Care Home: Chalfont Lodge Nursing Home

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What the care home does well There is information available and the opportunity to visit the home to help people decide whether they wish to move to the home. People`s health and social care needs are assessed before they move to the home, to ensure they can be met. People`s cultural and faith needs are identified with them at the initial assessment. People`s medication and healthcare needs are met. There is good support from the local general practitioner and residents have nursing and physiotherapist support. Other health professionals from the local primary care services visit regularly. There is a music therapist.Chalfont Lodge Nursing HomeDS0000019191.V376513.R01.S.docVersion 5.2There is a varied programme of in house activities and an environment which supports reminiscence and familiarity in the dementia care units. The standard and presentation of meals is high. There is a varied menu and residents diverse tastes and nutritional needs are met. There are complaints policies and procedures in place and people said that they knew who to speak to if they had concerns. The home has worked with the local authority to ensure that residents are safeguarded and protected from harm. The home is purpose built and there is good access for people with disabilities throughout the home. The organisation has an active staff training programme which is implemented in the home. Staff receive training in safe working practices to minimise the risk to them or residents of harm arising form care. They have training in dementia care to give them the skills and knowledge to care for this group of residents. The home is owned by a recognised national provider and is managed well locally. There is a quality assurance programme in place. Equipment and services are maintained and essential safety checks are undertaken. What has improved since the last inspection? There has been an ongoing refurbishment programme and the gardens have been redesigned to be more accessible and safe for people who use wheelchairs. A deputy manager has been appointed. A training strategy has been developed and is being implemented. A lead training coordinator has been appointed and opportunities for staff to develop their skills and knowledge have been introduced. What the care home could do better: The infection control policies and procedures should be reviewed to ensure that they are in line with the latest guidance form the Department of Health. Staffing levels and deployment of staff at night must be reviewed to ensure that residents feel safe and are reassured at night and that their needs are met in a timely way. Key inspection report CARE HOMES FOR OLDER PEOPLE Chalfont Lodge Nursing Home Denham Lane Chalfont St Peter Buckinghamshire SL9 0QQ Lead Inspector Chris Sidwell Key Unannounced Inspection 9th July 2009 10:00 DS0000019191.V376513.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chalfont Lodge Nursing Home Address Denham Lane Chalfont St Peter Buckinghamshire SL9 0QQ 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) 01753 888002 01753 893668 Chalfont@barchester.com www.barchester.com Barchester Healthcare Plc Mr Ian Harrison Care Home 119 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0), Physical disability (0) of places Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Physical disability (PD) 2. Old age, not falling within any other category (OP) The maximum number of service users to be accommodated is 119. Date of last inspection 17th May 2008 Brief Description of the Service: Chalfont Lodge is a large purpose built nursing home set in pleasant landscaped grounds adjacent to Gerrards Cross golf course and approximately two miles from the centre of Chalfont St Peter. It is operated by Barchester Healthcare PLC, which owns over 160 nursing and residential homes across the country. The home can accommodate 119 service users across three areas of care: younger physically disabled, elderly physically frail and elderly mentally frail. The home provides for a wide range of needs and abilities. People with disabilities and who use wheelchairs can access all areas of the home. All 93 single rooms and 13 double rooms have en-suite facilities. Room sizes exceed the minimum standards. There are well appointed communal areas in the home including lounges, a dining room, a library and large conservatory, which overlooks a small lake. There are qualified nurses supported by teams of carers on duty at all times in each of the five separate units. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was conducted over three days and included a review of the information we hold about the service and an unannounced visit of eight hours to the home on the 9th July 2009 . The key standards for older peoples services were assessed. Information received about the home since the last inspection was taken into account in the planning of the visit. The manager completed an annual quality assurance assessment (AQAA) in which he described the way in which the home ensures that the views of people who use the service are included in what they do, the way they ensure equality and diversity is respected, what they do well, the evidence to show it and their plans for improvement. This was completed in full and returned on time. Questionnaires were sent to the home for distribution to residents, staff and visiting professionals. Fourteen residents, ten members of staff and two healthcare professionals returned these. Residents and families were spoken to on the day of the unannounced visit. Discussions took place with the manager, operational manager, administrator, care and ancillary staff and some records were examined. Feedback was given at the end of the visit. Care practice was observed and the care of five residents was followed through in detail. The environment and accessibility of the home for people with disabilities was checked. The homes approach to equality and diversity was considered throughout. What the service does well: There is information available and the opportunity to visit the home to help people decide whether they wish to move to the home. People’s health and social care needs are assessed before they move to the home, to ensure they can be met. Peoples cultural and faith needs are identified with them at the initial assessment. Peoples medication and healthcare needs are met. There is good support from the local general practitioner and residents have nursing and physiotherapist support. Other health professionals from the local primary care services visit regularly. There is a music therapist. