Care Home: Chesterfield Lodge

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What the care home does well The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognise the diverse needs of the people living at the home. Observation of practice and discussion with the staff member on duty confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of people with specific mental healthcare problems. A health care professional said the staff team were excellent, caring and conscientious people who provided a high level of support for the people who live in the home. The health care worker said, "All my team are impressed by the commitment shown. I am very pleased with the excellent work they do". The relative of one person said they had been very impressed with the level of support being provided at the home. The relative said, "The staff are always there when needed providing care, attention and highly practical efficiency far beyond the call of duty". People spoken to said they liked living at the home and they were treated with respect and dignity at all times. One person said, "The staff are all lovely and they treat us well. I am happy and settled". Staff at the home are well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed people are treated with respect and dignity. The home has 100% of staff who have achieved National Vocational Qualifications (NVQ) ensuring people are supported by competent and qualified staff. What has improved since the last inspection? The homeowner has implemented a refurbishment programme making a number of improvements to the environment. These have included the redecoration of bedrooms and new windows being fitted. The person in charge said the improvements had just started and there were plans for the bathroom to be refurbished with a new shower unit and toilet and sink facilities and the hallway to be redecorated. People living in the home said they were pleased with the improvements being made. CARE HOME ADULTS 18-65 Chesterfield Lodge 15 Chesterfield Road Blackpool Lancashire FY1 2PP Lead Inspector Mr Wesley Cornwell Unannounced Inspection 1st July 2008 09:30 Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 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 Chesterfield Lodge DS0000064038.V367311.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 Adults 18-65. 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. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chesterfield Lodge Address 15 Chesterfield Road Blackpool Lancashire FY1 2PP 01253 628793 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) Pro-Care Dispersed Housing Ltd Manager post vacant Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 6 service users with a Mental Disorder, excluding learning disability or Dementia (MD). 15th August 2007 Date of last inspection Brief Description of the Service: Chesterfield Lodge is a care home registered for 6 young adults with mental health problems. The home is situated in the North Shore area of Blackpool close to the town centre. The accommodation provides 6 single rooms, which are located on the first floor. Communal areas consist of a lounge and dining room situated on the ground floor. The home does not have separate provision for non-smokers and would therefore be unsuitable for people who do not smoke. Toilet and bathing facilities are located on the first floor. There is no lift available at this home. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The range of fees at the home are £285.00 to £390.00 covering all aspects of care, food and accommodation. The manager provided this information on the 1st July 2008. Chesterfield Lodge DS0000064038.V367311.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 stars. This means the people who use this service experience good quality outcomes. This unannounced site visit was undertaken as part of the home’s Key Inspection. The site visit commenced at 9:30am and took place over 4 hours. Prior to the site visit a member of staff completed an Annual Quality Assurance Assessment form (AQAA) providing information about the service they are providing. During the site visit the Inspector spoke to five people who live in the home, two staff members, one relative, a health care professional, the person in charge and the owner of the home. Staff, care, maintenance and financial records were also examined. A full tour of the premises was undertaken with the person in charge. People spoken to during the visit have had their comments included in the report. What the service does well: The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognise the diverse needs of the people living at the home. Observation of practice and discussion with the staff member on duty confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of people with specific mental healthcare problems. A health care professional said the staff team were excellent, caring and conscientious people who provided a high level of support for the people who live in the home. The health care worker said, “All my team are impressed by the commitment shown. I am very pleased with the excellent work they do”. The relative of one person said they had been very impressed with the level of support being provided at the home. The relative said, “The staff are always there when needed providing care, attention and highly practical efficiency far beyond the call of duty”. People spoken to said they liked living at the home and they were treated with respect and dignity at all times. One person said, “The staff are all lovely and they treat us well. I am happy and settled”. Staff at the home are well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed people are treated with respect and dignity. The home has 100 of staff who have achieved National Vocational Qualifications (NVQ) ensuring people are supported by competent and qualified staff. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of people are met. EVIDENCE: The care plan records of one person admitted into the home since the last inspection had full assessment information including the religious/cultural and relationship needs of the person. The staff member on duty confirmed they had access to this information and was fully aware of the needs of the person and the level of support they needed. The staff member said they were responsible for the preparation of meals and had been informed about people who had special dietary needs and these were being accommodated. The person said he had visited the home on a number of occasions before making the decision to move there. He said he felt comfortable in his new surroundings and was happy with the support being provided. People spoken to during the visit confirmed they were also happy that their needs were being met. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of people’s health, personal and social care is taken seriously and closely monitored to ensure they are met. EVIDENCE: Individual records are kept for each person with a plan of care which had been generated through Care Management Assessment arrangements, setting out the action that needed to be taken by support staff to ensure all aspects of health, personal and social care needs of the residents were met. People spoken to said staff members were supportive in encouraging them to live independently. The person in charge said responsible risks are encouraged to enable people to pursue a lifestyle of their choice. Records observed confirmed where a potential risk had been identified these were closely monitored. The daily records of two people clearly described the level of support and assistance being provided by the staff team with their daily living routines and any activities being undertaken. People spoken to confirmed they are treated and respected as individuals and encouraged and supported by the staff team Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 10 to pursue their chosen lifestyle within acceptable boundaries. One person said, “I come and go as I please and make my own decisions about what I want to do. I have been out this morning running a few errands and will be meeting up with friends later”. Observation of care plan records confirmed there are clear risk assessment management strategies in place for dealing with potential risks to the people who live there. One person whose lifestyle potentially places them at risk was being closely monitored and appropriately managed. The home has a good record of dealing promptly with any unexplained absences of people according to written procedure and ensuring all appropriate organisations are kept fully updated. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure and employment opportunities are discussed and explored to ensure people have opportunities for personal development. EVIDENCE: Observation of care plans and discussion with people confirmed opportunities for personal development is being encouraged. There was evidence that educational and employment opportunities had been discussed with people and where appropriate explored. One person was due to attend an interview with a view to undertaking voluntary work. The person said they were looking forward to being accepted, as they would be doing something worthwhile. The staff member on duty said he had been discussing leisure activities and had agreed to take one person swimming. The person spoken to said they were looking for to this as they like to get out as often as possible and he has always enjoyed swimming. Other people spoken to said they were being supported by the staff team to undertake leisure activities of their choice in the community. Two Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 12 people said they enjoyed shopping and the house manager is always taking them out in her car. One person said, “I really enjoy the outings. We always have fun”. A healthcare worker spoken to said, “The service delivery at the home is very good. The staff provide a really good level of support in my opinion”. People spoken to said they were happy with the arrangements in place for receiving their visitors and they are always made welcome. The relative of one person said, “Always an atmosphere of cheerfulness and friendship that goes far beyond conventional expectations”. Routines observed throughout the visit appeared flexible with people being allowed complete freedom of the home. People spoken to confirmed they had access to the kitchen to prepare snacks and drinks whenever they wanted. The staff member on duty said he made the main meal when on duty but people could prepare their own meal if that was their choice. The home does not have a set menu with food being purchased for the week and then people can choose daily what they would like to eat. People were observed discussing with the staff member on duty what to have for the evening meal. One person said, “I like the meals”. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously and personal support is provided in a flexible and sensitive manner. EVIDENCE: Discussion with people confirmed they were happy with the level of personal care support they received and said they were encouraged to be independent and attend to their own needs. All of the people spoken to said they were able to attend to their own care and personal hygiene needs and were happy with the level of supervision and guidance available to them. A healthcare professional commented, “The staff at this home are excellent, very caring and conscientious people. They work very well with the people who live there and provide excellent support”. The relative of one person said, “ We have genuine appreciation of the absolutely fantastic kindness and care shown by Kay and her wonderful staff”. Entries on care plans confirmed staff communicate clearly and work in partnership with health and social care professionals. One healthcare professional said the manager and staff at the home demonstrated a clear understanding of the needs of people and he was satisfied with the overall care Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 