Care Home: Chine Breeze Court

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What the care home does well Chine Breeze Court continues to provide a very homely and comfortable atmosphere and residents are well cared for. The Registered Manager ensures that residents are only admitted to the home following a full assessment of their needs and having confirmed that the home can meet those needs.Staff at the home support resident`s rights to privacy in care routines and residents spoken with confirmed they are able to enjoy the privacy of their rooms when they choose without interruption. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made very welcome. Residents are helped to exercise choice and control over their lives as far as possible. The Registered Manager runs the home well and a competent and committed staff, whose main aim is to give a good level of care and support to all the residents, support her. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at the home. What has improved since the last inspection? Since the last inspection the Registered Manager has completed a degree in Care Management. The home now has a high proportion of healthcare assistants who hold the NVQ level 2 Care Award, which means that residents can be assured that staff have the training and skills to look after them well. There has been an ongoing programme of refurbishment at Chine Breeze Court. The home can now provide care to 20 residents with the provision of an extra bedroom with en-suite facilities. What the care home could do better: As a result of this inspection two requirements and five recommendations of good practice have been made. To ensure that staff are aware of local procedures with regard to protecting residents from abuse the home`s policy must be reviewed and made available to staff. The care staff need formal supervision six times a year to ensure that they are keeping abreast of best practice guidelines. An audit trail of medicines in the home should be maintained so that it is clear what stock is held.To remind residents what is available within the home each resident should be provided with a programme of activities and a weekly menu. The Registered Provider confirmed that she would review staffing levels to alleviate the healthcare assistants of their extended duties, which include laundry, organising activities and preparing and serving suppers. To ensure that the home is run in the best interests of the residents the quality assurance system needs some further work and the home should produce an annual development plan. CARE HOMES FOR OLDER PEOPLE Chine Breeze Court 73 Alumhurst Road Westbourne Bournemouth Dorset BH4 8HP Lead Inspector Amanda Porter Key Unannounced Inspection 30th October 2007 9:45 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 Chine Breeze Court DS0000020438.V353637.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. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chine Breeze Court Address 73 Alumhurst Road Westbourne Bournemouth Dorset BH4 8HP 01202 761307 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) Mr R Jenkins Mrs C Jenkins Mrs Jane Rosalie Morris Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person (as known to CSCI) in the category MD(E) may be accommodated to receive care. 4th July 2006 Date of last inspection Brief Description of the Service: The registered providers are Mr and Mrs Jenkins. The registered manager is Mrs Morris who is a suitably experienced nurse. Chine Breeze Court is registered to provide nursing and personal care for a maximum of 20 older people in 16 rooms, 4 of which may be used as shared rooms by residents who have made a positive choice to share with each other. 5 of the 12 single use bedrooms have en-suite hygiene facilities. The accommodation is on two floors with a passenger lift serving both floors. The home is located in a residential area of Westbourne, Bournemouth within walking distance of local amenities and the sea at Alum Chine. The home is on the local bus route and has off road car parking at the front of the home. The weekly fee rates are £550 - £650. Additional charges are made for hairdressing and chiropody. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 30th and 31st October 2007 over a period of approximately five hours. The purpose of the inspection was to review the requirement and recommendations made at the last inspection and assess all of the key standards. The Registered Manager, Mrs Morris, and the Registered Provider, Mrs Jenkins were on hand during the second part of the inspection. Staff and residents were most helpful. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment completed by the home. • 1 completed survey from a resident and 7 from relatives and friends. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents, visitors and staff. • Tour of the premises. During the course of the inspection four residents, one visitor and four members of staff were spoken with and asked their views on the service provided at the home. Comments received in surveys and through discussion included: They always take great care with all the patients.” “Very helpful and jolly staff.” “There is a home atmosphere.” “My relative has very good care and my mind is at rest.” “Chine Breeze look after my relative with the utmost care.” What the service does well: Chine Breeze Court continues to provide a very homely and comfortable atmosphere and residents are well cared for. The Registered Manager ensures that residents are only admitted to the home following a full assessment of their needs and having confirmed that the home can meet those needs. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 6 Staff at the home support resident’s rights to privacy in care routines and residents spoken with confirmed they are able to enjoy the privacy of their rooms when they choose without interruption. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made very welcome. Residents are helped to exercise choice and control over their lives as far as possible. The Registered Manager runs the home well and a competent and committed staff, whose main aim is to give a good level of care and support to all the residents, support her. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at the home. What has improved since the last inspection? What they could do better: As a result of this inspection two requirements and five recommendations of good practice have been made. To ensure that staff are aware of local procedures with regard to protecting residents from abuse the home’s policy must be reviewed and made available to staff. The care staff need formal supervision six times a year to ensure that they are keeping abreast of best practice guidelines. An audit trail of medicines in the home should be maintained so that it is clear what stock is held. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 7 To remind residents what is available within the home each resident should be provided with a programme of activities and a weekly menu. The Registered Provider confirmed that she would review staffing levels to alleviate the healthcare assistants of their extended duties, which include laundry, organising activities and preparing and serving suppers. To ensure that the home is run in the best interests of the residents the quality assurance system needs some further work and the home should produce an annual development plan. 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. Chine Breeze Court DS0000020438.V353637.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 Chine Breeze Court DS0000020438.V353637.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): 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure enables prospective residents, and/or those acting on their behalf, to make informed decisions about admission to the home and ensures that only residents whose needs can be met by the home are offered places there. EVIDENCE: The files for two residents who had recently moved into the home were inspected. These showed that the home has a good procedure in place. Prior to anyone moving to the home the manager assesses his/her needs. Sufficient information was obtained so that a care plan could be drawn up and made available to staff. The Registered Manager confirmed in writing to the resident and/or chosen representative that needs could be met by the home. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 10 One comment received stated, “This home was recommended to cater for my friend’s needs and I feel that I couldn’t have chosen better. Matron is a treasure!” Chine Breeze Court DS0000020438.V353637.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): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Two care files were reviewed and both contained the relevant assessments and care plans needed so that staff had the information to be able to give the high standard of care Chine Breeze Court strive to achieve. Residents and/or their chosen representatives were invited to be involved in drawing up care plans. The care plans were evaluated on a monthly basis. Where the need for specialist equipment was identified it was provided. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 12 It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, dieticians, clinical nurse specialists, chiropodists, opticians and dentists. Arrangements are made for residents to attend hospital outpatient appointments as necessary. The home has a well-written and informative medicines policy and procedure including reference to self-administration and associated risk assessment and arrangements for ordering, administration and disposal. Medicines were stored securely. However there was no clear audit trail to identify how much medication was held by the home. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. Residents and the visitor spoken with were happy with the care they or their relative received and confirmed that staff treated them with respect and were supportive and kind. Comments received included: “I have nothing but praise for the staff.” “They always take great care with all the residents.” “Generally the staff appear kind and caring.” Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to have contact with family, friends and the local community if they wish and are able. There is an adequate range of social opportunities available at Chine Breeze Court to suit the preferences of the residents living there. EVIDENCE: Residents spoken with said they were happy with the lifestyle that living at Chine Breeze Court afforded them. Some chose to spend time on their own but knew they could join in with any organised activities if they so wished. Recent organised activities included: • • • Extend, gentle exercise classes “Motivation” sessions, which include both mental and physical stimulation through games, exercises and music outside entertainers. DS0000020438.V353637.R01.S.doc Version 5.2 Page 14 Chine Breeze Court These activities are based on the preferences of the residents and are recorded. On a day-to-day basis the care staff were responsible for some activities with residents but, with many other duties to perform, time was very limited. Residents confirmed that their visitors were always made welcome at the home and they could have visits in private. One visitor commented: “The staff always give me a cup of tea when visiting, no matter how busy they are.” All residents spoken with confirmed they enjoyed the food provided. Records showed that residents’ likes and dislikes with regard to food were known and residents were aware that alternatives to the main menu were always available. Although the resident are told verbally what the menu offers a copy is not left with them for reference. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 15 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): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted although the home’s adult protection policy needs to be reviewed to reflect this. EVIDENCE: The home has a clear complaints procedure available to everyone. Residents spoken with during the inspection said that if they had any concerns they would feel confident about talking to the manager, knowing that she would listen to them. “I can always talk to Matron or one of the sisters.” The home has a policy and procedure to respond to suspicion or evidence of abuse or neglect. However it needs to be reviewed to ensure that it is in line with the Department of Health guidance “No Secrets” and local protection of vulnerable adults procedures. Staff confirmed that they receive training on the protection of vulnerable adults and said they promptly reports any concerns they may have but some were not sure about procedures within the locality and confirmed that they would find some further training useful. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 16 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): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment at Chine Breeze Court is good providing residents with an attractive, homely and safe place to live. EVIDENCE: The home has a programme of routine maintenance and the home provides a comfortable environment in which to live. Since the last inspection some areas of the home have been redecorated and refurbished and one further room, with en-suite facilities has been registered with the Commission for Social Care Inspection. The laundry floor has been replaced and the whole room has been decorated. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 17 All areas of the home were clean and there were no unpleasant odours. The care staff on duty managed the laundry. Adequate supplies of clean linen were seen to be available. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The extended duties of the care staff mean that they spend a period of time each day with tasks that take them away from the care of residents, which may mean that residents have to wait to be attended to. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can give a good standard of care to the residents living at Chine Breeze Court. EVIDENCE: There is always a registered nurse on duty who is supported by a team of healthcare assistants. The duties of the care staff also include doing the laundry, serving teas and coffees, washing up, organising some activities and preparing and serving suppers. This means that time is spent away from giving direct care to residents. The Registered Provider said it was her intention to review who would be responsible for these extra tasks so that the care assistants had more time to spend with the residents. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 19 The home has an ongoing training programme, which includes NVQ level 2 and 3 in care and over 50 of the care staff hold the minimum of a level 2 award in care. Three staff recruitment files were reviewed. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Training files demonstrated that staff were receiving induction training although some paperwork was incomplete. Staff confirmed that the Registered Manager had encouraged them to take up a number of training opportunities provided including: • Protection of vulnerable adults • Emergency aid • Dementia care • Moving and handling Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35, 36 & 38. 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 organised and the daily management and running of the home centres round the care of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: The Registered Manager and Provider have a very good working relationship and the home is well managed. Residents and visitors said that all the staff Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 21 were very approachable and if they had any concerns they would be happy to talk to them knowing that they would be listened to. Since the last inspection the Registered Manager has completed a degree in Care Management. There is a quality assurance and quality monitoring system in place. The home takes steps to review its performance regularly and resident surveys are conducted and results analysed. The information gathered from monitoring is not yet formalised into an annual development plan, which would indicate to those who use the service how the home is expected to perform over the year. The Registered Manager confirmed that residents have representatives to deal with their finances and this is frequently another family member. The home does not hold any monies on behalf of residents. Mrs Morris confirmed that formal staff supervision has not been fully developed but is committed to implement this on a regular basis. Staff said that the team worked well together and they felt well supported by senior staff. Records showed that staff had received recent training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and analysed and appropriate action was taken as necessary. Chine Breeze Court DS0000020438.V353637.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 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP18 Regulation 13(6) Requirement The Registered Person must make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. (This must include revising the home’s abuse policy to reflect local protocols and procedures). The registered person must ensure that persons working at the care home are appropriately supervised. Timescale for action 30/01/08 2. OP36 18(2) 30/01/08 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. 2. Refer to Standard OP9 OP12 Good Practice Recommendations There should be a clear audit trail for all medications held in the home. A copy of the activities programme and the menu should be circulated to residents. DS0000020438.V353637.R01.S.doc Version 5.2 Page 24 Chine Breeze Court 3. 4. 5. OP27 OP30 OP33 The Registered Person should review it’s staffing levels to ensure that there are sufficient staff for activities with residents and preparing and serving suppers. Following induction the training records should be signed and dated. The home should produce an annual development plan to support the home’s quality assurance procedure. Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Chine Breeze Court DS0000020438.V353637.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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