Care Home: Chase House Rest Home

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What the care home does well Prior to admission to the home each prospective resident has the opportunity to decide how much of their own furniture they would like to bring with them to make their bedroom as much their own as possible, to reflect their personality and taste and have a sense of identity and belonging. The residents benefit from living in a comfortable, safe, pleasant, wellmaintained environment, which is clean and hygienic. The home retained many of its original features, was equipped with good quality furnishings and fittings and all the rooms were pleasantly decorated. A resident commented, `the home is in lovely surroundings, it is always clean, tidy and fresh and there are always displays of flowers for us to enjoy. Oh yes, I have never seen a spot of dust.` There was a team of dedicated and loyal staff most of whom had worked at the home for some considerable time. 100% of the staff, including the cook and domestic staff, had achieved National Vocational Qualifications (NVQ) at level two or three or were working towards a qualification. The manager commented on the level of commitment to the home shown by all the staff in achieving this. The staff spoken with were happy in their work and complimentary about the management. Comments included, `It`s lovely working here,` `we couldn`t have a better manager` and `we work as a team and help each other`. It has always been a happy home. My mother was a resident for ten years and I would recommend it to anyone,` a staff member stated and a resident commented, `I would not like to go anywhere else, this is a lovely place to be, it is a well run and caring home.` What has improved since the last inspection? The statement of purpose had been reviewed to include the contact details of the Commission for Social Care Inspection (CSCI) and a copy was available pinned to the notice board in the entrance hall to inform residents, their relatives and representatives should they wish to contact us. A copy of the latest CSCI report was also available to residents and visitors to the home. A requirement had been made at the previous site visit with respect to formal staff supervision. The supervision records of two staff were sampled showing that practice had improved in this area in that formal sessions had been recorded to confirm the staff were receiving support and feedback on their work. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Chase House Rest Home Chase House Hindhead Road Hindhead Surrey GU26 6AY Lead Inspector Christine Bowman Unannounced Inspection 27th March 2008 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chase House Rest Home Address Chase House Hindhead Road Hindhead Surrey GU26 6AY 01428 652763 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Kathleen Harris Mrs Kathleen Harris Care Home 16 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (8), of places Physical disability over 65 years of age (2) Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2006 Brief Description of the Service: Chase House is a large detached property located in the village of Hindhead. The service provides accommodation and care for up to sixteen older people, six of whom may also have dementia. The accommodation is arranged over two floors, with the first floor being reached by stairs or chair lift. At present all bedrooms are used as single occupancy, however two of the bedrooms are registered for use as double rooms. All bedrooms have a hand washbasin and some rooms have en-suite facilities or adjacent bathroom/toilet. There is a spacious communal lounge and dining room and also further seating areas throughout the home. There are several bathrooms and toilets located on both floors, all of which have adapted facilities for those with mobility problems. The home has extensive gardens to the rear of the property and these are well maintained and accessible to the service users. There is parking for a limited number of cars to the front of the building. The home does not have its own vehicle but accesses a mini-bus from Age Concern for trips out. Fees at this home are in the range of £470 to £609 per week. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This unannounced site visit was conducted as part of a key inspection using the Commission’s ‘Inspecting for Better Lives’ (IBL) process. The site visit took place over five and a half hours commencing at 11.00am and ending at 16.30pm and was undertaken by Ms Christine Bowman, Regulation Inspector. The registered manager, Mrs Kathleen Harris was available throughout the day and assisted with the inspection process. A senior carer, the chef, another carer, a member of the domestic team and a National Vocational Award Assessor were interviewed and the staff were observed throughout the day as they interacted with the residents. Residents were interviewed as they socialised over lunch, a tour of the premises was undertaken and six residents permitted their bedrooms to be viewed. The home had a calm but purposeful ambiance; the staff were friendly, cheerful and enthusiastic about their work and the residents happily spoke about their interests, trips they had made to see shows in the local community and the entertainment provided at the home. Staff and residents alike were appreciative of the management and the compliment was returned by the owner/manager, who was committed to supporting the staff and ensuring the residents retained their independence, their dignity, interest in life and that the environment was comfortable, homely and well-maintained for their enjoyment. Resident’s files, including initial assessments care plans and risk assessments, were sampled and the personnel files of four staff including their recruitment, induction and individual training and development plans were also inspected. The complaints and compliments log, medication records, accident and maintenance records were viewed. Five residents completed surveys which were supplied by the Commission, with support from their relatives. Five staff also completed surveys and comments and information from these sources have been included in the report. The Annual Quality Assurance Assessment (AQAA) completed by the manager and sent to the Commission for Social Care Inspection (CSCI) and other information received since the previous site visit have been included in this report. