Care Home: Chirton Resource Centre

Similar services:

• Turret Villa Retirement Home
• Mendip House
• Beaconsfield Court Care Home
• Little Sisters Of The Poor
• Manor House
• Middleton Hall Ltd
• Middlesbrough Intermediate Care Centre

What the care home does well People who are admitted to the centre have a thorough assessment of their needs to make sure care is properly planned. They receive support that is tailored to meet their health and personal care needs, and this is recorded in personalised care plans. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 There is a high level of satisfaction with the service. People told us, "They look after me very well, nothing is too much trouble day or night for the staff", "I haven`t been here long, I feel safe and know they`ll take care of me until I`m well enough to go home", and, "I didn`t know there were places like this, it`s much better than being in hospital. They are helping me get my confidence back and do more for myself". The centre provides a range of short stay services for older people. The staff team work well with on-site health professionals and other services to enable people to live in their own homes, wherever possible. One professional said, "We have marvellous working relationships. The staff respect people as individuals". Another professional when asked what the service does well said, "Integrating care between NHS and Social Services. Responding to emergencies". People are encouraged to be independent and make decisions so they keep control over their lives. They are consulted on planning and reviewing their care and making arrangements for discharge from the centre. Weekly group meetings give people opportunities to air their views about the service and choose activities to meet their social needs. A varied and appealing diet is offered, with choice of meals that people enjoy. People told us the food is of very good quality. A clear procedure is in place for making complaints that people are confident to use if they are unhappy with the service. Staff are well trained to recognise and prevent abuse of vulnerable people to keep them protected. Good staffing levels are maintained and regular training is provided so the staff are skilled and competent to meet people`s diverse needs. The centre is well managed by an experienced and qualified management team. They are committed to improving the quality of the service and making sure it is run in people`s best interests. Health and safety is promoted through staff training and safe working practices so people are not harmed. What has improved since the last inspection? There is a clearer assessment process and people`s needs are assessed in a timelier manner. The centre continues to improve on the number of people that are supported to return to live in their own homes.Chirton Resource CentreDS0000042084.V377039.R01.S.docVersion 5.2Better systems have been developed to ensure people are safely assisted to take prescribed medication. Greater links are forged with the local community and people go on outings more often. Surveys that are sent to people after their stay have been adapted to fit in with how the quality of service is measured. Information from surveys is used to influence changes and is also planned to be used in the guide to the service so people can share their experiences with others. Redecoration and new furnishings in communal areas and bedrooms have made the building more comfortable and attractive. Significant improvements have been made to control of infection to keep people safe. What the care home could do better: When people return to the centre for further stays staff should always check if their needs have changed and update care plans where necessary. How staff respect people`s privacy and dignity should be built into their personal care plans. Whilst visits to report on the conduct of the service are being done with greater frequency, the Registered Person should make sure these are carried out every month. Key inspection report CARE HOMES FOR OLDER PEOPLE Chirton Resource Centre Headlam Way Byker Newcastle Upon Tyne NE6 2DX Lead Inspector Elaine Malloy Key Unannounced Inspection 5 and 7th August 2009 09:30 th DS0000042084.V377039.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chirton Resource Centre Address Headlam Way Byker Newcastle Upon Tyne NE6 2DX 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) 0191 276 2195 0191 224 1929 simon.mulligan@newcastle.gov.uk Newcastle City Council Social Services Department Simeon Peter Mulligan Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category Old Age, not falling within any other category - Code OP, maximum number of places 20 The maximum number of service users who can be accommodated is 20 1st November 2007 2. Date of last inspection Brief Description of the Service: Chirton Resource Centre is a registered care home that is operated by Newcastle City Council Social Services. The centre is located within the Byker Wall in Newcastle upon Tyne. It provides short stays for community rehabilitation, respite care and emergencies. A range of health and social care professionals supplement the staff team. Accommodation is provided over two floors and a passenger lift is available. All service users have single bedrooms. There are no en-suite facilities. A guide to the centre’s services and inspection reports are readily available at the centre. The current weekly fee for respite care is £69.55. Fees for service users admitted for emergency stay are dependent upon an assessment of their finances. Service users admitted for community rehabilitation stays do not pay fees for the first six weeks. Fees after six weeks are dependent upon financial assessment. Chirton Resource Centre DS0000042084.V377039.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 three star – excellent service. This means that people who use this service experience excellent quality outcomes. The inspection was carried out by: Looking at information received since the last key inspection on 1st November 2007. Getting the provider’s view of the service and how well they care for people. An inspector visiting the centre on 5th and 7th August 2009. Talking to the centre manager and other staff about the service. Looking at records about the people who stay at the centre and how well their needs are met. Looking at a range of other records that must be kept. Checking that staff have the knowledge, skills and training to meet the needs of the people they care for. Looking at the resources that the centre has to operate the service. Talking to people staying at the centre and staff to get their views. Checking if improvements from the last inspection have been made. The inspection was carried out over ten and a half hours. