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Care Home: Chase House Ltd

  • House Lane Arlesey Bedfordshire SG15 6YA
  • Tel: 01462731276
  • Fax: 01462731276
  • Planned feature Advertise here!

Chase House is a two storey Victorian building, which has recently had a further extension built on in the style and character of the original building. The home is now 50 50 registered to accommodate 50 people, in single and shared bedrooms, most of which will have ensuite facilities once the refirbishment of the existing building is complete. On the ground floor there are lounges, dining rooms, and some bedrooms, as well as a kitchen, laundry and offices. The first floor is mainly bedrooms, with a small lounge for people who like peace and quiet. Part of the new extension is The East Wing: a unit for 7 people under 65 years of age, with mental health problems. The East Wing is almost self-contained, with its own lounge, dining room/kitchen and smoking room. A large conservatory attached to the main lounge of the home overlooks extensive landscaped gardens that have a very attractive water feature and countryside views. The home is within easy walking distance of Arlesey Village, which is on the main bus route from Hitchin to Bedford. The towns of Letchworth Garden City and Hitchin are three and four miles away respectively.

  • Latitude: 52.01900100708
    Longitude: -0.26100000739098
  • Manager: Mrs Deirdre McGuire
  • Price p/w: ~
  • UK
  • Total Capacity: 50
  • Type: Care home with nursing
  • Provider: Chase House Limited
  • Ownership: Private
  • Care Home ID: 4315
Residents Needs:
Dementia, mental health, excluding learning disability or dementia, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 5th March 2009. CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Chase House Ltd.

What the care home does well We looked at the responses to questionnaires the home sent to residents, relatives and staff as part of their quality assurance process. Several people wrote comments, showing how pleased they are with Chase House. Residents wrote "It`s lovely and I`m very grateful"; Food and everything [is good] - I`m well looked after"; "I like it all"; "I like the atmosphere"; "The staff, atmosphere very good - the care is wonderful"; "I like the company and the way they run the place"; "Hope it carries on because it`s nice". Relatives wrote "Thanks to everyone for looking after (name) - she thoroughly enjoyed her stay"; "Staff are amazing, this reflects well on them as individuals, as a team and on the management"; "Friendly, homely, cosy and clean"; "Staff very caring, helpful, and work hard - they deserve medals. The atmosphere is happy and positive"; "Staff have been there a long time which is a credit to the home". During the inspection we spoke with 2 relatives who both visit every day and are both happy with the care their relative receives. One said "It`s fantastic". Staff we spoke with were all positive about the home and the manager. They said the home is "friendly and relaxed". It is not often that we say we are impressed with what we find, but we said this more than once at Chase House, especially about the way staff and residents treat each other, care planning, activities, and the quality of the new extension. Information about the home is available and assessments of people`s needs are carried out before they are offered a place. Care plans and risk assessments combine to give staff clear, detailed guidance on the way people want their needs to be met in all aspects of their daily life, including personal care, healthcare, activities, meals and so on. Daily records give a good account of how each person has spent their day, and generally medication is handled in a satisfactory way. Three staff are employed at Chase House specifically to organise activities. They work over the whole 7 days and a wide range of things happen, both in the home, and in the local community. The home has its own transport so individuals or small groups of people can go on trips out to places such as pubs, garden centres, bowling and so on. Menus show that a varied, nutritious diet is offered, and people are mostly satisfied with their meals which are all cooked with fresh ingredients. People know their complaints will be listened to, and we found evidence to show that up to date guidance about safeguarding is being followed. The existing home is in need of refurbishment as this has been put back because of delays with the building work, but once completed the home will be very smart and comfortable. When all the changes have taken place, most of the bedrooms will have ensuite facilities and people are encouraged to have personal items in their bedrooms. The turnover of staff at Chase House is very low, but any new staff are recruited well. Staff rotas show that there is always a qualified nurse on duty, plus the manager either in the building or close by on call. Staff are offered training in a range of subjects. Comments from people who live here, their relatives and staff show that the management of the home is good. People`s money is taken care of, and health and safety given a high priority, with 2 health and safety officers appointed from the staff team. What has improved since the last inspection? Our comments in the above section of this summary, and in the body of the report, will show that there have been a number of improvements in the service offered by Chase House. This includes that both the requirements we made following our last inspection of the home have been met. What the care home could do better: Overall, Chase House is doing most things well. We have only made two requirements: that medication must be stored at the correct temperature; and that staff must receive regular supervision. We have