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 6 Thanks are offered to the management, the staff and the residents of Chase House for their assistance and hospitality on the day of the site visit and to all those who completed surveys for their contribution to this report. What the service does well: What has improved since the last inspection? The statement of purpose had been reviewed to include the contact details of the Commission for Social Care Inspection (CSCI) and a copy was available pinned to the notice board in the entrance hall to inform residents, their relatives and representatives should they wish to contact us. A copy of the latest CSCI report was also available to residents and visitors to the home. A requirement had been made at the previous site visit with respect to formal staff supervision. The supervision records of two staff were sampled showing that practice had improved in this area in that formal sessions had been recorded to confirm the staff were receiving support and feedback on their work. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,3,6 People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Sufficient information is available to prospective clients to help them to make a decision about the suitability of the home to meet their needs and expectations. Prospective residents individual needs are assessed prior to the offer of a placement to ensure the home is able to meet them. The home does not provide intermediate care, so Standard 6 does not apply. EVIDENCE: Since the previous site visit, the statement of purpose had been reviewed to include the contact details of the Commission for Social Care Inspection (CSCI) and a copy was available in the home, pinned to the notice board in the entrance hall to inform the residents, their relatives and representatives should they wish to contact us. The Annual Quality Assurance Assessment noted that Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 10 this information was available in large print for those with visual impairment. A copy of the latest CSCI report was also available to residents and visitors to the home. The manager stated that prospective residents are all given copies of the statement of purpose and the service user guide and in addition to having an assessment prior to a placement being offered, prospective residents were encouraged to spend some time at the home, ‘so they can get the feel of the home and what it has to offer them and also to see if it meets with their expectations’. The five residents who completed surveys confirmed this and they all stated they had received enough information about the home before moving in so they could decide if it was the right place for them. One resident commented, ‘my family found the home and thought it had a caring and loving atmosphere and was just right for me,’ and another resident stated, ‘I visited the home, met the staff and people, spent some time here and thought it was all very nice.’ Information with respect to equality and diversity was recorded prior to admission and included the prospective resident’s ethnic background and their first language. Assessments viewed on resident’s files covered their ability to care for themselves with respect to personal care and domestic tasks, considered the implications and levels of risks involved in carrying out the tasks and recorded their lifestyle choices and preferences to ensure and individual care plan could be completed from this information. ‘Prospective residents are made aware of the fact that they can bring as much of their own furniture as they wish according to the dimensions of the bedroom’, the manager stated. Although the home provided good quality furnishings, the manager was prepared to put these items into storage to ensure the prospective clients had the opportunity to make their bedroom as much their own as possible, to reflect their personality and taste and have a sense of identity and belonging, which can so easily be lost in otherwise impersonal settings. Some clients had lived at the home for many years and when their bedrooms were viewed and the residents spoken with, it was clear this policy gave much added value to the experience of making this home their own. