Care Home: Chamarel

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Chamarel 8 High Street Longstanton Cambridgeshire CB24 3BP two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Shirley Christopher Date: 2 2 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Chamarel 8 High Street Longstanton Cambridgeshire CB24 3BP 01954789856 01954200101 gorles@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Lesley Joy Mowlabocus,Mr Gorabye Mowlabocus,Mr Roger Paul Shelley,Mrs Melanie Shelley care home 7 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 7 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection A bit about the care home Chamarel is a small family run home for up to seven adults with a learning disability, one service user is over the age of 65. The home is owned and run by joint proprietors, Mr and Mrs Mowlabocus and Mr and Mrs Shelley who are long time friends and associates with considerable experience between them. Mr Shelley is the registered manager. The home is situated in the village of Longstanton, which is close to the City of Cambridge and has good bus links to Cambridge and Bar Hill. The home is centrally located and provides spacious accommodation. Originally there were five single bedrooms and one double bedroom, but the house was extended to create all single bedrooms for the benefit of the existing residents. En suite facilities have been added to one bedroom and there is an additional bathroom/shower room and a communal room upstairs. The home has an attractive rear garden, and there is a front enclosed garden with adjacent car parking spaces. The weekly charge is £618.09 Copies of CQC reports can be made available to service users and relatives upon request. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home We, the Care Quality Commission, carried out a key unannounced inspection on 22nd April 2009.We met with the providers, care staff and residents to gather views regarding the care and support that is provided in the home. The home completed an Annual Quality Assurance Assessment (AQAA) which is a document that gives the home an opportunity to assess how they are meeting standards, regulations and outcomes for residents. Surveys were received from residents and staff regarding services provided in the home. A number of records were inspected including care plans, training records, staff files, medication records, fire testing and health & safety records. A tour of the building and grounds was also undertaken. What the care home does well Chamarel continues to provide residents with a well co-ordinated package of care and support to ensure that their independence and lifestyle is promoted as much as possible. Staff members remain committed in providing assistance to residents in making choices about their lives. Care plans continue to be person centred to ensure that individual residents needs and lifestyle preferences are being met. Residents spoken with during the inspection were positive about the care and support they receive and it was clear from observations that the residents and staff have a freindly and professional relationship and assistance is provided in a sensityive and social way. What has got better from the last inspection What the care home could do better It is recommended, that the care plan files are reorganised and that a file containing only the current care planning and essential details is developed to aid access to information with old unused documents archived. The manager organises recorded supervision meetings with individual staff members but it was noted that sessions have been infrequent since the last inspection. The manager recognises that this is an area that needs to be improved and he stated that he will action this with assistance from the management team in the home. Recorded supervision meetings with individual staff members have been infrequent since the last inspection. The manager stated that he woukld improve this area with the assistance of the management team in the home. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Shirley Christopher 33 Greycoat Street London SW1P 2QF 02079792000 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 set out on page 4. 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 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 carries out a thorough assessment of prospective residents needs to ensure that their care and support needs can be appropriately met. Evidence: There have been no admissions to the home since 2000. However, there is currently a vacancy in the home and local learning disability teams have been informed and the home anticipates referrals being during the next few weeks. When a referral is received the home obtains thorough and detailed information from the prospective residents care manager. A visit to the home is arranged which includes meeting the residents and staying for a meal. An overnight stay can be arranged, when possible, and the persons relatives are encouraged to be involved during the referral/assessment period. The manager stated that the assessment is pitched at the prospective residents pace to ensure that they are able to make an informed choice about moving in to the home. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this 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 are treated with dignity and respect and receive personal care to meet their assessed needs. Evidence: The home have detailed care plans containing a variety of information regarding the residents care and support needs. Two resident files were inspected and they were presented in a person centred manner, to ensure that health, personal and social care needs continue to be met. Care plans gave details of the residents daily activities, health care contacts, daily living skills, personal preferences and personal care needs. There was evidence of regular care plan reviews along with annual social service reviews and day service reviews. It is recommended, however, that the care plan files are reorganised as they are bulky and contain information from a number of years ago. It was suggested that a file containing only the current care planning and essential details is developed to aid access to information with old unused documents archived. The manager agreed to action this with members of the management and care team. Residents continue to be encouraged to participate in reviews of their care and support to ensure that their personal and social needs are being met. Risk assessments are in place regarding activities in the home and when accessing the community to ensure that residents are protected from potential harm. Residents continue take a full part in the running of the home which includes shopping, food preparation, cleaning and laundry. Residents were busy helping with laying tables Evidence: and tidying the lounge and kitchen area. There is a friendly and social atmosphere and residents and staff have a good and caring relationship. Comments in surveys, from residents and their relatives, received by the Commission were complimentary and positive about the care and support provided in the home. