Care Home: Charnley House

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What the care home does well The staff team at the home were well-trained and led by an experienced manager and enthusiastic senior team. Watching staff working with people using the service demonstrated their competency in using equipment such as an electric hoist and the way this was used made the person feel safe and comfortable during the process. Mealtimes were seen as a social occasion and people were encouraged to take their meals in a relaxed and informal atmosphere. We saw staff assisting people who needed support in a sensitive and unhurried way. This is important to ensure adequate nutritional intake for people and to minimise any potential risk of people becoming malnourished or dehydrated. People commented that they felt they were able to talk about their concerns and worries and that they would be listened to by the management and staff team. When asked about what she would do if worried about things one person said, "I would go to the office or tell my son". Staff who returned surveys to us felt supported by the management. Comments included, "Communication is good with staff and management. Staff are always fully aware of any changes in the home" and another said that, "The service does well in all aspects of care to residents, family and staff". What has improved since the last inspection? There had been an increase in the number of staff who had obtained a National Vocational Qualification (NVQ) at Level 2 or above. Training such as this should enable staff to continue their personal development in the jobs they do and provide appropriate support to people using the service. A new patio area had been completed to the side of the home. This area was accessible from the conservatory and gave people the opportunity to sit outside in the nicer weather. Carpets, decoration and some furniture had continued to be replaced and updated where needed. This had helped to maintain a pleasant and comfortable home for people to live in. What the care home could do better: The way in which care plans are written could be improved by making sure details of the assistance/support an individual person may require is clearly detailed. This should enable staff to support a person in the most appropriate way whilst maintaining independence wherever possible. There were no requirements made during this key inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Charnley House Albert Road Hyde Tameside SK14 1DH     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: John Oliver     Date: 1 2 0 5 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 28 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 28 Information about the care home Name of care home: Address: Charnley House Albert Road Hyde Tameside SK14 1DH 01613684664 01613687073 care@charnleyhouse.co.uk 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) : Charnley House Limited care home 41 Number of places (if applicable): Under 65 Over 65 41 1 41 41 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 0 0 0 0 The home is registered for a maximum of 41 service users to include: *up 41 service users in the category of OP (Old age not falling within any other category). *up to 41 service users in the category of PD(E) (Physical disability over 65 years of age). *up to 41 service users in the category of DE(E) (Dementia over 65 years of age). *up to 1 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). The service should 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 Charnley House is a large, detached building located close to the centre of Hyde. The property has been adapted and extended over the years to provide accommodation for 41 older people, some of whom can have dementia, physical Care Homes for Older People Page 4 of 28 Brief description of the care home disabilities, sensory disability or mental health problems. The accommodation is situated on three floors; there are 37 single and two shared rooms. 16 single rooms have en-suite facilities. In total there are 5 communal areas of differing sizes in addition to a conservatory. One lounge is currently provided for those people who choose to smoke. A dining room is located on the ground floor close to the kitchen. The home provides aids and adaptations to meet individual needs and there is a full passenger lift. At the time of our visit one of the shared rooms was being converted into a single en-suite room. Car parking is to the front of the building and there is a secure garden to the rear. Fees for accommodation and care at the home range from three hundred and ninety eight pounds and eleven pence to four hundred and forty two pounds. Additional charges were also made for hairdressing and chiropody services, newspapers, personal toiletries and trips. Care Homes for Older People Page 5 of 28 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 key inspection on this service was completed on 18 May 2007. This inspection was undertaken as part of a key inspection, which includes an analysis of any information received by us ( the Care Quality Commission) in relation to the home prior to the site visit. Before visiting the home, we asked the manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helped us to determine if the management of the home viewed the service they provide the same way that we assess the service. Additional information used to complete the inspection report may include incidents Care Homes for Older People Page 6 of 28 notified to us by the manager of the home and information provided by other people and/or agencies, including any concerns and complaints. Surveys were sent to people working at the home to find out their views of the service and six members of staff returned completed surveys. During the inspection visit time was spent talking to people using the service, observing how staff worked with people and talking to the management and staff on duty. Documents and files relating to people and how the home is run were also seen and a partial tour of the home was made. What the care home does well: 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 set out on page 4. Care Homes for Older People Page 8 of 28 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 28 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 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before admission into the home to ensure that identified needs can be met. Evidence: The management team had a procedure in place where all prospective users of the service would be visited by the manager and a senior member of the staff team prior to admission to carry out a full assessment of their needs. Where people were admitted into Charnley house as an emergency the manager confirmed that there was not always the opportunity to carry out a pre-admission assessment on behalf of the home but assessments of needs were always received from the referring local authorities before the person was admitted. If possible, people considering coming to live in Charnley House are encouraged to Care Homes for Older People Page 11 of 28 Evidence: visit and perhaps enjoy a meal with people already living in the home. Brochures were provided to all prospective users of the service and a very detailed Service User Guide was available at the home which was updated twice a year or as required. We examined the care files of two people and both contained details of pre-admission assessments that had been carried out. Staff spoken with told us that the