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 6 There is a varied programme of in house activities and an environment which supports reminiscence and familiarity in the dementia care units. The standard and presentation of meals is high. There is a varied menu and residents diverse tastes and nutritional needs are met. There are complaints policies and procedures in place and people said that they knew who to speak to if they had concerns. The home has worked with the local authority to ensure that residents are safeguarded and protected from harm. The home is purpose built and there is good access for people with disabilities throughout the home. The organisation has an active staff training programme which is implemented in the home. Staff receive training in safe working practices to minimise the risk to them or residents of harm arising form care. They have training in dementia care to give them the skills and knowledge to care for this group of residents. The home is owned by a recognised national provider and is managed well locally. There is a quality assurance programme in place. Equipment and services are maintained and essential safety checks are undertaken. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 8 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 Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is information available and the opportunity to visit the home to help people decide whether they wish to move to the home. People’s health and social care needs are assessed before they move to the home, to ensure they can be met. EVIDENCE: There is information available to prospective residents in the form of a statement of purpose, which describes the services provided by the home and a home brochure. Prospective residents and their families are welcome to visit the home and stay for a trial period before deciding whether the home is for them. The care files of five residents who have moved to the home since the Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 10 last inspection were checked. They had been assessed by a qualified nurse to identify with them their needs and wishes for care. The assessment documentation prompts staff to take note of people’s faith and cultural wishes as well as their health and social care needs. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents diverse personal, health and medication needs are met in a manner which protects their dignity, promoting their wellbeing. EVIDENCE: The care of four residents was followed through. All had comprehensive care plans which had been updated regularly with them and with their families. Residents diverse healthcare needs were recognised and recorded. Their risk of developing pressure damage had been assessed and appropriate action taken to prevent this. One resident had pressure damage when she moved to the home. This was treated appropriately and clear records were kept. The damage was now healed. Residents risk of malnutrition was assessed and action taken. Residents see the dietician if necessary. All those seen had Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 12 maintained their weight on moving to the home. There was evidence in all the files to show that residents see a general practitioner and other members of the local primary healthcare team regularly and are supported to visit hospital outpatient departments when necessary. Everyone who returned the questionnaires said that they always or usually received the care and support they needed. One respondent commented that staff are amenable and pleasant, another said they do well. There are medication policies and procedures in place and the staff spoken to were aware of these. The storage facilities were satisfactory. Records are kept of medication delivered and disposed of by the home. Residents individual medication administration records were completed in full and appropriate steps were taken to ensure that supplies were received regularly. None of the residents managed their own medication at the moment although there are policies and procedures in place to support this if residents wish. The residents spoken to said that they received their medication regularly and were happy for the home to manage this on their behalf. The staff spoken to said that medication was never given covertly. If a resident did not want to take their medication, this would be recorded. If the medication was essential and the resident lacked capacity, the doctor and family would be told and a way forward agreed. Residents said that care staff were discrete and that all care is given in residents rooms. They are addressed by their preferred name and had been supported to maintain their personal hygiene, to wear their own clothes and to have their hair dressed as they wished. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an in house programme of activities and people can choose how they spend their day. Younger people however said they would like to go out more. The standard and presentation of meals is very high meeting peoples social and nutritional needs. EVIDENCE: Residents spoken to said that they had a choice as to when they got up and when they went they went to bed. There is an activities coordinator in post and she arranges a programme of activities and 1:1 sessions with residents. Most people said that there were activities on offer and that they had a choice as to whether they joined in. The activities were well advertised. Younger people however commentated that they would like more outings, not just in the summer and that some of the in house activities were more suited to older people. On the day of the unannounced visit there were activities in all the lounges. The activities coordinator was holding a quiz and crossword Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 14 session in the main lounge and a carer was playing floor bowls with a group of older people in one of the smaller lounges. The memory lane unit has lots of items for people to reminisce with, which residents were seen to pick up and staff to engage residents in conversation about. The home has a music therapist who was holding a group session on the afternoon o the visit. This was structured and residents were seen to be enjoying themselves. Residents from the dementia care unit joined in and they were helped to maintain the beat of the music, clearly to their satisfaction and enjoyment. A number of family members were spoken to and all said that they could visit at any time and were made to feel welcome. They said that they were kept up to date with the relatives needs and were told of any untoward event. The chef is very knowledgeable about residents likes and dislikes and can provide menus to meet residents cultural wishes. There is a varied menu, with several choices at all meals. The chef said the menus were changed four times a year and that she has a network of lead residents who help her develop the menus. All food is home cooked. Some residents eat in the well appointed dining room. This is managed to a high standard with dedicated staff. The tables were pleasantly laid with tablecloths, flowers, cutlery and glasses and meals were seen to be a sociable occasion. Carers were observed to be supporting residents, who could not eat unaided, discretely. Everyone who returned the questionnaires said they liked the food. The chef was knowledgeable as to whether residents needed special menus on health grounds and provided soft and pureed food for those who had difficulty swallowing. She also knew those who were losing weight and provided them with fortified meals, smoothies and extra finger foods. She used full fat products to ensure older people who have smaller appetites receive the calories they need. Nobody needed a special diet on religious or cultural ground at the present although the chef said that she could provide an individual tailored menu if a resident wished. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are protected from harm and their concerns are listened to and addressed. EVIDENCE: People in the home know who to complain to. A copy of the complaints procedures is displayed in the home. Everyone who returned the questionnaires said that they knew who to speak to if they had concerns and how to make a formal complaint. One respondent said that she had raised a concern verbally with the manager and was very pleased with the outcome. The manager said in the annual quality assurance assessment that they have received ten complaints since the last inspection. The records showed that these had been responded to promptly and in a constructive manner. The home has a copy of the local multi agency safeguarding policies and procedures and staff have a received training in safeguarding vulnerable people. There are whistle blowing policies and procedures in place and the staff spoken to said that would have no hesitation in reporting any concerns. The home has made three safeguarding referrals which they have dealt with in conjunction with the local authority which is the lead agency in these matters. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained, has good access for people with disabilities and is a comfortable place for people to live in. Measures to minimise the risk to residents of acquired infection are in place although these should be improved if they are to meet the latest guidance from the Department of Health. EVIDENCE: The home is on two floors and is divided into a number of different units each with its own communal lounge, kitchenette and dining area. There is a large well appointed lounge and dining room on the ground floor. The home is accessible to people with disabilities. It is set in well maintained gardens. The access to the gardens has been improved for people who use wheelchairs and new paved areas and a barbeque area has been built. There is an ongoing Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 17 programme of maintenance and redecoration. Although some rooms are for double occupancy, all are being used as single rooms at present. Residents are supported to personalise their rooms with items of furniture and personal mementos. Many had chosen to do so. The home was clean and tidy on the day of the unannounced visit and there were no offensive odours. There are infection control policies and procedures in place and the home has a copy of the Thames Valley Health Protection manual on Infection Control which includes the latest guidance from the Department of Health. The laundry is well organised and the washing machines have programmes to deal with soiled linen and clothing. Soiled laundry is segregated and there is no need for laundry assistants to handle soiled laundry. Staff were observed to be wearing protective clothing correctly. Soap and paper towels are not available in residents ensuites for the use of staff and visiting professionals and alcohol hand sanitizer is not available for the use of staff. Staff said that they used a hand wash solution which was kept on the laundry trolley or went to the nearest bathroom or sluice to wash their hands. They also said that it was the companys policy not to use alcohol hand sanitizer. Staff said that residents did not share hoist slings. The home should review the infection control procedures to ensure that they are in line with the latest Department of Healths (DH) guidance, which states that hand hygiene should be performed immediately before and after every episode of direct care and that where appropriate alcohol hand rub should be used at the point of care. Further information about infection control is available on our website www.cqc.org.uk and the DH website www.dh.gov.uk Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In general there are sufficient staff who have the knowledge and skills to meet residents needs. Staffing levels and deployment at night should