recommended that the home considers using a heated trolley to store and transport meals; that food is pureed separately for people who need a soft diet; that staff training records are kept up to date; and that emergency lights are tested monthly by the staff in the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chase House Ltd House Lane Arlesey Bedfordshire SG15 6YA     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: Nicky Hone     Date: 0 5 0 3 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 29 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 29 Information about the care home Name of care home: Address: Chase House Ltd House Lane Arlesey Bedfordshire SG15 6YA 01462731276 01462731276 chasehouse@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chase House Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia physical disability Additional conditions: The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home is within the following categories: Dementia Code DE Mental Disorder (excluding learning disability) - Code MD Physical disability Code PD Date of last inspection Brief description of the care home Chase House is a two storey Victorian building, which has recently had a further extension built on in the style and character of the original building. The home is now Care Homes for Older People Page 4 of 29 Over 65 0 0 0 50 50 50 Brief description of the care home registered to accommodate 50 people, in single and shared bedrooms, most of which will have ensuite facilities once the refirbishment of the existing building is complete. On the ground floor there are lounges, dining rooms, and some bedrooms, as well as a kitchen, laundry and offices. The first floor is mainly bedrooms, with a small lounge for people who like peace and quiet. Part of the new extension is The East Wing: a unit for 7 people under 65 years of age, with mental health problems. The East Wing is almost self-contained, with its own lounge, dining room/kitchen and smoking room. A large conservatory attached to the main lounge of the home overlooks extensive landscaped gardens that have a very attractive water feature and countryside views. The home is within easy walking distance of Arlesey Village, which is on the main bus route from Hitchin to Bedford. The towns of Letchworth Garden City and Hitchin are three and four miles away respectively. Care Homes for Older People Page 5 of 29 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: For this inspection we (the Commission for Social Care Inspection) looked at all the information that we have received, or asked for, since the last key inspection of Chase House. This included: - What the service has told us about things that have happened in the home. These are called notifications and are a legal requirement; - Any complaints and/or safeguarding issues that have arisen; and - Information we asked for following our visit. We did not ask the home to complete an AQAA and we did not send out any surveys for this inspection. Care Homes for Older People Page 6 of 29 This inspection of Chase House also included a visit to the home on 05/03/09. No-one who lives or works at the home knew we were going to visit on this day. We spent time talking to the people who live here, the manager/owner, staff, and relatives. We looked round the home and spent time sitting in the main lounge so that we could see what happens during the day. We also looked at some of the paperwork the home has to keep including care plans, risk assessments, medication charts, and records such as staff personnel files, staff rotas, menus and fire alarm test records. Since our last inspection, a large extension has been added to the home. This has been done very well, in keeping with the existing Victorian building, so ground floor rooms have high ceilings and large windows. A new kitchen, and dining room on the ground floor and 11 new bedrooms on the first floor have been added to the nursing home. Included in the extension is a separate unit, called The East Wing, which provides a home to 7 people with mental health issues who are under the age of 65 years. At the time we visited the existing home was undergoing a complete refurbishment, with several rooms changing use, small bedrooms being combined into larger rooms, and the whole home being redecorated. Once completed, if the same standard of decoration and furnishings is used as in the new extension, the home will be really smart, and be a very pleasant environment to live in. What the care home does well: We looked at the responses to questionnaires the home sent to residents, relatives and staff as part of their quality assurance process. Several people wrote comments, showing how pleased they are with Chase House. Residents wrote Its lovely and Im very grateful; Food and everything [is good] - Im well looked after; I like it all; I like the atmosphere; The staff, atmosphere very good - the care is wonderful; I like the company and the way they run the place; Hope it carries on because its nice. Relatives wrote Thanks to everyone for looking after (name) - she thoroughly enjoyed her stay; Staff are amazing, this reflects well on them as individuals, as a team and on the management; Friendly, homely, cosy and clean; Staff very caring, helpful, and work hard - they deserve medals. The atmosphere is happy and positive; Staff have been there a long time which is a credit to the home. During the inspection we spoke with 2 relatives who both visit every day and are both happy with the care their relative receives. One said Its fantastic. Staff we spoke with were all positive about the home and the manager. They said the home is friendly and relaxed. It is not often that we say we are impressed with what we find, but we said this more than once at