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: People who are admitted to the centre have a thorough assessment of their needs to make sure care is properly planned. They receive support that is tailored to meet their health and personal care needs, and this is recorded in personalised care plans. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 6 There is a high level of satisfaction with the service. People told us, “They look after me very well, nothing is too much trouble day or night for the staff”, “I haven’t been here long, I feel safe and know they’ll take care of me until I’m well enough to go home”, and, “I didn’t know there were places like this, it’s much better than being in hospital. They are helping me get my confidence back and do more for myself”. The centre provides a range of short stay services for older people. The staff team work well with on-site health professionals and other services to enable people to live in their own homes, wherever possible. One professional said, “We have marvellous working relationships. The staff respect people as individuals”. Another professional when asked what the service does well said, “Integrating care between NHS and Social Services. Responding to emergencies”. People are encouraged to be independent and make decisions so they keep control over their lives. They are consulted on planning and reviewing their care and making arrangements for discharge from the centre. Weekly group meetings give people opportunities to air their views about the service and choose activities to meet their social needs. A varied and appealing diet is offered, with choice of meals that people enjoy. People told us the food is of very good quality. A clear procedure is in place for making complaints that people are confident to use if they are unhappy with the service. Staff are well trained to recognise and prevent abuse of vulnerable people to keep them protected. Good staffing levels are maintained and regular training is provided so the staff are skilled and competent to meet people’s diverse needs. The centre is well managed by an experienced and qualified management team. They are committed to improving the quality of the service and making sure it is run in people’s best interests. Health and safety is promoted through staff training and safe working practices so people are not harmed. What has improved since the last inspection? There is a clearer assessment process and people’s needs are assessed in a timelier manner. The centre continues to improve on the number of people that are supported to return to live in their own homes. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 7 Better systems have been developed to ensure people are safely assisted to take prescribed medication. Greater links are forged with the local community and people go on outings more often. Surveys that are sent to people after their stay have been adapted to fit in with how the quality of service is measured. Information from surveys is used to influence changes and is also planned to be used in the guide to the service so people can share their experiences with others. Redecoration and new furnishings in communal areas and bedrooms have made the building more comfortable and attractive. Significant improvements have been made to control of infection to keep people safe. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Chirton Resource Centre DS0000042084.V377039.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 Chirton Resource Centre DS0000042084.V377039.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have a comprehensive assessment of their needs so their care can be properly planned. People receiving intermediate care are well supported to promote their independence so they can return to live in their own homes. EVIDENCE: When a person is first referred to the service the centre, staff obtain a referral form that has basic details, reasons for the referral, background information, past medical history, medication and an initial assessment of needs. On admission to the centre staff record a ‘Baseline Assessment’ with the person. This is an extensive document that identifies a wide range of needs and risks. At the last inspection it was recommended that this assessment is Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 10 completed within the specified timescale. A sample of people’s care records was examined, and this showed that the assessment is completed over the first 48 hours following admission. People using the service are involved throughout the assessment process and their comments are recorded. Each section of the assessment specifies whether a care plan is required. Once the assessment has been fully completed a ‘Care Action Plan’ is recorded that summarises issues, goals and action to be taken to meet the person’s needs. The centre provides a community rehabilitation service for older people. Staff work with a team of health professionals to support people, wherever possible, to be able to live in their own homes. The team includes a Geriatrician (hospital consultant), Clinical Lead Occupational Therapist, part time Occupational Therapist, two Physiotherapists, Dietician, Community Psychiatric Nurse and a Social Worker. The service also works closely with people’s GP’s and District Nurses. The manager and a health professional said they have very good working relationships and meet bi-monthly to discuss the rehabilitation service. They told us a higher number of people, over 65 , have returned home in the past year. There are daily handovers and joint reviews are held weekly for each person to monitor their care. Discharge arrangements are well planned to make sure people have home visits to see if they can manage, and that appropriate care services are organised for when they return home. People who are unable to go home are supported to find alternative care services. In the past six months there have been a total of 175 admissions to the centre. 40 admissions were on an emergency basis and 62 were for respite care. 73 admissions were for the community rehabilitation service, and the average length of stay was 25 days. Of these 73 people, 47 returned home, 10 went into hospital, 7 to residential care, one person moved to an emergency bed, one person died and seven people were still staying at the centre. Chirton Resource Centre DS0000042084.V377039.