be reviewed to ensure that residents needs are met in a timely way and that they are not concerned about their vulnerability. EVIDENCE: The duty rota showed that there was good continuity of care staff. Care staff are usually allocated to one unit where they get to know the residents and residents get to know them. Most people who returned the questionnaires said that staff were always or usually available when they needed them, although four said sometimes. When asked what the home could do better three residents said more staff. One survey respondent said that she often has to wait ages for assistance. Two residents in Sunningdale unit had specific concerns about staffing at night. One had significant health problems and needed help from a breathing aid. She said she was sometimes afraid at night because the staffing levels had been reduced to one registered nurse and three carers, from one registered nurse and four carers and she was afraid they Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 19 would not be able to attend to her. Another gentleman said that his needs were met as he only needed one carer but his wife needed two and she often had to wait. Scrutiny of the rotas showed that this unit had the lowest ratio of staff to residents at night, although there was no information to say that the dependency of residents was lower. The residents spoken to had significant care and support needs. The staffing levels and deployment of staff at night must be reviewed and sufficient staff must be available to reassure residents and to meet their needs in a timely way. There is an ongoing training programme. The training records were up to date and showed that staff had training in safe working practices to reduce the risk of harm to residents, or themselves, arising from care. Staff who returned the surveys said that they had had an induction programme and felt that training was strength of the organisation. The training coordinator arranges a number of clinical update courses for qualified nurses, including training in the support of residents with specific healthcare needs for instance multiple sclerosis or motor neurone disease. The organisation has accredited trainers for the Alzheimer Society Yesterday, Today, Tomorrow dementia care training programmes and the home participates in this. The home meets the standard that fifty percent of staff hold the National Vocational Qualifications in Care at Level 2 or above. Staff who returned the surveys said that they were given up to date information about residents and that the home carried out checks before they started work. The recruitment files of three members of staff who had started at the home since the last inspection were checked. The required checks had been undertaken to protect residents from potentially unsuitable staff. There was evidence that the staff members identity had been checked. Criminal Records Bureau disclosures and two references had been sought before the staff member started work. The application form showed the staff members work history and interview records were kept. Work permits were in place where necessary. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the interests of residents. EVIDENCE: The manager holds a nursing qualification and a diploma in management studies. It is a large home and he is supported by a deputy manager and heads of care who are registered nurses and who take the lead in each unit. Staff said that the manager was approachable and that the atmosphere in the home was relaxed. They said that the manager gave them support and that there was someone they met with regularly to discuss how they were working. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 21 There is a quality assurance programme in place. There are regular resident, family and staff meetings. The manager said that he had an open door policy and this was confirmed by the relatives and residents spoken to on the day of the unannounced visit. The company has a regular audit programme in place and monthly returns of untoward events are made enabling trends to be identified. The home does not manage residents financial affairs. All expenditure is invoiced to families for payment. Residents can have locked storage in their rooms if they wish. There are health and safety policies and procedures in place and regular meetings are held. Maintenance records were up to date and there was evidence that essential safety checks of services and equipment are undertaken. Water temperatures are tested regularly and there are window restrictors to upper floors to reduce the risk to residents of falling. The fire risk assessment had been updated and fire safety checks were made. The last Fire Safety Officers visit was on July 2008 when all matters were considered satisfactory. The last Environmental Health Officers visit was in March 2008 when food hygiene standards were good. The training records showed and staff confirmed that they had had training in safe working practices, including moving and handling, fire safety and infection control. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 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 Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 23 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 OP27 Regulation 18 Requirement The home must ensure that there are sufficient staff, suitably deployed to meet the needs of residents at night. Timescale for action 31/08/09 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 OP26 Good Practice Recommendations The home should review the infection control procedures to ensure that they are in line with the latest Department of Healths (DH) guidance, which states that hand hygiene should be performed immediately before and after every episode of direct care and that where appropriate alcohol hand rub should be used at the point of care. Further information about infection control is available on our website www.cqc.org.uk and the DH website www.dh.gov.uk. Chalfont Lodge Nursing Home DS0000019191.V376513.R01.S.doc Version 5.2 Page 24 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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