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10 People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. A person-centred approach to care promotes the fulfilment of individual needs with respect to health, personal and social care. Medication is handled safely, the residents are treated with respect and their right to privacy is upheld. EVIDENCE: Three resident’s files were sampled and each contained a care plan and details of monthly reviews and daily records. The manager wrote in the AQAA that an improvement over the previous twelve months had been that the reviewing of residents care plans had included more input from relatives. Care plans had been written in a person-centred way describing the resident’s self-care ability, the nature and degree of intervention required and included the resident’s preferences to inform the staff. Risk assessments were included with respect to falls, nutrition and the development of pressure areas and a record of Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 12 intervention by healthcare professionals was kept. The five residents who completed surveys with support from their relatives/representatives confirmed they always received the care and support they needed. One resident commented, ‘I have always received good care, family always welcomed in and when health issues arise they are dealt with promptly,’ and another resident stated, ‘the staff are always willing and helpful in their care.’ The six staff who completed surveys all confirmed they were always given up to date information about the needs of the people they support. Access to district nurses, speech therapists, Parkinson’s nurses and monthly visits from a General Practitioner were recorded in the residents’ daily notes. The AQAA recorded that the residents had access to community eye care and hearing screening annually and benefited from a visiting chiropodist. Dog therapy was popular and had a regular slot in the weekly schedule. The manager noted that one resident had been supplied with an air mattress as a preventative measure with respect to the development to pressure sores and a bath hoist was available should it be required. To improve the service the manager recorded she, ‘would like to arrange six monthly dental checks’. Four of the five residents who completed surveys recorded that they always receive medical support when they need it and one that they usually did. One resident commented, ‘If I want it I ask for it and I am always listened to, and the staff will ask the doctor to see me if they think it is necessary,’ another resident stated, ‘I see the doctor regularly.’ Medication was safely stored in a secure trolley and no resident had been assessed as self-medicating. All the staff had been trained to administer medication, the manager stated, and the training had been delivered by a qualified trainer and externally accredited. Confirmation of the training records of two staff were viewed and a list of approved signatures for the administration of medication was kept. A local pharmacist supplied the medication in blister packs on a twenty-eight day cycle and records confirmed an audit was kept of drugs brought into the home, drugs administered and those returned to the pharmacy. The residents’ medication administration records contained photographs of the residents to ensure correct identification. The two residents’ records sampled had been completed appropriately. During the site visit the staff observed treated the residents very respectfully, knocking on bedroom doors and waiting to be invited in, and paying close attention when communicating with the residents. There was a good rapport between the staff and the residents. A cordless telephone enabled the residents to take calls from their relatives/friends in the privacy of their own bedrooms should they wish to do so. The Common Induction Standards were used, the manager stated, to ensure new staff were aware of how to support individuals with respect to privacy and dignity, to promote equal opportunities and to give support respecting diversity, different cultures and values. Staff who completed surveys commented on what they thought the service did well including, ‘The home gives the clients their independence, meets their needs Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 13 and provides a friendly atmosphere,’ ‘ the service we provide makes our residents’ lives as comfortable, pleasurable and safe as we can. The residents receive a lot of one to one care’ and a third thought the service did ‘Everything’ well. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15 People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Residents enjoy individual lifestyles, exercise choice and control over their lives, maintain social contacts and receive a wholesome, appealing balanced diet in pleasing surroundings. Access to the community could be improved in accordance with residents’ needs and wishes. EVIDENCE: The home’s ‘Lifestyle Choices and Preference Assessment’ provided information about the individual residents’ likes and dislikes with respect to food, and mealtimes, leisure and social interests, cultural and religious wishes and involvement and their aspirations with respect to continuing personal development and learning. Residents spoken with were clear about how they liked to spend their time. One resident stated they, ‘liked to play dominoes and go shopping’ another resident, ‘enjoyed walking in the garden’ and two others, ‘particularly liked seeing ‘The King and I’ in Haslemere hall’, and had favourite videos they enjoyed watching on the wide screen television.’ Clients take part Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 15 in activity planning, the manager stated and the AQAA recorded that there was a choice of church services, which were held at the home twice each month and that entertainment was provided by a theatre group three to four times a year. A soloist entertainer visited alternate months, and, the manager stated, ‘a visiting farm had been a great success.’ Of the five residents who completed surveys, three confirmed there were always activities arranged at the home they can take part in and two that there usually were. One resident commented, ‘ I get involved if the activity is suitable for me,’ and another wrote, ‘I enjoy activities such as singing and crafts etc.’ ‘Residents’ families and friends are always welcome to come and have meals with them at the home and to take part in all that is going on within the home’, the manager stated. Comments from the home’s own quality assurance questionnaires confirmed that residents and their relatives found the home calm, warm and welcoming and that the clients were content. Some residents had regular visitors, but for those who didn’t, the AQAA recorded, volunteers were encouraged to come in for a chat and take afternoon tea with the residents and the home supplies special treats such as flowers and sweets for those who do not have a visit. A relative who was supporting a resident to complete a survey commented, ‘It would be nice to have more outings for the residents – these have unfortunately decreased owing to lack of certified transport.’ The manager confirmed that transport had become more expensive to arrange and that she was looking into alternative possibilities to enable some residents to be accompanied to the local shops and garden centres. Plans were also in place to provide more social gatherings in addition to the annual garden party and Christmas celebrations. Lunch was a pleasant social experience and most of the residents gathered in the dining room to share this occasion. The AQAA recorded that one of the changes that had been made as a result of listening to the residents was arranging to have meals in their rooms. Some clients wanted to have dining table in their bedrooms so that meals would not always have to be provided on trays when they made this choice. One resident, who preferred the seclusion of their bedroom, was visited. She liked to watch for wildlife in the garden as she ate her meal at her own dining table. The residents enjoyed their lunch of steak and kidney pie and vegetables followed by jelly, fruit and cream. Comments included, ‘the staff make sure we always get good food,’ and ‘ the food is lovely and there’s plenty of it. The residents spoken with showed a great deal of interest in life and enthusiasm for entertainment both inside and outside the home. All the residents who completed surveys confirmed they always enjoy the meals at the home. One resident stated, ‘ the food is always excellent’ and another that, ‘the meals are very good.’ Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16,18 People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Policies, procedures and training ensure the staff are informed and the residents are confident that their complaints will be listened to and that they will be protected from abuse. EVIDENCE: Four of the five residents who completed surveys stated they always knew who to speak to if they were not happy and one commented, ‘yes I do know who to speak to, but I have no cause to! The staff always listen and help.’ Four residents also confirmed they knew how to make a complaint and one wrote, ‘I would speak to one of the staff I know well or to one of my daughters to speak for me, but I’ve got no complaints.’ The six staff who completed surveys stated they knew what to do if a resident, their relative/representative had concerns about the home. The AQAA recorded that residents and their relatives/representatives had been given a copy of the home’s complaints procedure, that the home had an ‘open door’ policy with respect to concerns and they were dealt with immediately. ‘We have had no complaints over the previous twelve months’, the manager stated and the Commission for Social Care Inspection had received no complaints on behalf of this service. The complaints and compliments log contained a compliment from the relative of a resident, ‘Thank you to all the staff for all the care you have given our mother over the last five years, we are most grateful.’ Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 17 The home had an up to date copy of the local authority safeguarding procedures and the staff had signed to confirm they had read them. On a notice board in the corridor outside the office was a safeguarding poster with referral details. The AQAA recorded that the staff are made aware of the whistle-blowing policy and they have all attended training in the prevention of abuse of vulnerable adults. No referrals had been made since the previous site visit. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,23,24,26 People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a comfortable, safe, pleasant, well-maintained environment, which is clean and hygienic. EVIDENCE: The home was located in a secluded and elevated position overlooking its own well-maintained and mature gardens and there was a small car park at the front of the house leading off the drive. The exterior of the attractive, detached house matched those in the surrounding area. The house retained many of its original features with high ceilings, large windows and fireplaces. A tour of the premises confirmed the home was suitable for its stated purpose and it was clear that much effort had been exerted to ensure this was a homely and Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 19 pleasant place for the residents to live. There were fresh flowers in the entrance hall, framed pictures on the walls, plants, pleasant domestic lighting, and comfortable and appropriate furnishings for the enjoyment and comfort of the residents. The home also had a shared cat, which enjoyed the attention of the residents as much as they enjoyed giving it. Communal areas included