14 being provided. The healthcare worker said, “This home accommodates people who have severe mental health problems and they often accept people who other services couldn’t cope with. I am very impressed with the excellent work they do”. Medication practices observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. EVIDENCE: The home has a detailed complaints procedure, which is made available to all people on their admission to the home. People spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. People spoken to during the visit said they were happy living at the home and didn’t feel the need to complain about anything. The home has a procedure in place for dealing with allegations of abuse. The staff member spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Discussion with the person in charge confirmed all staff employed by the home are due to attend a training course on how to recognise abusive practices and the procedures to be followed in the event of any allegations or incidents of abuse occurring. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure people live in a comfortable, homely, clean and safe environment. EVIDENCE: There has been some progress in upgrading the environmental standards in the home since the last inspection. One bedroom has been redecorated and a new window fitted in the dining room. The person in charge said the refurbishment is on going and there are plans for the bathroom to be refurbished with a new shower unit and toilet and sink facilities. People living in the home said they were pleased with the improvements being made. A tour of the building confirmed bedrooms had been personalised with personal belongings and decorated and furnished for their comfort. Each bedroom had Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 17 been fitted with a lock and the person issued with their own key ensuring their privacy was being promoted. People spoken to were happy with their rooms and said they had the choice of spending time on their own or in the lounge area’s. One person said they had everything they needed in their room and preferred to spend their time there than in the lounge. The person confirmed the manager and his staff always respected their privacy. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. The home was fresh and clean providing a pleasant environment for people to live. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes recruitment procedures are robust and these provide safeguards for the protection of people. EVIDENCE: Staffing levels were sufficient for the number of people living at the home. People spoken to said staff members were always available if needed. A healthcare worker said they were very satisfied with support provided to his clients. Records show over 100 of staff members have achieved National Vocational Qualifications (NVQ) ensuring people are in the safe hands of a qualified and competent staff team. Discussion with staff and examination of records confirmed training had been provided for staff members to ensure they had a clear understanding of the specific care needs of people accommodated at the home. The home has a small staff team and there has been only one new employee recruited since the last inspection. Examination of records showed good Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 19 systems were in place for obtaining relevant documentation for staff members employed by the home ensuring the protection of people who live there. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and has policies and procedures in place to ensure the health and safety of people and staff are promoted and protected. EVIDENCE: The home is presently without a manager who is registered with the Commission. The owner of the home said he has recently appointed a manager who is qualified, competent, experienced and who will run the home for the benefit of the people who live there. He stated that he expected to submit a manager application for registration to the Commission within the next two weeks. Records checked during the visit were found to be up to date and were being well maintained. The staff member on duty said they felt well supported and had access to the homeowner and general manager for support and guidance. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 21 An annual quality assessment of standards is undertaken within the home by a professionally recognised organisation who completes an audit of the care being provided and seek the views of people who live there and their relatives. People spoken to were very positive in their comments about the staff team who were described as being friendly, approachable and very helpful. The staff member on duty had a clear understanding of their role and what is expected of them during their shift. The staff member confirmed he had access to the homes risk assessment strategies and was able to explain how emergency situations would be dealt with should they occur. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for the people who live there. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 23 Yes 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 YA37 Regulation 8 Requirement A suitably experienced and qualified person must be appointed and an application to be registered with the Commission submitted to ensure people living at the home are supported by a person who is fit to do so. Extended from 26/09/07. Timescale for action 18/09/08 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 YA24 Good Practice Recommendations The homes refurbishment programme should continue to be implemented to ensure people live in comfortable and pleasant surroundings. Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection NW Regional Contact Team 3rd Floor Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 Chesterfield Lodge DS0000064038.V367311.R01.S.doc Version 5.2 Page 25 - 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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