Chase House, especially about the way staff and residents treat each other, care planning, activities, and the quality of the new extension. Information about the home is available and assessments of peoples needs are carried out before they are offered a place. Care plans and risk assessments combine to give staff clear, detailed guidance on the way people want their needs to be met in all aspects of their daily life, including personal care, healthcare, activities, meals and so on. Daily records give a good account of how each person has spent their day, and generally medication is handled in a satisfactory way. Three staff are employed at Chase House specifically to organise activities. They work over the whole 7 days and a wide range of things happen, both in the home, and in the local community. The home has its own transport so individuals or small groups of people can go on trips out to places such as pubs, garden centres, bowling and so on. Menus show that a varied, nutritious diet is offered, and people are mostly satisfied with their meals which are all cooked with fresh ingredients. People know their complaints will be listened to, and we found evidence to show that up to date guidance about safeguarding is being followed. The existing home is in need of refurbishment as this has been put back because of delays with the building work, but once completed the home will be very smart and comfortable. When all the changes have taken place, most of the bedrooms will have ensuite facilities and people are encouraged to have personal items in their bedrooms. The turnover of staff at Chase House is very low, but any new staff are recruited well. Staff rotas show that there is always a qualified nurse on duty, plus the manager either Care Homes for Older People Page 8 of 29 in the building or close by on call. Staff are offered training in a range of subjects. Comments from people who live here, their relatives and staff show that the management of the home is good. Peoples money is taken care of, and health and safety given a high priority, with 2 health and safety officers appointed from the staff team. 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. 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 29 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 29 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. Information is available about the home for people thinking about moving here, and assessments are carried out so that people know the home can meet their needs. Evidence: Chase House has a statement of purpose, and service user guide. These are updated regularly so that people know what they can expect from the service. As well as residential and nursing care, Chase House offers day care to a small number of older people. The personal records we looked at included full assessments of peoples needs, carried out before the person was offered a place at Chase House. One persons assessment, carried out by a social worker, stated that Chase House is the appropriate place for this person. The manager told us she visits each person before they are offered a place at the home. Care Homes for Older People Page 11 of 29 Evidence: Intermediate care is a service offered by some homes, which gives short-term, intensive rehabilitation for people leaving hospital before they return to their own homes. This service is not offered at Chase House therefore standard 6 is not applicable. Care Homes for Older People Page 12 of 29 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. A lot of good practice is shown in the care plans which are detailed and give staff good guidance on the way each person wants their needs to be met. Risk assessments are carried out and medication is dealt with in a satisfactory way. Evidence: During the inspection we based ourselves for quite a long time in the main lounge so that we could get a feel of what happens in the home, while we were reviewing the records. We noted that staff and residents have very warm, caring, friendly yet respectful relationships. The relatives were welcomed and were treated as friends, and the atmosphere was very pleasant. In the homes questionnaire, several people made positive comments about the atmosphere. We chose the personal records of 4 residents to look at. We were very impressed with the care planning, and found numerous examples of good practice. Each person has a care plan which gives staff good details and guidance on the way each person needs to be cared for. Each care plan had been reviewed monthly, and the reviews were meaningful and detailed. In one case they gave a clear picture of how the persons Care Homes for Older People Page 13 of 29 Evidence: general health has deteriorated, and how therefore their needs had changed. Care plans include the aims that the care plan is intended to meet. For example, a care plan relating to dementia for one person had aims of keeping (name) calm, stress free and happy. Care plans about pressure areas included the type of equipment each person needs, and a night care plan contained information about what time the person usually likes to go to bed. Records included a number of risk assessments, including a dependency assessment, nutrition assessment and pressure sore assessment. The dependency assessment had been reviewed each month since the person was admitted. A mental capacity assessment had also been carried out for each person. One persons nutrition assessment included a note that the kitchen had been informed about certain foods the person should not eat, to help with a medical condition. This persons records showed that she had lost some weight: the care plan stated that food/fluid intake charts were to be filled in. We found these near the person and they were being completed well. The records