Care Home: Chalkney House

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What the care home does well The home continues to support residents in a pleasant and homely environment, in which residents were seen to be at ease. The home liaises closely with a range of healthcare professionals who visit the home on a regular basis. Discussion with residents indicated that staff continue to support and enable them to maximise their independence. What has improved since the last inspection? Provision has been made to provide more recreational activities into the home. The home`s recruitment process has been strengthened to further safeguard residents. The induction process for new members of staff to the home has been radically improved. The manager in post has now been registered with the Commission for Social Care Inspection. What the care home could do better: Residents who require their meals presented in a pureed form, should receive them with each component of the meal individually pureed individually, as opposed to one mass, to enable them to enjoy the different textures and tastes. Areas of the main house are looking tired and worn, and refurbishment of a number of areas is needed. There is a need for more of the care team to be trained to National Vocational Qualification level 2 or better. CARE HOMES FOR OLDER PEOPLE Chalkney House 47 Colchester Road White Colne Colchester Essex CO6 2PW Lead Inspector Neal Cranmer Unannounced Inspection 2nd October 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chalkney House Address 47 Colchester Road White Colne Colchester Essex CO6 2PW 01787 222377 01787 222377 kpsohal@aol.com 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 Krishan Parkash Mrs Marion Turner Care Home 33 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (24) of places Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 24 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 9 persons) 4th October 2006 Date of last inspection Brief Description of the Service: Chalkney House is a large detached property set in its own grounds in the village of White Colne. The home provides care for 33 older people; the home is also registered to provide care for up to nine service users who may have a diagnosis of dementia. Accommodation is provided on the ground and first floors, for which access is provided by a lift. There are three shared rooms, with the remainder being single occupancy. A new wing was added to the home in November 2005. There is a large sitting room with a TV, two smaller sitting areas and two dining areas. In the garden there is a shed with heating and a call system for the use of any service users who smoke. The gardens are well maintained and provide lots of space for walking and sitting out in the summer. The home is served by a main bus route to both Colchester and Halstead. Fees for the home are from £426.09 to £450.00 per week, and additional charges are made for the following items: Hairdressing, chiropody and newspapers. This information was supplied by the manager to the inspector during the course of the site visit. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which took place over one day in October 2007, lasting 6.5 hours. All of the key standards were inspected. The inspection process included discussions with a number of the residents, the registered manager and a senior manager. During the course of the inspection a tour of the premises was undertaken, which included visiting residents rooms, bathrooms, communal areas and gardens. During this inspection a range of documentary evidence was sampled. What the service does well: What has improved since the last inspection? What they could do better: Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 6 Residents who require their meals presented in a pureed form, should receive them with each component of the meal individually pureed individually, as opposed to one mass, to enable them to enjoy the different textures and tastes. Areas of the main house are looking tired and worn, and refurbishment of a number of areas is needed. There is a need for more of the care team to be trained to National Vocational Qualification level 2 or better. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this home, and was therefore not inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s can expect their needs to be thoroughly assessed prior to a service being provided. EVIDENCE: The home’s pre admission assessments are comprehensively detailed and cover the following areas of need: • Personal Care needs • Oral health needs Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 9 • Any history of falls • Mental health status • Social interests • Medication • Means of communication. The pre admission assessments are then used as the basis of the resident’s plan of care, assessments are carried out by the home’s registered manager or another nominated individual. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s can expect their care plans to address all aspects of their health and social care needs and be supported by staff in a way that ensures their privacy and dignity. EVIDENCE: Care plans sampled were good, clearly setting out aims and objectives, and the actions that staff needed to follow to ensure that residents needs were met. Each of the plans seen was kept under regular review. The home accesses healthcare professionals as required, and resident’s healthcare needs seemed to be well met by the home, on the day of the Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 11 inspection district nurses were visiting the home. Residents spoken with spoke of being referred to the doctor if they were unwell, and of visits by district nurses being undertaken in private. Resident’s medication is currently dispensed directly from named containers, although the registered manager spoke of the intention for the home to soon transfer over to a Measured Dosage system. Staff administering medicines do so only following completion of accredited training. The home does not maintain any controlled medicines, and the manage liaises closely with the home’s pharmacists about medicines dispensed to the residents. Medication records sampled on the day of the inspection were all in order. Residents spoken with spoke of staff being polite and respectful, referring to them by their chosen forms of address, interactions witnessed were positive and appropriate. Care plans sampled were good, clearly setting out aims and objectives, and the actions that staff needed to follow to ensure that residents needs were meet, each of the plans seen was kept under regular review. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s can expect to be supported to exercise choice and control over how they spend their time and to maintain links with their families and friends and the community. EVIDENCE: The routines of daily living within the home are flexible and varied, and residents are supported to the best of their individual abilities to exercise some degree of choice. The home employs an activities person two days a week. Discussion with the registered manager indicated the intention for a further appointment. Discussion with residents indicated that access to activities had improved. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 13 Residents spoke of the home having an open door policy on the receiving of visitors, and of being free to choose where to receive their visitors, on the day of the visit visitors were seen coming and going. Residents are provided with three meals daily, at least one of which was a hot meal, and snacks are available during the day, most of the residents spoken with spoke of the food being generally good, although one felt that there could be a little more variety. The menus sampled looked to be varied and nutritious, and the lunchtime meal was pleasantly presented and looked appetising. However, the meals presented to residents who required their meals pureed, were presented as one mass, rather than each component of the meal individually pureed. It is strongly recommended that meals be provided individually pureed, so that residents may enjoy the variety of tastes and textures. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s can be assured that the home has in place sound polices and procedures for dealing with complaints and allegations. EVIDENCE: There have been no complaints about the home since the last inspection visit. Residents spoken with indicated that they were aware of how and who they should direct any complaints too. They furthermore were confident that their complaints would be listened to and responded to. The complaints procedure was displayed on the home’s notice board, which was situated ina prominent position near the front door. The home’s Adult Protection policies and procedures are sufficiently robust to ensure that residents are protected from the risk of harm and or abuse. All staff have received training in Adult protection, apart from those newly appointed, however training for these individuals has been scheduled. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a home that was safe and well maintained, however in the main house some refurbishment is required. Residents can however expect to be supported in an environment that was kept clean and tidy. EVIDENCE: The home is fit for its stated purpose, being accessible, safe and generally well maintained, although areas of the main house were starting to look tired and worn, this was discussed with the manager at the time, who spoke of the intention for the main house to be refurbished in the near future. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 16 The grounds of the home were viewed and were found to be tidy and safe, and were accessible to residents, although not on the day of the visit due to the inclement weather. The home was equipped with adequate toilet and bathing facilities in sufficient numbers to meet the needs of the residents, and a range of aids and adaptations were seen to be available including: bath hoists, specialist baths, hand grab rails. The laundry was situated well away from areas where food preparation is undertaken, and was appropriately equipped to meet the needs of the numbers of residents in residence. On the day of the inspection the home was clean and tidy and was free of any unpleasant odours. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s can expect to be supported by a team of staff who are competent and well trained. They can further expect to be protected by the home’s recruitment practice. EVIDENCE: The home is staffed during the daylight hours by four care staff; in addition to this the registered manager works Monday-Friday in a supernumerary capacity. Nights are covered by three waking night staff. In addition to these staff the home has a number of ancillary staff, which includes a cook, kitchen assistant, laundry person, domestic staff and activities person, in the case of the latter another is about to be appointed. Discussion with the registered manager indicated that the home has a number of staff who are N.V.Q qualified, although there was a clear recognition that there is a need for more to acquire this qualification. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 18 Staff recruitment files sampled on the day of the site visit were all in order, although it was noted that one member of staff was working in the home on the basis of a positive Pova (Protection of Vulnerable Adults Check). Discussion with the registered manager confirmed that the person in question was working under full supervision, and was not carrying out any personal care. Since the previous inspection visit to the home the induction process for new employees has been radically improved and is now in line with Skills for Care induction. The staff files sampled indicated that staff had received training in dementia awareness, adult protection, fire safety, appointed person’s first aid, and manual handling. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s can expect to be supported in a home that is well managed and run in their best interests, where their views are sought, and where policies are in place to protect their interests. EVIDENCE: Since the previous inspection visit to the home, the acting manager has been appointed as the registered manager they hold the registered managers award, and has significant previous experience of working and managing care. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 20 The area manager takes the lead on quality issues, and visits the home regularly to meet with residents. The views of residents and their families are sought through the use of questionnaires. The registered provider visits the home monthly to carry out Regulation 26 visits, and reports of these visits are provided to both the home and the Commission for Social Care Inspection. During the course of the inspection the inspector met with the area manager who spoke of plans to implement a number of internal audits into the home as part of the quality assurance process for the home. Staff team meetings are held three monthly, or more regularly if required, and minutes of these meetings were provided. As a further development the home has implemented a periodic in-house newsletter. The only money managed by the home on behalf of residents is personal allowances. Records relating to these were sampled and found to be in order. Money held in the home on behalf of residents was securely stored in a locked safe. The home’s safe working practices were sampled through the viewing of a number of safety certificates, all of those sampled were found to be in order. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 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 Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP15 Regulation 16 (i) Requirement Provision must be made for residents who require their meals provided in a pureed format to receive each component of the meal to be iindividually pureed, as opposed to one mass, to enable them to enjoy the different textures and tastes. Timescale for action 30/11/07 2. OP19 23 (d) Provision must be made to 31/12/07 ensure that all areas of the home of kept reasonably well decorated. 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 OP28 Good Practice Recommendations It is recommended that further staff be trained to National DS0000047576.V353768.R01.S.doc Version 5.2 Page 23 Chalkney House Vocational Level 2 or better. Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chalkney House DS0000047576.V353768.R01.S.doc Version 5.2 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. 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