Care Home: Chatham House

What the care home does well Chatham House has a warm and homely atmosphere: it is well maintained and is comfortably furnished. People who live at the home, and their relatives, are involved in the running of the home and they are kept informed through regular meetings. People who live at the home, and their relatives, are happy with the care and support provided by staff. Peoples` views are listened to and acted upon. The home has an experienced staff team; they have varied training opportunities available to them. The Manager and her Deputy are keen to identify where the home can improve; they have good systems in place to measure the quality of the service the home provides. What the care home could do better: The Registered Person must ensure that each person`s care plan contains enough detail to enable to staff to fully understand the care and support they should provide and whento raise concerns about people`s care. This would ensure each person is supported in an appropriate and safe way. The Registered Person must ensure that clear, detailed assessments are always in place for each person when risks are identified. This would promote the welfare and safety of these individuals. The Registered Person must ensure all staff are provided with appropriate supervision; any records kept must be accurate. This would improve the support provided to staff to enable them to provide safe and effective care to the people who live in the home. Random inspection report Care homes for older people Name: Address: Chatham House Chatham House 44/46 Wembdon Rise Bridgwater Somerset TA6 7QZ one star adequate service 28/09/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: David Smith Date: 2 8 0 5 2 0 1 0 Information about the care home Name of care home: Address: Chatham House Chatham House 44/46 Wembdon Rise Bridgwater Somerset TA6 7QZ 01278427758 01278427758 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jessie Joan Pope Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Jessie Joan Pope care home 26 Number of places (if applicable): Under 65 Over 65 26 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 2 8 0 9 2 0 0 9 Chatham House is registered with the Care Quality Commission to provide personal care for up to 26 people aged 65 years and over. The home is not registered to provide nursing care nor is it registered to provide dementia care or any other specialist care. The registered provider/manager is Mrs Pope. Chatham House is situated in the residential area of Wembdon, 2 miles from Bridgwater town centre. Two large Victorian houses are linked by a modern annexe. There is car parking at the front of the house. To the rear there are extensive gardens Care Homes for Older People Page 2 of 11 Brief description of the care home with wheelchair access and handrails with a pleasant patio area. Accommodation is on two floors, comprising of 22 single bedrooms and 2 double rooms. There are 19 rooms with en-suite WC facilities, some have a bath/shower facility. TV points are available in each room. There is a passenger lift and two sets of stairs to the first floor, one with stair lifts. The communal rooms comprise of a very large lounge with three distinct seating areas, a smaller lounge and an adequately sized dining room. There are three payphones in different locations in the home, plus the use of a mobile phone for incoming calls. There is a call system fitted to all areas of the home. Care Homes for Older People Page 3 of 11 What we found: This Random Inspection visit was carried out by one inspector and lasted approximately six hours; the term we is used within this report as this and the judgements within it are made on behalf of the Care Quality Commission. The last Key Inspection of this home was carried out in September 2009; Chatham House was rated as 1 star, which means people who live in the home experience adequate outcomes. We asked for some improvements to be made following the last Key Inspection; this visit was used to determine whether these improvements have been carried out. A meeting for people who live in the home, their friends and relatives was being held on the day we visited; we were invited to attend this meeting, which we did. It was a very pleasant, informal social event. Many of the people who live in the home attended as did relatives. During the meting people were asked to complete satisfaction questionnaires and a more general discussion was then held. People were seen to speak honestly and openly; each person said said they were happy with the care and support provided by the home. Where areas for improvement were identified, it was clear that staff in the home were happy to listen to peoples views and were keen to act on new ideas or implement changes. One person who lives in the home said it is fine here, I am happy with everything and another said I dont have anything to add, everything is fine. One relative told us I visit regularly and I am always happy with the care and another said I dont have any concerns, it is always fine when I visit. We looked at the care records belonging to two people who live in the home. Each had a plan which generally described the care and support they require and how staff should provide it; information is also included about their life history, who the important people in their life are, how they communicate and daily routines they may have. There was evidence that people and their relatives are involved in the care planning process; each care plan is reviewed by the home each month. Following our last visit we said that advice must be sought from appropriate health professionals where there was a need to do so. We did see evidence during this visit that this is now being done. One person who lives in the home had been referred to a specialist as they suffer from memory loss and confusion at times; another person had been offered support by a social care professional in relation to their finances. The requirement we made following the last Key Inspection has therefore been met. Risks to people are identified using an assessment; the home currently uses one assessment although this covers several different types of risks. The assessments we looked at were not very clear; the information contained in them was very brief, no level of risk was noted on the assessments or how (or whether) the level of risk was reduced if the care plan was followed by staff. One person had diabetes; the diet section on the risk assessment had been completed which simply stated diabetic and that staff should report any great loss of weight. There was no guidance on what a great loss would be for this person. The Manager also Care Homes for Older People Page 4 of 11 told us staff were regularly checking this persons blood sugar levels and recording this; there was no note of this on the risk assessment and no indication of what this persons normal blood sugar level should be or what level staff should be concerned by. The Manager told us that staff knew what a safe blood sugar level