we looked at showed that the home accesses a good level of healthcare support. We saw records of peoples appointments with their doctor, hospital and so on. A chiropodist visits the home about every 6 weeks: residents pay for this service if they need it. Staff write daily notes about each person: the notes we looked at were of a good standard, detailed and objective, giving a clear picture of what sort of a day each person has had. We were concerned about some of the information we found in one persons notes. This person was clearly having some acute mental health issues which were impacting on other people, especially staff. The care plan and guidance for staff were very good indeed, giving staff advice on what to do if the person had an outburst. The doctor and community psychiatric nurse (CPN) were visiting the person on the day of our inspection. The doctor was attempting to deal with the persons difficulties by changing their medication: this should be done in a specialised hospital setting, not in a care home. We discussed this with the manager, and followed this up after the inspection to make sure the person was being given the care they needed, in the right place. We looked at the way the home deals with medication. We were not able to look at medication or records in the East wing as one of the residents was quite unsettled. Care Homes for Older People Page 14 of 29 Evidence: However, we did note that the medication trolley was stored in a cupboard where there were heating pipes: the temperature of the room had been recorded daily, and was always above the recommended maximum temperature for medication storage which is 25 degrees centigrade. It was 27 degrees at the time we looked at the thermometer. Before we left, the manager and co-owner had already planned to build a lockable cupboard in the hallway so the medication could be stored at a lower temperature. In the main part of the home, the medication trolleys and medication cupboards were temporarily in the same room as the office. The manager said this would not be the case when the building work is finished. We checked medication and administration records and apart from a couple of minor discrepancies, which we discussed with the manager, everything was satisfactory. Care Homes for Older People Page 15 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered a wide range of opportunities so that they can lead full, satisfying and interesting lives. Evidence: We were very impressed with the activities that take place at Chase House. 3 staff are employed specifically to organise activities. Between them they work 93 hours a week, over the whole 7 days. They decide between themselves which hours they will work, depending on what activities they have arranged. All 3 were working on the day we visited. A wide range of activities takes place, including things that staff arrange in the home, trips out, and entertainment brought in. The home has its own transport which can take up to 4 people at a time. There are trips out arranged every week, for example to local shops, pubs, garden centres and bowling. In house, people are involved in activities ranging from pizza making and hand massages, to exercise sessions, games and quizzes. Religious services take place, and lots of people go for walks locally. There were a number of things happening during our visit, including two people from the East wing going bowling. The staff agreed that unfortunately the records are not good enough to reflect what actually happens, as they forget to write a lot of it down. Care Homes for Older People Page 16 of 29 Evidence: We saw lunch being served in the dining room. People were assisted to the tables, choosing which table they wanted to sit at, or they were assisted to eat in the lounge. Staff made sure people were sitting down comfortably before offering them a drink. The choice of meal was braised steak in a tomato and basil sauce, with new and mashed potatoes, carrots, broccoli and cauliflower, or a ham and cheese salad. People could also choose a jacket potato with whatever filling they liked. The meal was served quickly and efficiently, and staff knew who needed help. 6 residents ate at a dining table in one of the lounges. Their meals had been plated up and kept hot in the oven, and were delivered to them on a trolley. Unfortunately the meals had become a little dry, and all these people said the meat was too tough to eat. Staff (and some of the residents) told us this was most unusual as the food was usually very good. We recommended that the home uses a heated trolley (hostess type perhaps) that would keep the food at a safe temperature, but not let it dry out. We tasted a very small portion of the meal and it was delicious. We spoke with the catering manager/chef who showed us that the menus have a good selection of varied and nutritious meals. He bases the menus on what the residents say they like to eat. He said that almost all the food at Chase House is produced using fresh ingredients, with 3 or 4 fresh vegetables every day. Salads or jacket potatoes are always available for people who dont want the main meal, and lots of homemade puddings and cakes are offered. In the questionnaire which residents completed (see Management section of this report), people showed they are satisfied with the food. People who could not sit in the dining room were assisted with their meal in the lounge. Two relatives visit every day at lunch time and help their relative with their meal. Other people were assisted by staff, who were sitting down to help people. There seemed to be plenty of staff to help anyone who needed it, and all round, lunch time was a very pleasant, unhurried affair, with staff and residents chatting to each other and enjoying each others company. We saw