Care Home: Chapel Brook House Nursing & Residential Care Home

What the care home does well Chapel Brook House is well run and the manager is well regarded by people living in the home, relatives and staff. One staff member commented, "our manager is also very approachable if we have any problems." Staff working at the home are also highly thought of, one relative writing, "Mum always looks clean and tidy and seems relaxed most of the time. A visiting GP commented," overall I feel there is a good standard of care." A staff member wrote, "the service provides good quality balanced day to day care and it is very good at meeting individual needs no matter how complicated." The standard of catering is good so people living in the home are well nourished and are offered choice. The home has an activity coordinator so that people are offered a range of group and individual activities. The home receives few complaints and measures are in place to protect people from possible abuse. The home is well maintained so that people live in a safe environment. Staff receive training to carry out their role. One staff commented, "I have over 10yrs experience in care and with regular training my knowledge is always being updated." What has improved since the last inspection? More than 50 percent of care staff have achieved a NVQ2 qualification in care so they are trained to carry out their role. The registered manager told us that all staff have received up to date training in safeguarding adults so they know what to do if they suspect someone is being abused. The home`s induction programme is linked to a nationally recgonised training organisation so induction training is carried out to a good standard. There is a qualified first aider on duty at all times so that people living in the home are well cared for. What the care home could do better: Assessments of people`s needs should include more information and particularly about their mental health, social and spiritual needs so that staff at the home know what actions need to be taken to meet those needs. Care plans should include more information about how to prevent and manage pressure ulcers so that people living in the home are protected. Recruitment procedures need to be more thorough so that people living in the home know that measures have been taken to recruit suitable staff to work at the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chapel Brook House Nursing & Residential Care Home Moody Street Congleton Cheshire CW12 4AN     The quality rating for this care home is:   two star good service 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: June Shimmin     Date: 0 7 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. that people have said are important to them: They reflect the things 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 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 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. Care Homes for Older People Page 2 of 26 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Chapel Brook House Nursing & Residential Care Home Moody Street Congleton Cheshire CW12 4AN 01260277364 01260277364 info@chapelbrookhouse.co.uk www.chapelbrookhouse.co.uk Stylepeople Ltd care home 32 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 32 0 old age, not falling within any other category physical disability Additional conditions: 0 2 Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. The home is registered for a maximum of 32 service users to include:- * Up to 32 service users in the category of OP (old age not falling within any other category) * Within the maximum of 32 beds, two named service users may be accommodated in the category of PD (physical disability under 65 years) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection Brief description of the care home Chapel Brook House Nursing and Residential Care Home is a Grade II listed building of Georgian style situated in its own grounds and wooded areas. It is just a few minutes walk from the town centre of Congleton and close to local amenities such as the library, shops, bus station, theatre, churches and railway station. Care Homes for Older People Page 4 of 26 Brief description of the care home Accommodation is provided on three floors with access between floors being provided by a passenger lift or staircases. Shared areas for the residents include two lounges and a dining room on the ground floor. The home has 21 single bedrooms, 9 of which have en suite facilities. There are also 5 double rooms, 1 of which has en suite facilities. Bedrooms without en suite facilities have a wash hand basin. An emergency call system is supplied in all bedrooms. The home has a number of aids and adaptations for residents who need help with moving around. There is also a garden area with seating. The weekly fees are 468 to 650 pounds, which includes the nursing contribution of 106 pounds per week. There are additional charges for hairdressing, toiletries, newspapers and chiropody. Care Homes for Older People Page 5 of 26 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 17 April, 2007. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This key unannounced inspection visit took place over four and a half hours. One regulatory inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Before the visit the registered manager was asked to provide information about the home as part of this inspection process. We sent questionnaires to people living in the home and staff members to find out their views about Chapel Brook House. We also spoke to a number of people living in Care Homes for Older People Page 6 of 26 the home, a relative and staff members during the visit. Their views are incorporated into the findings of this report. During the visit various records and the premises were looked at. Records of care plans, medication, maintenance and staff training records were also examined. What the care home does well: What has improved since the last inspection? What they could do better: Assessments of peoples needs should include more information and particularly about their mental health, social and spiritual needs so that staff at the home know what actions need to be taken to meet those needs. Care plans should include more information about how to prevent and manage pressure ulcers so that people living in the home are protected. Recruitment procedures need to be more thorough so that people living in the home know that measures have been taken to recruit suitable staff to work at the home. Care Homes for Older People Page 8 of 26 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. