Care Home: The Chaseley Trust

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What the care home does well The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required enabling them to make an informed choice about where they live. Residents in the home each have their own copy in their room to refer to; one resident said " I refer to it when I need to, I find it very helpful" some residents were not aware of the meaning. The atmosphere in the home was comfortable and relaxed. The care plans and pre-admission assessments of the residents have been maintained to a good standard, and clearly identify the needs of the residents. The risk assessments in place are consistent and support the complex needs of the residents enabling them to partake in life outside of the home. There is a variety of good nutritious food offered and fresh fruit is readily available. Meals are taken in comfortable and homely surroundings.The home is clean and safe with all the necessary specialist equipment to enable residents to be as independent as possible, which is appreciated by the residents and their relatives. The activities are well organised and provide a wide range that meet the interests and needs of the residents. The residents who expressed an opinion were very positive about the support they receive, they felt their needs were met and that they were consulted about what care is most appropriate for them. The quality and choice of meals remain good and all residents spoken with confirmed this. " The food is good" "we get a choice of food everyday" " the food is always freshly prepared". Systems are in place to regularly consult with residents via service users meetings and surveys. There is an open-house policy, which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard resident`s finances. Staff provision is well maintained with good recruitment practice being followed and appropriate numbers of staff suitably qualified working in the home. The staff group on the whole is stable. Both residents and their relatives spoke highly of all the staff saying `staff are always nice and kind` `staff are helpful, approachable and are available to talk to`. The training for staff is good, and covers a wide variety of resident related conditions, which give the staff an understanding of the residents needs. What has improved since the last inspection? The requirements and recommendations from the previous inspection have been met or continue to be monitored. Respite residents care plans have been reviewed and evidenced that residents admitted for regular respite care are assessed fully on admission taking into account any changes in their physical or medical needs. The medication audit continues to be beneficial in ensuring that the policies and procedures in place are followed which protects the residents from possible harm. This needs to be continued. There is a redecoration programme in place. What the care home could do better: From the results of the internal medication audit, there is evidence that it is proving beneficial in identifying poor practice, and it should be continued. The staff need to ensure that residents dignity is preserved when moving between shower rooms and bedrooms. CARE HOMES FOR OLDER PEOPLE Chaseley South Cliff Eastbourne East Sussex BN20 7JH Lead Inspector Debbie Calveley Key Unannounced Inspection 21st August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chaseley DS0000013972.V307156.R02.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. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chaseley Address South Cliff Eastbourne East Sussex BN20 7JH 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) 01323-744200 01323-744208 The Trustees of the Chaseley Trust Helena Barrow Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (55), Physical disability (55) of places Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is fiftyfive (55). The service users will be sixty-five (65) years or over on admission. That service users with a physical disability must be aged eighteen (18) years and over on admission. That a maximum of eight (8) day care service users can receive rehabilitive care. 20th December 2005 Date of last inspection Brief Description of the Service: Chaseley is a care home registered to provide nursing and supporting care for fifty-five service users, who meet the registration category of elderly and physically disabled. It provides nursing care and support for a wide range of disabilities including spinal injuries, neurological conditions acquired brain injuries. It is a large detached Victorian property situated on Eastbourne seafront, which has been extended and adapted extensively to provide an environment where severely physically disabled residents can live and receive nursing care. Chaseley provides further facilities for day care and specialist services including physiotherapy and occupational therapy. The accommodation consists of ample communal areas, an activity suite, a physiotherapy/sensory room, large lounge areas, and a dining area. There are forty-five single bedrooms without an ensuite, four with ensuite, two double without an ensuite and one double with an ensuite. There are ample disabled bathing facilities in the home to meet the specialised needs of the residents. On the day of the unannounced inspection there were fifty-four service users in the home. Eastbourne town centre is approximately 2 miles from the home and Meads Village with its shops and amenities is approximately ¾ mile. A regular bus service runs from Meads to Eastbourne, passing near the home. There is a parking facility for residents and staff to the rear of the home and parking for approximately eight vehicles is available at the front. Copies of inspection reports and the homes Statement of Purpose are given to all residents and their representatives. Fees charged as from 1 April 2006 range from £1,200, which does not include personal toiletries. Additional charges are made for hairdressing, chiropody, newspapers and outside activities such as visits to the theatre and trips. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Chaseley will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and follow up contact with resident’s representatives and visiting health and social care professionals. This unannounced inspection was carried out over 10 hours on the 21 August 2006. There were fifty-one residents in residence on the day, of which twelve were case tracked and spoken with. During the tour of the premises ten other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the service users guide, statement of purpose, care plans, medication records and recruitment files. Six members of care staff, three trained nurses were spoken with in addition to discussion with the senior manager on duty. The pre-inspection questionnaire was received back from the registered manager on the 03 August 2006 completed in full. Comment cards received from twelve residents and four relatives were generally positive and indicated that both groups were satisfied with the services provided. Two comment cards were received from social and healthcare professionals, and eight staff surveys were received from a selection of staff. The information contained in the returned surveys has been incorporated into this report. What the service does well: The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required enabling them to make an informed choice about where they live. Residents in the home each have their own copy in their room to refer to; one resident said “ I refer to it when I need to, I find it very helpful” some residents were not aware of the meaning. The atmosphere in the home was comfortable and relaxed. The care plans and pre-admission assessments of the residents have been maintained to a good standard, and clearly identify the needs of the residents. The risk assessments in place are consistent and support the complex needs of the residents enabling them to partake in life outside of the home. There is a variety of good nutritious food offered and fresh fruit is readily available. Meals are taken in comfortable and homely surroundings. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 6 The home is clean and safe with all the necessary specialist equipment to enable residents to be as independent as possible, which is appreciated by the residents and their relatives. The activities are well organised and provide a wide range that meet the interests and needs of the residents. The residents who expressed an opinion were very positive about the support they receive, they felt their needs were met and that they were consulted about what care is most appropriate for them. The quality and choice of meals remain good and all residents spoken with confirmed this. “ The food is good” “we get a choice of food everyday” “ the food is always freshly prepared”. Systems are in place to regularly consult with residents via service users meetings and surveys. There is an open-house policy, which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard resident’s finances. Staff provision is well maintained with good recruitment practice being followed and appropriate numbers of staff suitably qualified working in the home. The staff group on the whole is stable. Both residents and their relatives spoke highly of all the staff saying ‘staff are always nice and kind’ ‘staff are helpful, approachable and are available to talk to’. The training for staff is good, and covers a wide variety of resident related conditions, which give the staff an understanding of the residents needs. What has improved since the last inspection? What they could do better: From the results of the internal medication audit, there is evidence that it is proving beneficial in identifying poor practice, and it should be continued. The staff need to ensure that residents dignity is preserved when moving between shower rooms and bedrooms. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 7 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. Chaseley DS0000013972.V307156.R02.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 Chaseley DS0000013972.V307156.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective residents and their representatives are provided with information about the home in order to make an informed choice about whether to live at the home. The pre-admission assessment procedures ensure residents admitted can have their care needs met within the home by experienced staff. EVIDENCE: There is a range of well-documented information about the home and the services it provides. This includes a statement of purpose and Service User Guide. Copies of these are available in the front entrance area. A social care professional that had recently visited the home confirmed that relevant information was provided to a prospective resident. It was confirmed whilst talking to residents that the contract arrangements were clear and understood. A review of the care documentation confirmed that pre-admission assessments are completed, and are currently completed by the manager or a senior nurse. Eleven of the twelve assessments were found to be completed and were used Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 10 to ensure new admissions to the home were suitable and that the home have the staff and environment to meet the care needs of the new resident. The information contained in these assessments is then used to provide the basis of the care documentation in the home. The prospective residents’ are seen either in their home or hospital before admission and the manager confirmed that wherever possible the family or representative is involved. Two relatives confirmed that they were consulted about the pre-admission visit and were given the opportunity to attend. The staff spoken with were able to verbally demonstrate their knowledge and awareness of the different specialities required in the home and it is ensured that the Registered Nurses employed have attended relevant courses to deal with the needs of the residents admitted to the home and also specialised courses for certain diseases. Trial visits to the home can be arranged. It was confirmed that all residents are invited to a trial period to ensure suitability of the home; this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Respite care is provided at Chaseley Trust. Chaseley DS0000013972.V307156.