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 staff provide appropriate support to ensure that residents can engage in activities appropriate to their needs. Residents have a choice of meals, which are prepared and served in a homely manner. Evidence: The home continues to provide a wide range of activities to residents both in the home and in the community. During the inspection there was clear evidence of residents and staff engaging socially in the home. Relatives and friends are encouraged to visit the home as much as possible. Residents activities are recorded in their care plan with any changes monitored and reviewed. Examples include cookery sessions, art and crafts and attendance at two local day centres, regular trips to the local community, football matches, pub trips, barbecues and cinema/theatre trips. Trips to local towns and resorts e.g. hotel stay in Suffolk, are also organised during the year. Two residents prefer to spend more time in the home rather than have a full attendance at a day centre or other regular activities. One of the residents has a part time job at a local supermarket and also is involved in the monthly Parliament meetings via the learning disability advocacy group, Speaking Up. Residents continue to personalise their bedrooms so that they able to enjoy spending time in their own rooms as well as using the communal areas in the home which has Evidence: television, video and a dvd available. Four bedrooms were seen and they were individually personalised with equipment, personal belongings and choice of decoration. One of the residents proudly showed us his electric guitar which he enjoys playing. Residents are also assisted with personal and house shopping. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 receive appropriate health care to meet their needs. There are clear guidelines regarding the safe administration of medication. A risk assessment procedure is in place to protect residents. Evidence: One of the residents health has deteriorated since the last inspection and her mobility is reduced. She has moved to a ground floor bedroom and has an intercom device to call staff when she needs assistance. She also receives some assistance with personal care from staff. She has lived in the home for a number of years and the manager stated that her needs can be met successfully by staff and through regular outpatient appointments at the local hospital. There have been no further changes to health care contacts since the last inspection and residents have regular appointments or input from a range of health care professionals including GPs district nurses outpatient appointments. Residents users are all registered with a local GP surgery and care plans inspected evidenced that regular health care checks and appointments are recorded. A risk assessment procedure is in place to protect service users from potential harm from activities in the home and when accessing the community.Medication records were accurately recorded and staff receive medication awareness and administration training. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 has a satisfactory complaints process to ensure that residents and their representatives are able to raise concerns. There are suitable arrangements for ensuring the protection of residents from neglect or harm. Evidence: The homes complaints procedure continues to ensure that all complaints or concerns are listened to and fully investigated and actioned appropriately. There have not been any complaints raised with the home since the last inspection. The Care Quality Commission has also not received any complaints regarding the home. The home ensures that adult safeguarding issues are dealt with in line with local authority policies to ensure that residents are protected from any potential abuse. Staff receive appropriate safeguarding training through the local authority to ensure and this was confirmed in the homes training files. Care staff interact and speak with residents in a friendly and social manner and they are clearly committed to care and support in a private and dignified manner. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 environment of the home provides residents with a safe and comfortable place in which to live. Evidence: The home and grounds are appropriate for the needs of the residents and is presented in a clean, homely and well-maintained manner. The providers carry out decoration in the home along with minor repairs. Local contractors are used to carry out any major refurbishments or repairs that are required.There have been a number of improvements since the last inspection. The upstairs shower room has been completed. Decoration has also been carried in one of the bedrooms and the vacant bedroom is in the process of being refurbished. New furniture has been purchased in the lounge and new dining chairs have been added to the kitchen/dining area. Residents bedrooms are personalised, furnished and equipped to meet individual preferences and tastes. This was confirmed by residents during the inspection. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 homes recruitment policy and processes ensure that residents are protected from harm.Training is provided to ensure that staff are competent to deliver care to the residents they support Evidence: Three staff files were seen and they contained all appropriate recruitment information including two references and evidence of a satisfactory Criminal Records Bureau checks. The manager organises recorded supervision meetings with individual staff members but it was noted that sessions have been infrequent since the last inspection. The manager recognises that this is an area that needs to be improved and he stated that he will action this with assistance from the management team in the home. There continues to be a detailed training programme in place to ensure the staffs ongoing safe practice. Training in the home is regularly updated to ensure that mandatory and resident based issues are covered throughout the year. Staff files confirmed that a variety of training had been completed since the last inspection including;food hygiene, moving and handling, health and safety, safeguarding adults, infection control, medication and fire safety. A member of staff spoken with confirmed that she had received regular training and felt well supported by the management in the home. This view was also echoed in surveys received from staff in the home.NVQ training courses at levels two and three have been undertaken by staff. One of the providers continues her NVQ assessor role with Cambridge County Council. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 and the staff are supported to ensure that residents receive good quality care. Evidence: The providers and manager are clearly committed in providing a well run service to ensure that residents receive good quality care and support. One of the providers confirmed she continues to be a signatory for one of the residents. The personal allowance records of two residents were checked and they were accurate. No other financial records were inspected on this occasion. Records of weekly fire alarms, emergency lights testing and fire drills were seen and found to be accurate. Service contracts are also in place to ensure that equipment and services in the home are safely maintained at regular intervals during the year.The home continues to audit their services and an annual quality assurance review is carried out to ensure that the service meets the needs of residents. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 It is recommended, that the care plan files are reorganised and that a file containing only the current care planning and essential details is developed to aid access to information with old unused documents archived. Helpline: Telephone: 03000 616161 or Textphone : or 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) Commission for Social Care Inspection (CSCI). 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. 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