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Inspection on 18/05/05 for The Chimneys

Also see our care home review for The Chimneys for more information

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a very friendly atmosphere and is welcoming to the resident`s, the staff and visitors. The new providers have made improvements in the communal rooms that have really made a difference to the resident`s comfort. The manager insists on a high standard of care and the staff are confident in their leadership. The residents are treated as individuals and their wishes are respected. The staff know each resident very well and the residents are fond of the staff. The residents are very positive about being able to choose how they spend their time and they do not want organised activities, although the manager arranges trips out based on the interests of the residents, for example, one resident has been to the garden centre and another to a town that they know.

What has improved since the last inspection?

The care plans, which document information about each resident and inform the staff about the care they need have been improved. They are now much more focused on each resident`s likes and dislikes. The new providers have made improvements in the communal rooms that have really made a difference to the resident`s comfort. The manager has made improvements to the records that are kept in the home and the residents are consulted regarding the records kept about them.

What the care home could do better:

The manager needs to improve the staff guidance about the reasons they give some medication. This is so the staff know why and when to give medication that is prescribed to give as required` such as painkillers. The manager is aware that they need to start regular formal supervision of the staff, even though they do work alongside staff and monitor the way they work. The owners need to make changes to the electrical installations following a recent inspection. There is a plan to improve the home further and some of the electrical fixtures need to be mended urgently and some can be done over a longer time.