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although an assessment of the persons care needs is usually carried out before admission to the home there is only limited information available about the persons family and social care needs so these needs may not be fully identified or met. Evidence: We looked at the assessments of two people who had recently been admitted to Chapel Brook House. The assessments are carried out by the manager or her deputy so that they are able to advise the person if the home can meet their needs. One person had been admitted to the home in an emergency situation and there was an assessment from a social worker. The home carried out an assessment after the person was admitted to the home. Although information about the persons physical care needs was recorded little information was written about the persons family, leisure and spiritual care needs and a form available for this was blank. We chatted to this person during our visit and the person was able to tell us what her interests were. Care Homes for Older People Page 11 of 26 Evidence: This person also said that she had been given a choice of two rooms and that the room was nicely decorated. The second assessment was carried out before the person was admitted to Chapel Brook House and the content of the assessment was brief and not detailed. For instance the section on communication stated, unable but gave no reason for this. We spoke to this person during the visit and communication did not appear to be a problem. Similarly, there was very little recorded about this persons family, leisure and spiritual needs so those needs may not have been understood by staff. Chapel Brook House does not currently provide intermediate care. Care Homes for Older People Page 12 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. The health care needs of people living in the home are met and in a manner that respects their privacy and dignity. Evidence: We looked at the care plans of the two people who had recently moved into the home. The content of the care plans was of a good standard and included risk assessments for any identified risks. There were no care plans for several new care needs so that these needs might not be fully met. Although measures were in place to prevent people from developing pressure ulcers, such as the provision of suitable equipment, the documentation for this needed to be looked at so that it correctly indicated when a person was at risk of developing pressures ulcers and the location and size of presssure ulcers so that effective care could be provided. There was no written evidence that people living in the home or their family members had been consulted or involved in the care planning process so they might not be able to discuss their care needs or say how they wanted care to be provided, where appropriate. Care plans did indicate that nurses referred people to other health professionals when necessary so Care Homes for Older People Page 13 of 26 Evidence: these further health care needs were met. A GP who visits the home on a regular basis commented, good at liaising with other health professionals, very flexible in their approach. People living in the home were treated with respect and their privacy protected. One relative said, residents well cared for, treated with respect. We looked at how medication was being managed. This was mainly of a good standard although several minor issues were pointed out to the deputy manager. Care Homes for Older People Page 14 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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 standard of catering at Chapel Brook House is good but the lack of recording of the individual social care needs of people living in the home means that those needs may not be fully met. Evidence: We looked at the dining room and menu at the home. The dining room has now been relocated to a former lounge and provides a pleasant environment in which to eat. The menus were written in large enough print for people with slightly impaired vision to read. The home provides a range of hot and cold foods at each meal with a choice of main course and dessert so people enjoy variety and a good standard of nutrition. The home uses mainly fresh produce whenever possible and also provides homemade food such as cakes. Chapel Brook House employs a person to organise and provide activities. One relative was very complimentary about the activity coordinator, the entertainment/activities guy is exceptional. I feel the home is very lucky to have him . He was organising a bingo session for the afternoon of our visit. However, there was very little written on assessments and care plans about the individual social and leisure interests of people living in the home. This means that although people are able to join in group activities Care Homes for Older People Page 15 of 26 Evidence: there is no evidence that this is their preference. The GP did comment that, I notice that the residents are taken out and about far more than other nursing homes. Care Homes for Older People Page 16 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Policies, procedures and training about complaints and safeguarding adults are in place so that people living in the home are protected. Evidence: Chapel Brook House has a complaints procedure which is displayed in the foyer of the home. There is also a suggestions box so that people can make any suggestions about how the home is run or any preferences they may have. The manager said that the complaints procedure is also included within the information leaflet or Service User Guide, which is given to people or their families when they first come to the home. The home has a policy and procedure about safeguarding adults, which is backed up by training on this subject. This means that staff are aware about how to recognise possible abuse and know what to do if they suspect someone is being abused. The manager told us that this training is ongoing and a number of staff will be attending training during the coming months. Care Homes for Older People Page 17 of 26 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, 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. 