the large entrance hall with a sitting area above from which there was a good view of the garden through a large window, which created a light and airy space. The sitting and dining room were combined in one large room with French doors leading to the garden, which was well maintained and equipped with garden furniture for use in the warmer weather. In the sitting room was a bookcase containing large print books, which the manager stated was changed on a two monthly basis by the mobile library to ensure there were always new titles for the residents to enjoy. By ensuring the books were available in large print, equal access for residents with limited visual ability was promoted. There was also an organ in the sitting room and when the residents were chatting over lunch they said how much they were looking forward to having a singsong around the organ in the afternoon. In fact some of the residents could not contain their enthusiasm and a practice session of songs from ‘The Sound of Music’ occurred between courses. Some of the resident’s bedrooms were located on the ground floor and some were on the first floor. Although the home was registered for two double bedrooms they were being used as single rooms, so all the residents had their own bedrooms and no one needed to share. The staircase was wide, light and airy and a stair lift was available to assist those for whom the staircase was too challenging. The manager stated that residents were encouraged to walk up the stairs independently if they were able. The resident’s bedrooms which were seen were clean and fresh. Residents had been encouraged to bring their own furniture into the home, to make their rooms more personal. This policy promoted the retention of the residents’ self-esteem and their rights and choice to make the home ‘their’ home and resulted in the experience of visiting a number of diverse ‘homes’ reflecting the individuality of each resident. The AQAA confirmed there was an on-going programme of maintenance and repair, that the recommendations made by the fire officer with respect to fitting smoke strips on all doors and the changing all locks had been completed to safeguard the residents. The rolling programme of re-decoration and maintenance included plans to decorate the main hall and stairway, to review seating in main hall and to replace the soft furnishings. Appropriate laundry facilities were provided and hand washing facilities were available to promote infection control. Staff training records confirmed that infection control training was included in the mandatory annual updates for all the staff. The five residents who completed surveys confirmed the home was always fresh and clean and one resident stated, ‘the home is in lovely Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 20 surroundings, it is always clean, tidy and fresh and there are always displays of flowers for us to enjoy. Oh yes, I have never seen a spot of dust.’ Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30 People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. A stable, well-trained staff team meet the needs of the residents and ensure they are in safe hands at all times. Although most recruitment documents and information had been obtained, one aspect of the recruitment procedures and practice needs to be reviewed to ensure the protection of residents. EVIDENCE: The AQAA recorded that no staff had left the employment of the home in the previous twelve months and that the home benefited from having a team of dedicated and loyal carers, most of whom had worked there for some considerable time. Throughout the day of the site visit, there were sufficient care and domestic staff on duty to cater for the needs of the residents and the staff rota showed that the night staff consisted on one waking night staff and one sleeping in. The staff spoken with were complimentary about the management and made comments including, ‘It’s lovely working here,’ ‘we couldn’t have a better manager’ and ‘we work as a team and help each other’. 100 of the residents who completed surveys confirmed the staff were always available when they needed them and that the staff listen and act on what they say. One resident commented, ‘The staff are always willing and helpful in Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 22 their care.’ The home was well maintained, clean and hygienic and free from unpleasant odours. 100 of the staff, including the cook and domestic staff, had achieved National Vocational Qualifications (NVQ) at level two or three or were working towards a qualification and the manager commented on how pleased she was at the level of commitment to the home shown by all the staff in achieving this. An NVQ assessor was visiting on the day of the site visit to work with one of the domestic staff. The manager stated that she had taken advantage on the ‘Train to Gain’ scheme, which had enabled her to ensure a high standard of training and that she employed a training manager to over-see staff training and ensure it was up-to-date. The manager was also an NVQ assessor and stated she was committed to supporting the staff in their achievements. Staff personnel files sampled showed that two staff were in the process of recruitment but their Criminal Record Bureau (CRB) checks had not yet been received. Protection of Vulnerable Adults POVA First checks had been applied for, to enable them to work under supervision in the meantime. The manager confirmed that newly recruited staff would not be confirmed in post until all recruitment checks had been received and proved to be satisfactory. Application forms had been