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs are well met in a sensitive way and the medication system has improved to ensure people are better protected. EVIDENCE: People have individual care plans that link directly to their assessed needs and risks. These are recorded to a good standard of detail and clearly set out the support that staff and other professionals will provide and how to promote the person’s independence. Care plans are now evaluated at least weekly due to the short term nature of service. Day and night reports are well recorded and cross reference to care plans. Some people have regular stays at the centre, and staff should routinely check if their needs have changed since the previous stay, and update care plans where necessary. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 12 People using the service told us they receive very good support from staff and health professionals to meet their needs. Comments included, “The staff help me with the things I can’t do for myself yet. I know I have to do as much as possible so I can go home”, and, “They are all very kind and the care is second to none. I’m feeling better in myself already”. People can retain services from their usual health professionals during their stays. Temporary registration with a local GP practice is arranged, where necessary and district and practice nurses visit people at the centre. The team of health professionals support people using the rehabilitation service. Information is kept on each person’s medical history and current health conditions. Health related needs and risks are assessed and care planned, including pain, mobility, falls, continence, nutrition, skin care, foot care, and dental health. Each area of the assessment prompts whether the person needs to be referred to a health professional for medical assessment or treatment. Assessment of mental capacity is now carried out. Discussion with staff showed they have clear understanding that this is about people’s abilities to make specific decisions, and to involve other professionals so there is a multidisciplinary approach. People can continue to take their own medication and locked storage facilities are available in bedrooms. Staff usually administer medication for the first 48 hours following admission whilst assessing the risks involved in the person taking their own medication. Two people’s records showed there had been unnecessary delays in the individuals taking responsibility for their medication. The manager agreed that greater flexibility will be built into the process to prevent people being deskilled. Two medication errors and a dispensing error have been notified to the Commission in the past year. Management are making sure that everything possible is being done so medication is given safely. On admission staff verify current prescribed medication with the person’s GP. All staff have completed extensive medication training and competency assessments are being introduced. New medication charts are in now in place, with photographs for identification, and records are audited after each medication round. At the last inspection it was recommended that staff should follow the medication procedure at all times, to make sure records are completed after medication is administered, prompted, or not given for any reason. Current charts have clear directions recorded and all medications given were appropriately signed for by staff. Each person has a single bedroom and is given a key to their room so they can choose to keep it locked. There are some larger bedrooms that could be used by two people wishing to share. The centre has a pay telephone that people can use, or if they prefer they can use a portable telephone to make or receive Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 13 calls in private. Clothing is marked or labelled to make sure it is returned to the right person after laundering. People told us that personal care and any treatment are carried out in private. They described being provided with sensitive care and said staff respect privacy and dignity. One person said, “Staff know me well and they are very gentle with me when I’m having a bath, I don’t feel embarrassed”. People are asked if they prefer male or female staff to support them. This is recorded on their assessment and in care plans for personal care. Privacy and dignity issues are also discussed at weekly meetings to get people’s views. Some aspects of privacy and dignity are included in care plans though this could be more specific to state how it is respected according to people’s preferences. The centre provides services to people of different age, gender, disability, religion and beliefs. Staff have received training on equality and diversity, mental capacity and deprivation of liberty to give them understanding of peoples diverse needs and rights, and how legislation affects their practice. Staff told us they have the right experience and knowledge to meet the different needs of the people who stay at the centre. There is a privacy and dignity policy and the manager has completed dignity training. Newcastle Social Services has a Dignity Forum with representatives from various bodies including the Primary Care Trust, Elders Council and care providers from different sectors. The manager said he will be attending this forum and sharing information with staff to enhance their practice. Chirton Resource Centre DS0000042084.V377039.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are very well supported to live their preferred lifestyle, exercise choice and control over their lives and meet their social and dietary needs. EVIDENCE: Social, spiritual and cultural needs are assessed and care planned. People told us they are offered choices and confirmed there are weekly meetings where they discuss many aspects of daily life. The minutes of the latest meeting are displayed on a notice board. These showed there had been discussion on activities, meals, house issues, staff, privacy and dignity, and infection control. People had decided to have a music quiz, a general knowledge quiz, an exercise group, film afternoon, drinks and nibbles and a trip out. Staff keep a social diary where they record what has taken place each day and the people who participated. This is audited to make sure daily activities have been provided or an alternative has been offered. People are also told about Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 15 and can take part in the activities going on in the day centre within the resource. One lady said she would prefer more activities in the evenings. This