reading should be; when asked if this was recorded in the care plan or risk assessment the Manager said no it isnt in the care plan. One person who recently moved into the home was noted as being at a high risk of falling; they had a recent history of falls, one of which had led to a hospital admission prior to them moving to the home. A risk assessment had been completed, but this was very brief and only suggested staff to walk with this person to reduce the risk of them falling. When we looked at their daily records, they had fallen six times within the first 10 days of their stay. The accident records completed by staff did not correlate with the daily records on three occasions so it was not possible to tell if the person had suffered more falls than those noted in the daily records. It was clear that there was a pattern in relation to the time this person was most prone to falling, although this had not been identified by the home and no action had been taken to reduce the risk to this person by changing their plan of care or by using any aid. This was discussed with the Manager and her Deputy who agreed with our findings; they did say that this person has not fallen recently but did agree that they should have acted as soon as staff began recording the falls. The Deputy Manager said I can see that we didnt do all we could and that all of the staff are responsible for making sure people are safe, not just the Managers. Despite this, staff generally now have a better understanding of the local safeguarding procedures and we noted additional training had been provided to staff in March 2010. During our visit we looked at records relating to one incident of poor staff practice where managers had clearly followed the correct safeguarding procedures and were considering reporting this staff member to the Independent Safeguarding Authority (ISA) whose role it is to make independent barring decisions and place or remove individuals on either the ISAs Childrens Barred List or the ISAs Vulnerable Adults Barred List, or both. The recommendation we made following the last Key Inspection in relation to improving safeguarding procedures has therefore been actioned. Since we last visited the home, there has been an improvement in the way we are advised of significant events which have happened. We have been regularly contacted by the Manager to discuss issues in an informal way and we have also received several formal written notifications. The requirement we made following the last Key Inspection has therefore been complied with. We looked at staff recruitment records; these showed that appropriate checks are carried out on new staff to make sure they are suitable to work with vulnerable people. Staff also had to provide at least two satisfactory references and proof of their identity before they started work in the home. A photograph is now kept of each staff member and any gaps in the employment history for new staff is documented. The two recommendations we made relating to staff recruitment following the last Key Inspection have therefore been actioned. Care Homes for Older People Page 5 of 11 Staff are generally provided with regular supervision; this can be a 1:1 meeting with their supervisor, a team meeting or a senior member of staff observing their care practice. We did note one instance where a staff members work performance was causing concern; this staff member had not been supervised since August 2009 (and the records for this meeting could not be located during our visit). It was not clear how their poor performance had been addressed and there was certainly no record of what improvements were required. The main supervision record we looked at suggested that two supervisions had taken place in 2010 for this particular member of staff; the managers we spoke with said this was not correct, these meeting were planned but had never taken place. This was discussed with the Managers who agreed that this member of staff should have been formally supervised on a regular basis and been given clear targets for improvement. Also, the records kept in the home should be accurate and if a planned meeting had not taken place, this must be clearly recorded. We looked at medication administration records for the people who live at the home; these were well kept. We noted that the pharmacist last carried out an audit of the homes medication storage and administration in February 2010; their report stated the medicines are now well managed in the home. The recommendations we made following the last Key Inspection in relation to medicine administration have therefore been actioned. We saw some communal areas of the home; each was clean and tidy and we saw staff members cleaning the home during our visit. There is a plan to improve the environment which is already underway. This will involve re-decorating rooms and re-carpeting some parts of the home. This work will be completed by the end of this year and the Manager told us it is already ahead of schedule. What the care home does well: What they could do better: The Registered Person must ensure that each persons care plan contains enough detail to enable to staff to fully understand the care and support they should provide and when Care Homes for Older People Page 6 of 11 to raise concerns about peoples care. This would ensure each person is supported in an appropriate and safe way. The Registered Person must ensure that clear, detailed assessments are always in place for each person when risks are identified. This would promote the welfare and safety of these individuals. The Registered Person must ensure all staff are provided with appropriate supervision; any records kept must be accurate. This would improve the support provided to staff to enable them to provide safe and effective care to the people who live in the home. 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 2. Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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, 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 7 15 The Registered Person must 28/07/2010 ensure that each persons care plan contains enough detail to enable to staff to fully understand the care and support they should provide and when to raise concerns about peoples care. This would ensure each person is supported in an appropriate and safe way. 2 36 18 The Registered Person must 28/07/2010 ensure all staff are provided with appropriate supervision; any records kept must be accurate. This would improve the support provided to staff to enable them to provide safe and effective care to the people who live in the home. 3 38 12 The Registered Person must ensure that clear, detailed assessments are always in place for each person when risks are identified. 28/07/2010 Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 This would promote the welfare and safety of these individuals. 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 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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