first six weeks of a persons stay at the home was used as a trial period and also to carry out further assessments to ensure that the home is a suitable placement and can fully meet the individuals needs. It is important that prospective users of the service feel confident that their needs have been assessed and can be fully met by the staff and home they are considering moving in to. Care Homes for Older People Page 12 of 28 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. People living at Charnley House have their needs met and their care is provided in a manner that protects their privacy and dignity. Evidence: Each person using the service had care plans in place that had initially been written using information taken from all the pre-admission assessments that had been undertaken, together with any risk assessments completed following admission. Although all relevant information was available in the care plan files it was difficult to follow as the files were inconsistent in how information was put together. No two files were in the same order and information such as linking risk assessments to individual care plans was difficult to do. The deputy manager informed us that a review of the systems used was currently taking place and a new care plan format was being developed. Information in care plans gave details of needs and identified when and where Care Homes for Older People Page 13 of 28 Evidence: assistance from staff was required, for example, Personal Hygiene - assistance required from carer. What was not clear was how much assistance was to be offered/given by the carer? It is important staff know what specific assistance is required in order to maintain the individuals independence wherever possible. In most instances care plans were being reviewed on a monthly basis and we also saw evidence of a recent review carried out by one local authority. Input from health care agencies, such as the District Nursing Service, General Practitioners and others were recorded in the individuals files. We also saw that people who required support with specific health conditions such as diabetes, continued to be supported to access the relevant community health service, such as chiropody and opticians. The way in which medicines were administered in the home was examined. Staff with the responsibility for administering medicines to people using the service did so using a monitored dosage system and staff had been trained by an external training consultant. It was also confirmed that this training was updated on a regular basis to ensure staff remained competent in this area. We observed the deputy manager administer medicines at lunch time. This was done competently and efficiently and each record was signed at the time medicines were administered to the individual. Many of the people having medicine administered to them suffered with some form of dementia and were unable to communicate verbally. It is recommended that a photograph of the individual person be placed on the medicines file to further ease identification when administering medicines and to reduce the potential risk of medicines being administered to the wrong person. Medicine administration records were sampled and found to be mostly accurate except for two where medication had been administered but not signed for. At the time of our visit one person was being administered a controlled drug and a check on the records and balance of this medication was found to be correct. We watched staff working and interacting with people living in the home and saw that they treated people in a positive way whilst respecting their privacy and dignity. One person using the service told us, The girls will do anything for you and another said, I get my tablets morning and night, without fail. We also observed staff using an electric hoist to assist one person to transfer and it was apparent the staff were competent in the use of such equipment and did their best to make the person feel safe and comfortable during the process. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 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. People were supported to make choices and maintain control over their own daily routines and activities. Evidence: The management team take the lead in organising activities in the home and information about available and planned activities was displayed on notice boards in the main hallway. These included Afternoon tea with... which is held on a Monday afternoon and involves listening to the music of well known singers and people can join in by playing musical instruments. Within the information returned to us before the inspection took place we were told that this is a highly successful, stimulating and enjoyable afternoon. Other activities throughout the week included a visiting therapist who provided movement to music, reminiscence, professional entertainers and occasionally, karaoke sessions. The staff team also organised theme days where they enjoy dressing up (along with those people living in the home who want to) to support events such as red nose day, cancer awareness day and seasonal events such as Halloween. Photographs displayed within the home indicated that everyone appeared to have an enjoyable time. Care Homes for Older People Page 16 of 28 Evidence: People living in the home told, Things do go on such as singing and dancing and We go daft now and again and dress up, its good fun. Staff also told us that a number of staff recently supported people from the home to enjoy a canal boat trip in Marple. Arrangements were made for a local Vicar to visit the home every 6 weeks and a visiting hairdresser attended the home on a Wednesday for those people preferring not to visit a hairdresser in the community. The management team and staff consider meal times to be a social occasion where people using the service are encouraged to come together and enjoy each others company. Lunchtime was observed in the dining room and it was found to have a relaxed and informal atmosphere with staff providing assistance where required. Lunch was served between 12:00 until 1:00, which was a light meal, soup and sandwiches. The main meal of the day was served around 5:00pm with a light snack provided at supper time. Tea, coffee and a range of juices were available throughout the day. For those people requiring a little more time to enjoy their main meal and where a little more assistance may be required, staff start serving those people from 4:30pm. This enables staff to support people in the most appropriate way and helps maintain their dignity when eating. We saw that staff supported people by sitting next to them and assisting them in an unhurried and dignified way and this appeared to encourage those people who may otherwise get up and walk away to sit and enjoy a meal. This is obviously important when supporting people with dementia to ensure adequate nutritional intake and to minimise any risk of people becoming malnourished or dehydrated. People living in the home told us, (The) food is not too bad, we have a choice mostly, The meals are pretty good but lately not very hot and Meals are excellent. During our visit we saw family and friends visiting people and there were no restrictions on when people could visit other than recommending not at meal times. People had the choice of private and communal areas in which to see their friends and family. Care Homes for Older People Page 17 of 28 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. The policies, procedures