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Generally care plans provide a good framework for the delivery of care. The home was found to be meeting resident’s health and general needs with accessed additional specialist support when needed. EVIDENCE: Eight care plans were viewed, and were found to be informative. All were found to have a plan of care, which is generated from the initial pre-admission assessment. The care plans identify the specific health, personal and social care needs of the individual residents. There were some care plans seen that were overdue for a review; this was said to be due to the key nurse being on sick leave. The risk assessments were clear and evidence was seen of regular review. A new moving and handling assessment is in the process of replacing previous risk assessments, some were seen to be missing the plan of action for staff to follow. This will be reviewed. All residents have their vital signs, weight and urine tested on a monthly basis, which due to the complexity of their illness/disability is beneficial in monitoring their health needs. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 12 There is evidence of resident/representative consultation in individual plans. All of the residents spoken with said they had been involved in the discussions regarding their care plan, two said that they meet monthly with staff and discuss there feelings about how they are getting on. The care plans also evidenced the formal six monthly reviews, which are attended by the resident, a relative or other key person. From the information gathered from the care plans and then meeting those residents, it was found that the health needs of the residents were met. Specialist equipment was found in place where required, e.g. air mattresses, cushions and various hoists with different slings. The individual risk assessments for moving and handling need to specify which hoist and sling is to be used, which will guide staff in this area. Staff spoken to confirmed that they received a full report on each resident daily and read the care documentation that is kept in the ward office. They felt that their views were taken into account when planning resident’s care. Feedback from residents regarding the care they receive was in the main positive and included “the staff know what they are doing” “ I think that they understand me and look after me very well” “the staff are caring and try hard to ensure that I am okay” “ I would not want to be anywhere else” “ Sometimes they are too busy and I get forgotten” Two residents were able only to communicate by signals but were able to respond to open questions and indicated by sign that they were happy in the home and that they had no concerns. Two residents confided that they were not always very happy and these residents were asked if they would share their feelings with the senior nurse. The clinical rooms were found clean and tidy, the equipment well maintained. There are policies and procedures in place for the storing, administrating, disposal and receipt of medication. It is acknowledged that the policies and procedures are currently under review. The temperature of the fridge and room are recorded daily and are of an acceptable temperature to maintain dressings and medications. The medicine administration charts continue to be audited by a senior nurse on a weekly basis, and any gaps are identified and followed up. The results of the audit were discussed and the action taken regarding repeat poor administration practice were seen as appropriate. Residents are registered with a G.P surgery and are referred to other health professionals as and when required. It was noted again that the relationship between staff and residents is friendly and relaxed and throughout the inspection it was observed that residents were treated with friendship, dignity and respect. Two visitors commented, “ The staff are very kind, the atmosphere in the home is good, lots of movement, lots of noise and laughter”. A resident said, Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 13 “ The staff here are special, they have lots of patience and nothing is too much trouble for them”. Another said, “ They treat us with respect and make sure that we are looked after well”. Good practice was observed throughout the inspection in respect of administering personal care and staff were seen assisting residents with their meal in a calm and dignified manner. The practice of residents being transferred from bathroom to bedroom with little body covering needs to be reviewed and steps taken by staff to ensure that the residents dignity and privacy is upheld. Chaseley DS0000013972.V307156.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. EVIDENCE: Chaseley continue to promote independence and freedom of choice. The routines of daily living are flexible as possible, and residents choose their daily schedule when they are able to, including their meal times and venue. Feedback from six residents and from direct observation on the day, it was apparent that residents are given the opportunity to spend their time as they wish. Three residents said that they chose not to attend the activity sessions, even though they were always asked, they said they prefer to spend time in their room with their books and television. One resident again demonstrated her creative talents with work she has completed whilst attending the art sessions. It was not possible to speak to the activities co-ordinator due to annual leave. However the activities programme demonstrated a wide variety of activities, in the home and outside of the home to suit all residents. The day care residents mix well with the residents of the home and enjoy the services provided. A Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 15 recent event that residents were still talking about was the Eastbourne Air Show. The home continues to play a large part in the event. The Cas Bar remains popular with the residents and several mentioned that they visited the bar to relax and meet friends. Residents spoke positively about the variety of activities and about events that were happening. Two surveys received stated that due to staff shortages, physiotherapy and activities were not as frequent. Residents are facilitated to maintain their independence for as long as they are able. There are no restrictions on visiting times as long as consideration is shown to all the residents. Residents are encouraged to make choices about all aspects of their lives and are supported if they wish to make changes to their daily routine. Residents are encouraged and facilitated to personalise their bedrooms and bring in items of their own furniture. The majority of rooms have been individualised and many residents have their own fridges and electrical items that allow them independence within a risk assessment framework. Residents’ artwork is displayed in rooms and corridors throughout the building. An advocacy policy is in place and there is information regarding how to