was passed onto a staff member who said these could be arranged, and talked to the lady to see what she would like to do. The centre has an open visiting policy and people are able to receive visitors in private. One lady said her family is welcomed and can have drinks when they visit. People have opportunities to go out regularly and are asked at meetings about weekly outings, decide where they want to go and staff book the transport. They can also go on outings arranged by the day centre. The centre accommodates people going out individually, either alone if they are able, or accompanied by a staff member. One gentleman told the inspector he prefers to keep himself occupied during respite stays, has his own routines and goes out alone or with family. Links have been established with a nearby community centre, and people use this to take part in a wide range of activities and also as a drop-in place to meet others. People staying at the centre told us they make decisions about their lifestyles. One lady described not being well enough to go home and said she has been supported to choose a care home. She had decided it was the right place for her after visiting the home, and said the home manager was coming to see her to discuss her needs. Another lady said, They always ask you what you want, it’s very flexible here”. Some people told us they like the weekly service user meetings as they give everyone the chance to contribute, and influence the service they receive. People are encouraged to be involved throughout the process of assessing their needs and planning and reviewing their care and discharge. Good recording was evident of individual’s comments and respecting their opinions and choices. People are asked to give their consent to share relevant recorded information with others involved in their care. Mental health, ability to communicate and make decisions is assessed. People have their nutritional needs assessed. Care plans are devised and people are referred to the dietician where necessary. Staff inform the cooks about individual’s dietary requirements on admission, and special diets can be catered for. The centre has a three week cycle of menus that are based on research to meet the nutritional needs of older people. There is very good variety and choice of meals. Menus are displayed and each person is asked their meal preferences daily. People gave very positive comments about the food. They Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 16 said, “It is very good, they always ask what you want and you can have other things”, “The meals are great, very tasty”, and, “There is plenty of food, it’s well cooked and good quality”. People also told us the cooks come and talk to them about the meals. One person said, “The cooks are lovely, they are always happy to oblige”. The inspector dined with people at lunch time. Food was presented attractively and there were good portion sizes, with extra helpings if wanted. People are encouraged to be as independent as possible with eating, with aids if needed. Staff were attentive and offered discreet support and encouraged fluids. The meal time was a relaxed and social occasion and all people spoken with said they enjoyed their meal. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are properly protected from harm by effective procedures for making complaints and safeguarding vulnerable adults. EVIDENCE: The complaints procedure is included in the guide to the service, and leaflets are also on display in the centre. Staff know the process to be followed, and people using the service told us they are aware of the procedure. They said they would talk to a staff member or the manager if they were unhappy. No complaints have been received, either directly to the service or to the Care Quality Commission in the past year. Systems are in place to get feedback about the quality of the service, including meetings and surveys, and people’s views and suggestions are acted on. The centre has policies and procedures on recognising and preventing abuse, safeguarding vulnerable adults and whistle blowing (informing on bad practice). No safeguarding alerts have been raised in the period since the last inspection. The manager has completed advanced safeguarding training and is well aware of his responsibilities in the event of an allegation of abuse. All staff Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 18 are fully trained in safeguarding and team leaders are booked to attend advanced training. People using the service told us they feel listened to and secure, and that staff treat them with respect. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service stay in a clean, safe and comfortable environment that is maintained to a good standard and is equipped to meet their needs. EVIDENCE: Since the last inspection a programme of decoration has been followed. The majority of bedrooms are redecorated and have new carpets fitted. Bedrooms do not have en-suites, and commodes are provided where needed. New chairs, sofas and soft furnishings have been provided in communal areas and seating areas in corridors have been enhanced. Wallpaper and paintwork in corridors is worn and marked. The manager said the building has been assessed to check suitability for people with disabilities. He confirmed the corridors will be Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 20 redecorated after work to comply with access, such as widening doorways, has been completed. There is a range of well equipped bathing, shower and toilet facilities. The laundry is well organised and a sluice facility is provided. There are plans to purchase further equipment to help control infection. The centre is kept very clean and hygienic, and free from odours. Suitable hand washing facilities and protective gloves and aprons are provided. All staff have received infection control training and relevant guidance and legislation information is available. Chirton Resource Centre DS0000042084.V377039.