Inspection on 08/11/05 for The Chimes

This inspection was carried out on 8th November 2005.

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 Chimes 30/07/08

The Chimes 30/07/07

The Chimes 21/06/06

The Chimes 02/12/04

The Chimes 24/06/04

The Chimes 18/04/04

The Chimes 26/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Chimes 6 St Christopher Avenue Penkhull Stoke-on-trent Staffordshire ST4 5NA Lead Inspector Rachel Davis Announced Inspection 8th November 2005 09:30 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 Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Chimes Address 6 St Christopher Avenue Penkhull Stoke-on-trent Staffordshire ST4 5NA 01782 744944 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr William Molton Mrs Marilyn Molton Mr William Molton Care Home 28 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (28), of places Physical disability over 65 years of age (3) The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd December 2004 Brief Description of the Service: On the day of inspection there were 25 service users residing at The Chimes. The home is a large, extended detached property located in a residential area in Penkhull. Local amenities are within a short walking distance. Local towns are accessible by car or public transport. The exterior of the property at the back of the home has been painted and the window frames have been repaired or renewed as needed. The interior of the property is adequately maintained and redecoration is taking place in a number of areas. The service users are offered easy access throughout the home by the use of stairs or a lift. Communal areas are spacious and comfortable; there are two lounges, which can be opened into one if required. The dining room is well maintained, sizeable and sited next to the kitchen. Small, quiet sitting areas are available on all floors. There are 26 single rooms, 12 with en-suite facilities and one double room with an ensuite. Bathrooms and toilets are appropriately situated. There are garden areas for service users and their visitors to use with the appropriate seating facilities. Adequate parking is available to the rear of the property. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one day by two inspectors; during the afternoon only one inspector was on the premises. A tour of the home was undertaken; a large number of service users, staff and the manager were spoken to. Care plans and some staff records were examined. Information was crossreferenced to reaffirm evidence. Staff practice was observed throughout the inspection. Nine service user comment cards were returned to the inspector, as were seven relative and visitor questionnaires, the inspector also received a response from one doctor and one nurse. The findings of these can be seen below. The inspector has also carried out two additional visits to the home since the last inspection held in April 2005 to ensure compliance with regulations and requirements. These were undertaken on 18 July 2005 and 6th September 2005. Medication administration practice was unsafe and placed both staff and service users at risk, this has now been resolved and a robust system is in place. The senior staff and the manager have also undertaken additional training in this field. On the second additional visit it was very pleasing to note that the vast majority of requirements had been addressed and it was evident that the home had worked hard to comply with legislation. Five requirements and four recommendations have been made following this inspection. This was deemed a very positive inspection. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 6 What the service does well: The home provides a good standard of residential care, for older people and people with dementia related conditions, in a homely atmosphere. Staff interaction with service users was very good and there was a high level of satisfaction from those living at The Chimes. Responses to questionnaires were very positive examples include: “The home is very clean and the staff are very caring” “Extremely friendly and supportive manager.” “Excellent patient care.” “The Chimes is always clean and bright” All relatives felt they could visit the home at any time; they stated they were made welcome and kept informed of important matters. Everyone who responded thought The Chimes had sufficient staff; they were aware of the complaints procedure and had access to the inspection reports. Service users confirmed that they liked living there, were well cared for and safe, they felt the staff treated them well and that they enjoyed the food. Over 50 when asked, does the home provided suitable activities replied – sometimes. Reference to this is made under what the home could do better. During the inspection service users spoke highly of the care staff team and respectful attitudes were observed. Staff were heard offering choice and enabled the service users to make decisions and as many choices as they were able in their daily lives. The care team and service users spoke well of the manager, direct observation and information from visitors confirmed that open, reliable and helpful connections were in place. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 7 What has improved since the last inspection? The manager has now met all the requirements made from previous inspections. A lot of effort had taken place to improve the care planning processes within the home, systems have been updated and more information is readily available to the staff team. The registered person has provided the Commission with an external and internal maintenance programme. There was evidence to verify that a lot of work has been, and continues to be undertaken both internally and externally. Bedroom carpets have been replaced and commodes that were corroding have been condemned. The painting of corridors and stairs has started and the carpet has been repaired on the first floor landing. Externally the back of the property has been repainted and the window frames repaired where needed. The home has amended their complaints procedure to ensure it meets the legal requirements. The home can actively demonstate its ability to meet the needs of service users with dementia. The home now ensures that staff adhere to the policies and procedures relating to the receipt, storage, recording, handling administration and disposal of medication. All radiators are guarded. The completion of risk assessments is much better, the home ensures it works within a risk assessment framework and the recording of such is satisfactory, staff awareness has also improved. The registered manager has completed the required managers qualification and is just waiting for verification and his certificate. The home has chosen to implement all six recommendations that were made at the last inspection. The relationships and day to day running of the home between the manager, staff and service users continues to improve. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 8 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 Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 9 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 Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. The statement of purpose and service user guide provided adequate information for permanent and prospective users to enable them to make an informed decision about the suitability of the home. Contracts were provided to service users prior to moving into the home. EVIDENCE: The revised Statement of Purpose and Service User Guide was examined and it was clear that a considerable amount of work had been undertaken to provide an informative and detailed document that would assist potential service users when considering moving into the home. However, some slight amendments were required and it is a requirement that reference is made to the relevant qualifications and experience of the registered provider/manager and a recommendation that the reference to National Care Standards Commission within the document is changed to Commission for Social Care Inspection. A sample of the standard occupancy contract was provided to the inspector and the terms and conditions within it were seen to contain all required elements as set out in the National Minimum Standards for Older People. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 11 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 and 8. The care planning processes within the home were clear and concise providing adequate information for staff to meet the needs of the service users. The admission sheets could be further improved to ensure more in-depth recording of needs, and risk assessments should be reviewed regularly. EVIDENCE: A number of service user care plans were examined and each contained a photograph of the service user, an admission assessment, health, social and personal care needs, daily reports and risk assessments. Overall, the care plans were well documented and provided a meaningful record for staff of the service users current needs. Each care plan was reviewed monthly, but the risk assessments, which were seen to be detailed and well laid out, had not been reviewed for some time. Therefore it is a requirement of this report that pertinent risk assessments are reviewed monthly for each service user. In addition to this, the admission documentation would benefit from a review and it is recommended that this be further developed to provide a stronger foundation for the care plans. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 12 The health care needs of the service users were also well documented and up to date. There was extensive evidence to show that service users had access to a wide range of health professionals such as the optician, Parkinson’s clinical nurse specialist, chiropodist, district nurses and the doctor. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15. Visitors are made welcome and various avenues for encouraging service user choice were in place. Stronger emphasis could be placed on more structured activity planning and the recording of such. EVIDENCE: Discussions with service users confirmed that the activities within the home were suitable to meet some needs, however, others commented that they would like to see more activities available. The inspector was shown ‘The Chimes Newsletter’ by one of the service users in the home which had been put together by staff. This was bright, and informative and provided a humorous and personal communication for the service users and their relatives. The newsletter included ‘what’s new’, photographs of service users enjoying a recent day trip, regular and special events such as forthcoming entertainers and a record of a notable event where the proprietor caused much hilarity, according to the service users, by coming to work in fancy dress! Service users and staff birthdays were also recorded in the newsletter for the period from October to December, plus a ‘wordsearch’ for leisure time, impending staff changes and an article called ‘Residents Voice’. The staff were to be commended for the time and effort in putting together this newsletter which clearly impressed the service users. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 14 Discussion with service users evidenced that service users do not have to join in activities if they do not wish to. One service user told the inspector that “I like to stay in this room with my friends and watch the others do things instead”. Another service user said she preferred to stay in her room and staff supported her decision. Service users also confirmed that they attended regular Holy Communion services within the home. A number of service users made similar comments about how much they liked the staff and Mr Molton, ‘Bill’ in particular. One service said: “he has a really good sense of humour and makes us laugh so much”, another said: “he sometimes sings out loud and we all join in”. Comments from service users were very positive about the food and one lady said “I have been here for over three years and I have never had a bad meal yet!” The home is now aware of the need to offer a light supper for those who choose thus ensuring that service users do not exceed a 12 hour period without the a snack. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 – 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Service user complaints were listened to, and action was taken to resolve the complaints as quickly as possible. EVIDENCE: A number of service users spoken to stated that they did not have any complaints about the service within the home. One lady said: “No complaints at all, the staff are really good”. They also confirmed that if they did have a complaint, they were certain that their complaints would be listened to and resolved if at all possible. The Commission for Social Care Inspection have undertaken two complaint investigations since the last inspection held in April 2005. One of these was partly upheld the other was not upheld. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 16 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): 19, 21, 24, 25 and 26. Redecoration and repair had taken place at the rear of the home and improved the environment for residents and relatives alike. The front of the home still required attention. Internally, the home is up to a safe and acceptable standard. EVIDENCE: The Chimes makes it clear which clientele the home is aimed at and has suitable facilities for service users with dementia, small areas are available within the home where they can eat, relax and wander if they so choose. Suitable security systems are in place to meet the needs of those residing at The Chimes. A large notice board sited in the hall offers service users and their family and friends up to date information on activities, outings and church services. It also has a number of photographs attached and a copy of the newsletter with the most recent inspection report also attached. The dining room has a white board where the meal of the day and the alterative is displayed. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 17 A tour of the home evidenced that all radiators have now been covered for the safety of the service users and the registered care manager confirmed that some of these covers were due to be painted by the home’s maintenance person shortly. Bedrooms were personalised and decorated to a reasonable standard. There was some slight malodour in two bedrooms but overall, the home was very clean. It is a requirement of this report that the home is kept free from offensive odours at all times. All bedrooms were seen to contain adequate numbers of sockets, smoke detectors and wardrobes were restricted and safe. Overall, a satisfactory standard of furnishings and fittings were witnessed and each room contained a locked drawer facility to hold medication or money, if the service user had been risk assessed as safe to self medicate or able to manage their own finances. One service user presently chooses to hold a key for their bedroom door. A range of personal items were seen in each room belonging to individual service users. Two bedrooms have been completely redecorated since the last inspection. There are ample and adequate toilets and bathrooms within the home on every floor. Standards have much improved and the majority of staff have undertaken infection control and health and safety training. It was noted in a number of toilets that locks were not available, this needs to be rectified so that every individuals’ privacy needs can be met. Externally, the windows at the rear of the home had been repaired and painted. The quality of the work had significantly raised the profile of the home and the registered manager confirmed that the front of the home would be completed in the same way once the weather improved. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29. Staffing numbers and skill mix were appropriate to the needs of the service users. The procedures for the recruitment of staff were robust and contributed to the protection of service users. EVIDENCE: Discussion and observation revealed that the staffing levels were appropriate. On duty were four care staff, one senior care, the manager, a cook, one kitchen assistant and one cleaner. The home had a vacancy for a cook (24 hours); there are no care worker vacancies to be filled presently. An examination of staff files evidenced that recruitment and selection processes had been handled correctly. One of the proprietors confirmed that significant efforts had been made to improve the processes to provide continuous protection for the service users. Files showed that staff had been subject to Protection of Vulnerable Adults and Criminal Record Bureau comprehensive checks. Files evidenced records of the interviews, two references and a contract of employment. Qualifications and training history were also included. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38. All aspects of the health, safety and welfare of both service users and staff were protected and maintained correctly. EVIDENCE: Since the last inspection the manager, Mr William Molton has completed the Registered Managers Award. Completing this award helps to ensure that a competent skilled manager is in place who is adept at fostering an atmosphere of openness and respect, in which service users, family, friends and staff all feel valued and that their opinions matter. One of the senior care assistants is enrolled to start on the next available National Vocational Qualification level 4 (NVQ4)training programme. The inspector examined a range of records and documentation which evidenced that the health, safety and welfare of service users and staff were protected. Fire safety records show that fire drills took place every 13 weeks The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 20 and Fire Officers, as part of the ‘Fire Safety in Residential and Nursing Homes’ training course provided a fire prevention booklet for all staff in the home. Records showed that fire safety training had recently been carried out for staff on 7th October 2005, fire alarm/detector testing was carried out by an accredited company on 10th August 2005, fire extinguisher maintenance due December 2005 and the home’s fire risk assessment was reviewed November 2005. Other records seen were: Landlord Gas Safety Check 18th October 2005 Food Safety Inspection 2nd December 2004 Electrical Inspection 19th August 2005 Disabled Aids Service 17th November 2005 Wheelchair Service 6th October 2005 PAT appliance check 1st October 2005 Hot water checks completed weekly. Records also showed that the registered manager ensured safe working practices took place in the home. Policies were examined by the inspector and signatures of staff were recorded as evidence of staff having read and understood the content of the following policies: Abuse Guidance September 2005 Whistle-blowing September 2005 Confidentiality October 2005 Infection Control October 2005 Fire Safety October 2005 There were general risk assessments in place, these had all been reviewed by the registered manager in October 2005. The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 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 2 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 2 X X 3 3 2 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 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 OP1 Regulation 4(1)(c) Schedule 1 Requirement The registered manager must ensure that reference is made to the relevant qualifications and experience of the registered provider/manager in the Statement of Purpose. The registered manager must ensure all necessary risk assessments to be reviewed each month. The registered manager must ensure that service users receive a snack in the evening, the interval between this and breakfast the following morning must be no longer than 12 hours. The registered manager must ensure that a lock is available on all toilet doors. The registered manager must ensure the home is free from offensive odours at all times. Timescale for action 07/12/05 2. OP7 15(2)(b) 07/12/05 3. OP15 16(2)(i) 14/11/05 4. 5. OP21 OP26 12(4)(a) 16(2)(k) 18/11/05 14/11/05 The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 23 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 OP1 Good Practice Recommendations The registered manager should ensure that reference to the National Care Standards Commission, within the Statement of Purpose and Service User Guide be changed to Commission for Social Care Inspection. The registered manager should review the admission documentation to provide a stronger foundation for the care plans. The registered manager should consider introducing resident relatives meetings. The registered manager should consider a more efficient and effective system in the laundry. A sluice facility within the washing machine needs to be in place when it is next replaced. 2. 3. 4. OP7 OP12 OP26 The Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Chimes DS0000008211.V259661.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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