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. Chapel Brook House is well maintained so people live in safe, comfortable and pleasant surroundings. Evidence: We looked round the home and noted that most parts of the home were clean, tidy and well maintained. The manager sent us information about the home before the inspection. This confirmed that appliances, equipment and installations at the home had been serviced on a regular basis so that people in the home are safe. The home has systems in place to ensure that any potential infections are well managed so people are protected. However, we discussed several aspects about the cleanliness of the home with the manager, which she assured us would be put right. The home provides a variety of equipment suitable for people with a disability. The manager said that rooms are redecorated as they become vacant and there was evidence that people are encouraged to bring items into the home so that they have familiar objects and memorabilia around them. Care Homes for Older People Page 18 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staffing levels at Chapel Brook House appear adequate and staff receive training to enable them to carry out their role. Some aspects regarding the homes recruitment procedures need to be more thorough to ensure that people living in the home are protected Evidence: The number of staff working at Chapel Brook House appear adequate to meet the needs of people living there. Staff are highly regarded by people living in the home and relatives. One family visitor wrote, I feel that the whole team are totally dedicated - they are very friendly and caring and I can rest assured that Mum is in good hands and being well cared for. Staff receive appropriate training so they are skilled and knowledgeable in their roles. One staff member wrote, we also have ongoing training about all aspects of the job old and new. The manager told us that more than 50 percent of staff have achieved the NVQ2 qualification in care and are encouraged to continue with this training if they wish. In relation to supervision one staff member commented, we speak weekly and appraisals are monthly so staff are kept up to date with their progress and training opportunities. We looked at recruitment records but these needed to be more detailed so that people living in the home know that the home has obtained all necessary information about staff. There was only one reference on file for a nurse who was working at the home and the other Care Homes for Older People Page 19 of 26 Evidence: reference did not relate to the nurses professional experience so the home did not know if this was up to date. Also the home uses a curriculum vitae [CV] rather than an application form so that reasons for gaps in employment and appropriate referees may not be included. The home owner wrote to us after our visit to state that the home does use application forms and that this was a solitary incident. The manager did not record any interview notes to clarify where there were any inconsistencies during the recruitment process but we have been informed since our visit that interview forms are now used. Security checks were carried out before staff started work in the home and staff worked under supervision until the full security check was received from the Criminal Records Bureau [CRB]. One staff member commented that it would be useful to have training on equality and diversity issues and the manager told us that this had been arranged for later in the month. The homes induction programme is linked to the nationally recognised foundation standards established by Skills for Care so staff are receiving appropriate induction training. Care Homes for Older People Page 20 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. Chapel Brook House is well managed so that it is run in the best interests of people living there. Evidence: Chapel Brook House is well managed and run. The registered manager has worked at the home for 12 years and has been registered with us for the last three years as required by law. The manager keeps herself up to date in terms of her professional qualifications so she is competent and knowledgeable. The registered manager is supported by a deputy manager and the owner of the home visits the home several times a week to offer support and ensure that the home is being well run. Staff meetings are held regularly so staff can voice their opinions about how the home is run. The manager said that although no recent meetings have been held for residents and relatives a meeting was being planned for the near future so people living in the home could put forward their views about the running of the home. The manager said that she met with residents and relatives on an informal basis so they were able to Care Homes for Older People Page 21 of 26 Evidence: communicate any concerns or wishes. We spoke to a relative during our visit who said, theyre very good - I spend alot of time here and the atmosphere is nice and welcoming. We looked at fire safety in the home and this was being well managed. The home also has a safe system in place so that the finances of residents are protected. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 23 of 26 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 Requirement 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 Requirement 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 3 Assessments should include information about the persons family, social, leisure, spiritual and communication needs so that care staff can provide care that is appropriate and person centred People living in the home or their family/representative, where appropriate, should be involved in the care planning and review process so they can contribute to their care if they wish and express their opinion about how care is provided. Documentation relating to the prevention and management of pressure ulcers should be reviewed so that it accurately reflects what actions need to be taken by care staff to prevent and manage pressure ulcers. Care plans should indicate how the individual social care needs of people living in the home are met so that staff can demonstrate that care is person centred. Two references should be obtained for all staff including a reference that relates to the staff members most recent employment so that the homes recruitment practices are thorough. The registered manager should keep records of the Page 24 of 26 2 7 3 8 4 12 5 29 6 29 Care Homes for Older People interview conducted with prospective staff members to explain any inconsistencies on the staff members application form so that recruitment practices are thorough. Care Homes for Older People Page 25 of 26 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). 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