that 2 people were being assisted to eat a thick, brown soup. This was the same meal, but all pureed together in a bowl. Pureed food should be served like a meal, with each different food pureed separately so that the person eating it can see the different colours and taste the different flavours of each food. Care Homes for Older People Page 17 of 29 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. People know that their concerns will be listened to and acted on, and that systems are in place to keep them safe from harm. Evidence: Chase House has a complaints procedure and a record would be kept of any complaints: there have not been any complaints made since 2003. The procedure includes details of how people can contact CSCI if they feel their complaint has not been dealt with. We received some information from a relative in September 2008 who was concerned that people were not being kept safe during the building work. We contacted the home who assured us that everyone was safe. We asked them to send us the risk assessment that they were using during the time the work was being done. On the day we inspected there was building work to the side of the main entrance hall: this was being done safely. In the personal notes we looked at, we found examples of good practice in relation to safeguarding (SOVA). For example, one person had a risk assessment and care plan because she has a history of slips, trips and falls. The care plan stated complete SOVA referral if more than 3 incidents in the month, or if injury occurs which is the current Bedfordshire guidance. Care Homes for Older People Page 18 of 29 Evidence: The training records showed that some staff have had safeguarding training. A number of other staff are currently completing a workbook on safeguarding vulnerable adults (SOVA). They will take an exam when they have completed the workbook, which is sent away for external marking. Care Homes for Older People Page 19 of 29 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. Once the building and refurbishment work is complete, Chase House will offer a welldecorated, well-maintained, comfortable and clean place for people to live. Evidence: Chase House has been extended since our last inspection. The extension provides a large conservatory on the main lounge, a brand new kitchen and a large new dining room on the ground floor and 11 new bedrooms with ensuite shower rooms upstairs. Also on the ground floor is a separate wing, called the East Wing, which is a selfcontained unit for seven people, all under the age of 65. The extension is very impressive. It has been built in keeping with the original Victorian house, so the ground floor rooms are very spacious, with high ceilings and large windows. The East Wing has a kitchen/dining room, lounge, smoking room, and seven ensuite bedrooms, as well as a staff area in the hallway. There is good access to the gardens, and the wing can be reached from the front of the house without walking through the main home. All areas of the wing are well decorated and very comfortably furnished. As well as the new bedrooms, there is also a small sitting room upstairs for people who do not like the hustle and bustle of the main lounge area. One lady told us she loves the peace and quiet. We saw a number of personal items, for example furniture, pictures, photographs, ornaments and so on in peoples bedrooms: the manager said Care Homes for Older People Page 20 of 29 Evidence: people are encouraged to bring in their own things for their room if they want to. There have been some major changes to the rest of the home, and building work was still going on at the time of our visit. The manager showed us that the old dining room and kitchen have been converted to large new bedrooms, one single and one which might be a double. Some parts of the existing home are long overdue for redecoration and a number of the carpets need to be replaced. The person who contacted us in September 2008 (see Complaints section of this report) commented that gaffer tape was holding carpet seams together, and this was still apparent during this inspection. The manager explained that they had wanted to wait until the extension was complete before refurbishing the existing building, because there are still some major changes, such as 4 small single bedrooms being made into 2 large single rooms with ensuites, to take place. There had been some long delays in planning the extension, which has put everything else back. She was not able to give us a timescale for the refurbishment but she assured us it will be done as quickly as possible. If the same standard of decoration and furnishings is used in the refurbishment of the existing building, as has been used in the new extension, the home will be very smart indeed when it is all finished. In spite of the building work, the staff have managed to keep the home clean, and, apart from a couple of old rooms where carpets have been down a long time, everywhere smelt fresh. Care Homes for Older People Page 21 of 29 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. Staff are happy working at Chase House, new staff are recruited well, and training is offered so that staff can do their jobs well. Evidence: Staff rotas showed that there is always a qualified nurse on duty, plus the manager (herself a qualified nurse) either in the building or close by on call. There are also 7 to 8 staff on duty during daytime hours (8 when the home is full), plus 3 staff who are employed solely to organise activities. The home has a twilight shift of 5p.m. to midnight so that residents who want to stay up later can do so and there will be enough staff to assist them to bed. There is a separate team of chefs, kitchen and domestic staff, and an administrator. The co-owner does