CARE HOMES FOR OLDER PEOPLE St Oswalds Rest Home 1 Station Road Alford Lincoln LN13 9HY Lead Inspector Kima Sutherland-Dee Unannounced 18 May 2005 10.00 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 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. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Oswalds Rest Home Address 1 Station Road Alford Lincolnshire LN13 9HY 01507 462789 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) Miss Victoria Jacklin, Mr Phillip Taylor Mrs Annette Jacklin, Mr Hugh Jacklin Miss Victoria Jacklin Care Home 9 Category(ies) of Older Person (OP) - 9 registration, with number of places St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The Home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Old age, not falling within any other category (OP) (9). The maximum number of service users to be accommodated is 9. Date of last inspection 26.01.05 Brief Description of the Service: St Oswald’s is situated close to the centre of the market town of Alford. Service users confirmed that all the town’s amenities are within walking distance of the home. The property is on a recognised public transport route. The building is a detached two-storey property that is sited in a predominantly residential part of the town. The front garden is paved to make it accessible to service users. There is a garden to the rear with car parking spaces for two cars. Accommodation for service users is on two floors. Access to the first floor is by stair lift. There is a lounge and a lounge-cum-dining room on the ground floor. The home is registered to accommodate 9 older people in 7 single and 1 double room. It is a family owned business, which aims to provide personal care for service users over 65. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 2.35 hours and consisted of talking with 6 residents in groups and in private, a tour of the home and discussions with the owner/manager and the staff who were on duty. A sample of the documents were seen during the inspection. What the service does well: What has improved since the last inspection? The care plans, which document information about each resident and inform the staff about the care they need have been improved. They are now much more focused on each resident’s likes and dislikes. The new providers have made improvements in the communal rooms that have really made a difference to the resident’s comfort. The manager has made improvements to the records that are kept in the home and the residents are consulted regarding the records kept about them. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4 The home provides clear information for prospective and existing residents. Residents are assessed and assured in writing that their needs can be met. EVIDENCE: One resident was admitted 3 months ago and the home carried out a full assessment prior to admission. Before an admission the home writes to the resident or their relative stating that they can meet their needs. The service user guide has been given to each resident and they knew about the content. The statement of purpose is displayed and available in the home and the residents know where to find this. Each resident had a signed contract which included the terms and conditions of their stay. Each part of the records held about residents has been signed. One resident said that the manager explains everything and asks them to sign. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11 The care plans clearly state the needs of each resident and, the staff are able to meet these. The medication is stored and administered correctly and with the development of new guidance for staff they will fully meet the standard. The residents are treated with respect and with individual care. EVIDENCE: The care plans are holistic and, state residents preferences and routines. The care plans are reviewed and after consultation the residents had signed them. The resident’s wishes following their death are included in the plan wherever possible. Any medical needs are recorded and 1 resident said that the manager had been really kind taking them to the hospital. The manager said that they would rather take residents to hospital appointments themselves instead of sending people on transport, as they usually have to wait for long periods of time. The staff are trained by the manager to deal with basic health care and to refer to the G.P where necessary. The manager has changed the arrangements for storage of drugs after consultation with the pharmacist. The storage is secure, well organised and correctly recorded. It was noted that medication prescribed ‘as required’ had St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 10 the dosages, however there were no protocols for staff to judge when these should be given. The residents said that the staff was extremely kind and helpful. The staff spoke about the residents with respect when describing the care they receive. It was noted that personal care is carried out in private. The manager works alongside staff and they monitor and improve the standard of care. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The lifestyle at the home suits each of the residents, they follow their own routines and they maintain contact with their family, friends and community. The residents have control over their own lives and they are offered a home cooked, quality diet. EVIDENCE: The staff spent time talking to the residents throughout the morning and they stated that this was an important part of their role. The residents said that they didn’t want organised activities and there was enough going on’ to keep them busy. 1 resident had gone into a local town on the bus and 4 other residents are able to go out independently. The manager stated that although they do not organise activities they take residents out to various places depending on their interests. The residents said they could carry on their own routines and ‘do as they please’. If a resident express’s a religious need this is recorded and services are attended or priests come to the home. Two residents said their families are made welcome and that they are offered drinks. Any family contacts are recorded in the care plans. One of the partners cooks for the residents and they were all very complementary about the food. They are able to make choices and the food is varied and home cooked, using local ingredients. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 12 St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 The staff are trained and confident to deal with any suspicions of abuse appropriately. EVIDENCE: The staff were taking part in abuse awareness training on the day of the inspection. The staff work in pairs on most shifts and they are confident to speak to the manager if they have concerns. The home has the documents relating to adult protection and these are included in the induction for new staff. The residents said they would speak up if they had any concerns and 6 of the 8 residents are independent enough to raise issues with the staff. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19,20,22,24,26 The residents live in a clean comfortable environment and they have the equipment they need to maintain their independence. EVIDENCE: The providers have made dramatic improvements to the communal areas of the home. They are now clean fresh and well furnished. The residents say they really like the new decoration. The providers have a long-term plan for improvements. The upstairs bathroom is in the worst state and this is next to be improved. The residents do not currently use this room. The staff spend some time each day cleaning, because of the number of residents this is possible without compromising the care. The residents said they like their rooms, which are comfortable and individual. Each resident has equipment to suit their needs, this includes walking frames and trilators. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 The residents are cared for by staff in sufficient numbers to meet their needs. The staff are increasing their skills through training and they care about each resident. EVIDENCE: The staff have had an increase in their training opportunities in the last 5 months. Courses have included first aid, manual handling, medication administration and health and safety. Staff are taking part in National Vocational Qualifications ( N.V.Q) and the manager is waiting to start the registered managers award. The manager has employed 2 new part time carers so they can concentrate on management tasks. The residents were all very positive about the staff attitude and the staff were positive about their relationships with the residents. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 The home is managed competently and the staff are encouraged to support the residents to a high standard. The staff are not currently supervised formally although their practise is monitored. The providers are in the process of making the home comply with modern safety standards. EVIDENCE: The manager is competent and they demonstrated this during the inspection. They are managing their team and monitoring their practise. The manager described extra support that they have put into place for a member of staff. The staff said that they have good leadership and their views are listened to. The residents said that they are very fond of the manager and their partner who live on the premises. One resident described how they are helped and that the manager and staff ‘treat us like real people and not like imbeciles’. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 17 The results of a consultation survey carried out in February 2005 are included in the statement of purpose. Seven residents responded and the results were positive. The manager is aware that they need to start formal recorded supervision for all staff, however they stated that other priorities had taken precedence since they took over the home. The manager does monitor the staff’s work informally on a daily basis. An electrical check took place on the 16th May 2005 and the manager was awaiting the report. A wire from the light pull in the upper bathroom was detached from the ceiling. The residents do not currently use this room. One of the partners also stated that there were some issues with the boilers although they are perfectly safe to use. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 2 3 3 x x 2 x 2 St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 19 Yes 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. 2. Standard OP9 OP38 Regulation 13(2) 23(2)(b) Requirement Timescale for action 30th June 2005. A protocol for giving PRN ( as required )medication must be developed and used by the staff. The provider must comply with 30th the requirements of the electrical September check that was carried out on 2005. the 16th May 2005. 3. 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 OP36 Good Practice Recommendations The staff should receive regular, formal, and recorded supervision. St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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 St Oswalds Rest Home C53 C04 S62493 St Oswalds V228433 180505 Stage 4.doc Version 1.30 Page 21 - 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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