots to do here’, and, Its lovely to sit outside in the garden with a blanket over my knees to keep me warm. Families and friends are encouraged to visit at any time and to have meals with residents if they wish. One visitor said, Im made very welcome here. I always get offered a piece of cake and a cup of tea when I arrive. The home has a full-time cook who has worked at the home for 15 years. Healthy eating is encouraged and most food served is homemade. Shopping is done in the village and at local supermarkets and includes local produce. A resident commented, The meals are ever so good. A visitor said, Since my relatives been here hes put on weight and looks good. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents feel able to talk to staff about any concerns they might have. This judgement has been made using available evidence including a visit to the service. (Standards 16 and 18 were inspected.) EVIDENCE: The home has a complaints procedure that is made available to residents and visitors and displayed in the entrance hall. All residents interviewed said they would be happy to speak out if there was anything bothering them. The following comments were made: If there was anything wrong Id tell the Manager. If I was unhapy about something Id tell my relatives and theyd go to the Mananger. If I had a problem Id tell the Manager and if she wasnt here Id tell a member of staff - theyd sort it out. The home’s ‘Safeguarding Adults’ procedure has been reviewed and improved so it gives clearer instructions to staff about what steps to take if abuse is suspected. The Chestnuts Care Home DS0000064773.V342061.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): Quality in this outcome area is excellent. The Chestnuts provides homely, comfortable and clean accommodation for residents. This judgement has been made using available evidence including a visit to this service. Standards 19 and 26 were inspected. EVIDENCE: The Chesnuts provides exceptionally homely and comfortable accomodation in a detached period property. On the ground floor there is a large beamed Lshaped lounge and a beamed dining room. There are bedrooms on the ground and first floors, 11 of which have ensuite facilities. Patio gardens with seating areas surround the home. One resident was sitting outside during the inspection and said how pleasant the gardens were. All residents interviewed said they like their bedrooms. One said, The rooms are lovely and a good size, another commented, ‘My bedroom is beautiful and very cosy. The staff keep it very clean.’ The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 16 Since the last inspection the following improvements have been made to the premises: • • • • • • • The exterior of the home has been painted New windows have been fitted One bedroom has been refurbised A new washing machine and tumble dryer have been supplied A ‘standaid’ hoist has been purchesed Radiators have been covered There are new carpets in some areas The kitchen is in need of some improvement as some of the cupboards are chipped and the central table is worn. This should be considered as part of the home’s ongoing improvement plan. The home employs a part-time cleaner. All areas inspected were cleaned to a high standard. The Chestnuts Care Home DS0000064773.V342061.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): Quality in this outcome area is excellent. An established team of friendly and professional staff provide care to residents at the home. This judgement has been made using available evidence including a visit to this service. (Standards 27, 28, 29, and 30 were inspected.) EVIDENCE: The Chestnuts has a friendly and welcoming atmosphere and the staff are caring and professional. All residents interviewed praised the staff team and the following comments were made: The The The The staff staff staff staff are very nice, if you want help they help you. are so kind - theyd do anything for you. look after us ever so well. They couldnt look after us better. are kindness itself. Staff employed include the Manager, her Deputy, carers, a cook, a cleaner, and a maintenance man. There are satisfactory staffing levels during the day and at night, with additional staff on call. The Manager said, ‘Residents are part of a family here. Members of staff visit when they’re not working and also bring their families to visit. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 18 The staff team is established, the majority having been at the home for over eight years, and turnover is low. This means residents have continuity of care and get to know the staff well. Staff receive good training opportunities. Since the last inspection the Manager has achieved the Registered Managers Award and the NVQ Assessors Award. Four staff have passed NVQ 2 and five have passed NVQ 3. Staff have also attended courses in Moving and Handling, Food Hygiene, First Aid, and Fire Safety. Staff recruitment procedures and records were inspected. The Manager confirmed that appropriate checks, inlcuding POVA and CRB, are carried out for new staff and two references obtained. All staff undergo an induction and forms for recording this have been introduced. This will help to ensure that staff are competant in all the areas they work. Staff do not receive regular formal supervision, although the Mananger meets with them on a one-to-one basis if necessary. No records are kept of these meetings. This was discussed with the Mananger and she agreed to keep a record in future as this will assist in staff monitoring and development. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. Residents live in a home that is safe and well managed. This judgement has been made using available evidence including a visit to this service. (Standards 31, 33, 35 and 38 were inspected.) EVIDENCE: The Manager has been in post for 14 years. She is dedicated to the home and its staff and residents, and works hard to ensure the care provided is of a good standard. Since the last inspection she has competed her NVQ Level 4 Registered Managers Award and NVQ Assessors Award. Her Deputy has completed NVQ Level 3 in Care. All residents and staff interviewed praised the Manager and said she was approachable and caring. An annual quality assurance questionnaire is sent out to residents and relatives. Responses were inspected and seen to be good. One relative wrote, The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 20 ‘We have been coming here for ten years in total and have always found it very comfortable with caring staff.’ Staff will look after small amounts of cash for residents with appropriate records kept. Records showed that policies and procedures are in place to protect the health, safety and welfare of residents and staff in the home. Since the last inspection radiators have been covered and thermostats fitted. The Manager and Deputy have been on a Fire Safety course and the home’s Fire Risk Assessment (dated 25.07.06) has been reviewed and approved by the Fire Department. The home’s Environmental Health Officer has visited and made a few recommendations, all of which have been met. These actions will help to keep the home safe for residents and staff. The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 21 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 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Chestnuts Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 22 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(1) Requirement A care plan must be put in place detailing each resident’s identified needs. This will help to ensure all needs are met. Timescale for action 07/10/07 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 Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Care Home DS0000064773.V342061.R01.S.doc Version 5.2 Page 24 - 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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