all the homes maintenance, and with a team of construction workers has carried out all the building of the extension and the refurbishment of the existing home. The manager said that the staff team are very good and cover for each other when there are holidays or sickness. The staff turnover at Chase House is very low. Some of the comments in the homes questionnaires indicated that there have been times when there have not been enough staff on duty. One relative said Lack of staff on the ground floor in the early evening, and 3 staff all said that more staff would give even better opportunities for the residents. The manager monitors this closely and brings in extra staff when needed. For example, during our visit, one person was very restless Care Homes for Older People Page 22 of 29 Evidence: and was disturbing other people. The manager had arranged for this person to have one-to-one support all the time, so a member of staff stayed with her at all times to make sure she did not come to any harm. The staff training record forms part of the statement of purpose. The manager explained that all the building work, moving rooms around and having to operate from a very cramped office, as well as a high level of sickness amongst staff in December, January and February meant that training had to be cancelled and the training records had not been brought up to date. However, the records show that staff are offered a good range of training opportunities, in a number of different ways. One of the staff is a clinical nurse tutor so she trains the other nurses, for example in care of people with dementia. A number of staff are completing a workbook on safeguarding vulnerable adults (SOVA) (see Complaints and Protection section of this report). Care Homes for Older People Page 23 of 29 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. Chase House is managed well so that people have a good quality of life. Evidence: Chase Houses quality assurance system includes a regular QA meeting attended by senior staff, and sending out questionnaires to the residents, their relatives and to all staff. The responses to the questionnaires are collated into a report, which we saw. Some of the comments have been included in the summary and other sections of this report. Almost all the residents have decided they would like to keep a small amount of cash in the homes safe. A record is kept of any money that goes into or out of the account. We checked one persons records: these were kept well and the cash and balance were correct. The manager said if there are any problems with residents financial affairs, she reports back to the social work or safeguarding teams. Staff supervision is cascaded through the home, with the manager supervising senior Care Homes for Older People Page 24 of 29 Evidence: staff, and the seniors supervising other staff. We did not look at records of when supervision has taken place. Staff told us that supervision does happen, but it has been a bit sporadic recently because of sickness and staff holidays. Two of the staff are health and safety officers. They showed us their fire records, which are all kept in a fire-proof box in the front porch. The fire risk assessment was updated in January 2009: when it was sent to the fire station to be approved, the fire officer told them it was the best one he had seen. 12 of the staff have been trained as fire wardens and all staff have fire safety awareness training every year which they get a certificate for. Fire drills are held randomly at different times during the day and staff are given feedback on how well they have reacted. There were information cards, which are also round the home, describing where the services are located (for example the stop-cock for the main water supply, fuse boxes, and the gas supply tap). The fire equipment is checked regularly by an external contractor: he was doing the yearly check of the fire extinguishers while we were at the home. Records showed that staff test the fire alarms every week, and the emergency lights are tested every 6 months by the contractor: these should also be tested monthly by the home. We also saw a contingency plan which has been put in place in case the home needs to be evacuated. Temporary accommodation has been arranged for everyone in the village hall. A personal evacuation plan has been drawn up for each of the residents, which we saw in their files. Care Homes for Older People Page 25 of 29 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 29 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 1 9 13 Medication must be stored at the correct temperature. So that medications are not damaged and are able to do what they are meant to do to keep people healthy. 30/04/2009 2 36 18 All staff must receive regular 31/05/2009 supervision. Each staff member must receive one supervision session within the timescale, and regularly thereafter. So that staff are properly supported to do their job well. 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 15 When soft or liquid food is needed, each item of food should be pureed separately so that people can still see the colours of the food and taste the different flavours. Care Homes for Older People Page 27 of 29 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 2 15 The home should consider providing a heated trolley or similar so that meals can be kept at the correct temperature without drying out. Staff training records should be kept up to date so that there is evidence that all staff have received appropriate training. Emergency lighting systems should be tested at least monthly by the staff in the home. 3 30 4 38 Care Homes for Older People Page 28 of 29 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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