and staff practices were present to protect vulnerable people from abuse and protect their wellbeing. Evidence: The formal Complaint Procedure set out the stages, timescales and the procedure for people to follow if they want to make a formal complaint. The procedure was made available to people and was also displayed in communal areas. Any informal concerns and worries that people raised would be dealt with by the staff at the time. Comments from people living in the home included, I would go to the office or tell my son, I would tell one of the staff and I would tell her (pointing to the deputy manager). The Adult Protection Policy and procedure set out the role of the management and staff in protecting people. The manager and deputy was aware of the process to follow in the event of an allegation or incident of abuse. Staff spoken to were also aware of their role in protecting people and what they would do if they had any concerns. The manager had discussed the adult protection procedure with staff during one to one supervision sessions and other training in this subject has been provided by an external trainer. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 of 28 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. The premises were clean, safe and offered people enough space and flexibility to meet their needs. Evidence: Accommodation was provided over three floors in a large Edwardian house which had been extensively extended over the years. The main office, bedrooms, laundry and storage facilities were located in the basement. On the ground floor there was the kitchen, dining room, smoking room, office, bedrooms, toilets and bathrooms, lounge areas and conservatory. Further bedrooms, bathrooms and toilets were located on the second floor. A passenger lift provided access to the upper floor and a stair lift was also in place in case of emergencies. A partial tour of the premises was undertaken. Communal areas were nicely decorated and comfortably furnished and those bedrooms seen were personalised to varying degrees reflecting the character of the person whose room it was. There was an ongoing maintenance and renewal programme in place and on the day of our visit a number of bedrooms were being redecorated. Work was also taking place to convert a companion room into a single en-suite room. The domestic team at the home kept the house clean and fresh smelling and no Care Homes for Older People Page 20 of 28 Evidence: unpleasant odours were detected during our visit. The manager told us that all staff in the home work to the policies, procedures and cleaning schedules to reduce and minimise the possible risk of infection and cross contamination. The laundry facilities were sufficient to meet peoples needs and appropriate measures were in place to provide staff with disposable gloves and aprons. Care Homes for Older People Page 21 of 28 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. People were being supported by sufficient numbers of appropriately qualified and expereinced staff. Evidence: On the day we visited the home sufficient numbers of staff were on duty to meet the needs of the people using the service and we saw them spending time with people, not just in supporting and assisting their needs but also in social interaction such as sitting and talking with them. People using the service told us that enough staff are available to assist them and comments included, Theres always someone around to help you and Staff are always there when you need them. Staff spoken with said, (There are) usually enough staff on duty, short notice sickness can cause a problem and There are always enough staff to cover the rota and extra staff are brought in if we need them. The manager told us that agency staff have never needed to be used. Within the Annual Quality Assurance Assessment (AQAA) the manager told us that of the 23 permanent care staff, 22 had obtained a National Vocational Qualification (NVQ) at Level 2 or above and those staff spoken with confirmed this. We checked a number of staff training records and saw that various courses had been attended throughout Care Homes for Older People Page 22 of 28 Evidence: the year and again, this was confirmed by those staff spoken with. We looked at the files of two staff that have been employed in the home since the last inspection visit. All required information was available on the files and evidence was available to show that they had undertaken the Skills for Care Induction modules based on the Common Induction Standards. It is important that robust recruitement procedures are in place to minimise the potential risk of unsuitable people being employed to work in the home. Charnley House currently hold the Investors In People Award. This award recognises the performance and management of the home in such things as ensuring people have the right knowledge, skills and motivation to work efficiently. Care Homes for Older People Page 23 of 28 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. The management, policies and procedures for the operation of the home were in place and worked in the best interests of people. Evidence: Both the registered manager and the deputy manager have worked at Charnley House for a number of years and therefore know the home and the people using the service well. They both continue to update their knowledge and skills by attending most courses attended by staff and the registered manager holds the Registered Managers Award (RMA). To assist in monitoring the service delivered to people living in the home the management team sends out questionnaires to both residents and their families and all comments are then collated and action is taken where required. The management team regularly reviews its policies and procedures and undertakes Care Homes for Older People Page 24 of 28 Evidence: regular servicing and maintenance checks of equipment and aids and adaptations used in the home. We randomly selected a number of service records to check and found them to be in order. The manager confirmed that they did not handle the finances of any person living in the home and billed families for things such as hairdressing and other purchases made on behalf of people using the service. We saw evidence on the staff files that supervision was taking place on a regular basis along with regular appraisals of staff performance. Written records were kept of each one to one session held with the staff member. In discussions with staff about the management of the home we were told Brilliant management - supportive, Good owners who try their best with things like the rotas, Absolutely fantastic employers and Communication is good with staff and management. Staff are always fully aware of any changes in the home. Care Homes for Older People Page 25 of 28 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 26 of 28 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 7 It is recommended that where a person using the service requires the assistance of staff with any aspect of their care needs, the care plan details clearly what and how that assistance should be offered/given. It is recommended that a photograph of the individual person be placed on the medicines file to further ease identification when administering medicines and to reduce the potential risk of medicines being administered to the wrong person. 2 9 Care Homes for Older People Page 27 of 28 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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