completed in the staff personnel files which were sampled, but a full employment history with a written explanation of gaps in employment had not been obtained, and a statement of ‘no criminal convictions’ had not been signed to confirm safe recruitment. Advice should be sought from the Criminal Record Bureau, with respect to the recording and updating of Criminal Record Bureau checks. Recruitment was in line with equal opportunities and information with respect to equality and diversity was requested on the application form. The six staff who completed surveys recorded that their employer carried out checks, such as CRB and references before they started work. A programme of staff training and development was in place and induction was in line with the Skills for Care Common Induction Standards. The six staff who completed surveys thought the induction covered everything they needed to know to do the job when they started very well, that the training they received was relevant to their role, helped them understand the needs of the residents with respect to equality and diversity and kept them up to date with new ways of working. One staff member commented, ‘Very good training is provided; all the mandatory training is completed each year. It is done very well and enjoyable.’ Staff personnel files contained certificates for mandatory training, NVQ Awards and other training to support the residents’ needs including care of the dying, medication administration, the prevention of falls, the management of continence, dementia awareness and essential communication skills. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,38 People who use the service experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Good leadership and systems are in place to ensure the home is run safely and in the best interests of the residents. EVIDENCE: The manager was well qualified to run the home, having achieved a National Vocational Award at level 4 in Care and the Registered Managers Award, and she and had many years of management experience. More recently she had undertaken an NVQ A1 Assessors Award to support the staff in their training. Her management style was open and transparent and the staff commented, ‘ Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 24 our manager is very good at making sure we are well informed and supported in our job’, ‘we all have a very good working relationship and are able to ask our manager anything’ and ‘I would not like to work anywhere else, this is a lovely place to be. It is a well run and caring home.’ Systems were in place to ensure the views of the residents, their relatives and representatives and the staff contributed to the running of the home. Quality assurance questionnaires were completed on a regular basis and included the views of visiting social and health care professionals, in addition to the residents, their relatives and representatives. Staff and residents meetings were held to enable their views to be sought to contribute to the continuous development of the service. The home did not manage the residents’ financial affairs. Residents or their relatives and representatives retained this responsibility. Standard 36 was not fully inspected on this occasion, but a requirement had been made at the previous site visit with respect to formal staff supervision. The supervision records of two staff were sampled showing that practice had improved in this area in that formal sessions had been recorded. The six staff members who completed surveys confirmed they meet regularly with their manager for support and to discuss how they are working. The health, safety and welfare of the residents was promoted by regular staff training in moving and handling, fire safety, first aid, food hygiene and infection control. Certificates were viewed on staff personnel files to confirm this. The Annual Quality Assurance Assessment, completed by the manager confirmed that policies and procedures with respect to health and safety had been reviewed since the previous site visit, and that the essential maintenance of equipment had been carried out according to manufacturers’ recommendations. A sample of certificates were seen on the day of the site visit confirming that maintenance checks had been carried out in a timely fashion. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 Schedule2 Requirement Persons must not be employed to work in the care home unless the specified documents and information have been obtained in respect of those persons, including a full employment history with a satisfactory written explanation of any gaps in employment. Timescale for action 22/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP29 Good Practice Recommendations It is good practice to obtain a signed statement of any criminal offences under section 1 of the Rehabilitation of Offenders Act 1974(a), and this information should be taken into consideration in the recruitment process to ensure residents are safeguarded. Advice should be sought from the Criminal Record Bureau website with respect to the recording and updating of Criminal Record Bureau checks. DS0000041177.V359221.R01.S.doc Version 5.2 Page 27 2. OP29 Chase House Rest Home 3. OP29 It is recommended that the home’s staff application form is reviewed and revised to ensure that it requests a full employment history and a written explanation of any gaps in employment. Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chase House Rest Home DS0000041177.V359221.R01.S.doc Version 5.2 Page 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. 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