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Skilled and competent workers who are trained to meet people’s diverse range of needs support people using the service. EVIDENCE: The centre provides short stay care for up to 20 older people. Good staffing levels are maintained with a minimum of four care staff across the waking day, with a senior on each shift, and two staff at night, supplemented by an on-call system. The manager’s time is extra to these levels and most of the hours worked by the two team leaders are also additional. Staff work to a three week rota that incorporates an overlap day each week that can be used for training and meetings. Cover for absence is provided by existing staff. An administrator is employed. The centre has good ancillary staffing of four full time and one part time domestic staff and two full time cooks. There have been a number of changes to the staff team since the last inspection, due to transfers and redeployment from other social services resources. One external appointment has been made in the past year and further staff are currently being recruited. During the inspection staff at all grades were observed to work well together and demonstrated good Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 22 knowledge of the needs of people using the service. People staying at the centre told us staff are available when they need them and they described being well supported. One person said, “They work hard and even keep check on you at night”, and another said, “Staff are very kind to everyone”. 56 of staff have achieved National Vocational Qualifications (NVQ) at levels 2-4, and one staff member is currently studying for NVQ Level 2. Both team leaders have NVQ Level 4, one has also completed the Registered Manager Award and the other team leader is starting this soon. New staff undertake thorough induction training. Each staff member has an individual file with training records and certificates. In the past year a variety of courses has been undertaken including fire safety, moving and handling, food hygiene, first aid, safeguarding, Mental Capacity Act awareness, Deprivation of Liberty, and falls prevention. In-house training has also been provided on infection control and health care associated infection, and hand washing. Further training is planned on group work, and foot care theory and practice, with a competency assessment. Chirton Resource Centre DS0000042084.V377039.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a quality service that is well managed in their best interests and promotes their safety and welfare. EVIDENCE: Mr Simon Mulligan took up post as manager of the centre in May 2008, and was approved as the Registered Manager in December 2008. He previously managed another social services resource centre and has a total of 27 years experience in care and nursing, 20 years of which are at a senior or management level. He holds a range of nursing, social work and management qualifications. Senior staff meetings are held every one to two weeks. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 24 Mr Mulligan provided a well completed Annual Quality Assurance Assessment (AQAA). This is a self-assessment that the Commission requires registered care services to fill in each year to tell us how well the service is delivering outcomes to people. The AQAA showed that there is clear understanding of what the service does well and evidence to support this, improvements made in the last year and plans to develop the service further in the next year. The centre works to an annual development plan to assure the quality of the service. This is set out into objectives, actions and timescales and includes measurable methods of monitoring quality, and responsibilities. The views of people using the service are sought during reviews and weekly meetings, and through discharge surveys with a good range of questions that are linked to performance indicators for the service. There are plans to include up to date results of surveys and comments from people in the Service user Guide. Various audits are also carried out to assure quality such as audits of care records, medication, social activities, and health and safety. The staff team work with other professionals to improve service quality both within the centre and for when people have returned home. This work has included improving infection control through the Health Improvement Foundation programme. The centre has also taken part in a Telecare pilot to support to people in their own homes through technology, and referring people to Warm Zone, a project that helps people to make their homes affordably warm and energy efficient. At the last inspection, visits and reports on the conduct of the service were not being consistently carried out monthly, as required. It is the registered provider’s responsibility to make sure these are done. Managers of other local authority care services are delegated to do these visits, and some visits over the past year have been missed. People using the service can choose to keep cash in the safe during their stay. Personal financial transactions are appropriately recorded on individual account sheets. A range of health and safety procedures and risk assessments with control measures are in place to guide staff on safe systems of work. All staff receive health and safety and safe working practices training and updates. Significant work has been done to develop control of infection at the centre. This has included improvements to training for staff, revised protocols and systems to manage infections, and involving people using the service and their visitors to comply with hand hygiene. The manager has lead on this work and has been invited to be a member of the Primary Care Trust Steering Committee for infection control. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 25 Risks are assessed according to individual’s vulnerabilities to prevent people being harmed. Strategies to manage or minimise identified risks are detailed in care plans. Fire safety checks and tests are conducted at the correct intervals. All staff receive fire instructions every three months and there is a reminder system to make sure these are carried out. There is a system for reporting and recording accidents and incidents and this is monitored and analysed. Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 26 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 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 X X X X X X 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations (a) Staff should routinely check if individual’s needs have changed when they return to stay at the centre, and update care plans where necessary. (b) Privacy and dignity issues should be developed within personal care plans according to people’s preferences. The Registered Person should make sure that visits to report on the conduct of the service are carried out every month. 2. OP33 Chirton Resource Centre DS0000042084.V377039.R01.S.doc Version 5.2 Page 28 Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Chirton Resource Centre DS0000042084.V377039.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!