access this service in the service users guide. Residents, relatives and friends spoke positively of the care and support provided at Chaseley. They feel that the management team are approachable and that their opinions are taken seriously. The dining area is spacious with natural light, pleasantly decorated with tables of varying heights to allow wheelchair dependent service users to choose where they sit. The food is displayed in a servery, which enables residents to choose their meal and mix and match with what takes their fancy. There are dispensers in place for soft drinks, hot drinks and soup which service users can help themselves, thus promoting their independence. Lunchtime servings are divided in that the more heavily dependent use the dining area first followed by the more abled and the dining room is open from 1200-1330. The meals provided had had mixed feedback and as a result the catering providers were being replaced. Resident’s comments regarding the food choices were positive, the surveys received also stated that the food was good, and they always enjoyed the food. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 and 18. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Procedures in the home ensure that complaints and any allegation or suspicion of abuse made would be managed appropriately. EVIDENCE: There are appropriate policies and procedures in place and it was confirmed that these are followed when investigating any concerns raised at the home. The staff interviewed, were knowledgeable of the complaint procedure and of how to start the process if the manager is not available. The complaint book was viewed during the inspection. Three complaints have been received in house and there was evidence of full investigation, action taken and action plan. The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. The management team has a clear understanding of adult protection guidelines and have initiated this procedure appropriately in the past. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home provides a comfortable, clean and safe environment for those living there and visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. EVIDENCE: Chaseley continues to provide a comfortable, homely and well-equipped environment for the residents and for those who visit. There is wide range of communal areas for the use of the residents and their visitors; and these include a dining room, sun terrace, bar and function area and three other quiet areas. The home promotes independence and due to a large amount of residents that use electric wheelchairs, walls are continually being damaged, so the home has an on-going maintenance and redecoration programme. Residents are enabled to smoke following an individual risk assessment, and the bar area is an allocated smoking area. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 18 There are attractive garden areas that have sea views and fully disabled access. The home has been designed and modified to meet the needs of its nonambulant service users who have complex needs. There is assured accessibility to service users both internally and externally. Large lifts provide level access to all floors. There is an on-going upgrading and refurbishment programme in place which will enhance the facilities offered. The internal redecoration continues to be on going. Two underused bathrooms have been converted to nurse’s stations. Individual rooms are decorated to the service users specific colour choices. The rooms viewed were seen to be personalised with the resident’s own furniture, pictures and equipment, such as fridges and computers. Chaseley’s Statement of Purpose promotes the facilities available to meet the needs of residents with severe physical disability and promote their independence. There is continual fund raising to purchase equipment to enhance the lives of those with disabilities. There is a Physiotherapy and Occupational Therapy unit on site and the input from the staff is discussed regularly as part of a multi disciplinary team to discuss the on-going needs of the residents. All the bedrooms are equipped with the needs of the individual resident in mind, the necessary adaptations have been made to ensure that the rooms are easily accessible, comfortable and provide as much privacy as the residents require. The doors are opened and closed by the use of a touch pad. The size of the rooms is beneficial for those who use an electrical wheelchair, encouraging independence. There are separate facilities provided to store and recharge the wheelchairs on the ground floor. The cleanliness of the home has been maintained to a good standard, and there are systems in place to prevent the spread of infection. Good practice by staff was observed during the inspection. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staffing arrangements are good and suitable and ensure the needs of the residents living in the home are met. Residents are protected by the home’s recruitment policy and practices. EVIDENCE: The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was confirmed by the senior nurses that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. Staff spoken to said that the levels of staff on duty were sufficient to give the care required, they also said that the trained staff always helped out. Residents also confirmed that they had no complaints regarding the amount of staff, one resident said the “staff is always helpful, they look after me very well”. Another said, “ The staff are really nice, always take time to talk to me”. Staff files of five employees were viewed and evidenced that the home management team follow robust procedures when employing staff. They contained the required information and demonstrated that the appropriate induction training had been completed in respect of the job they were to undertake in the home. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 20 Staff interviewed confirmed a high satisfaction with the training provided and stated that recent training was interesting and informative. Five staff surveys received stated that they were satisfied with the standard of training provided. Staff and records seen confirmed that they had undertaken compulsory training such as manual handling, adult protection, first aid, and food hygiene and fire safety. In addition specialist training in understanding Dementia, challenging behaviour, Huntington’s disease, Parkinson’s disease palliative care, and stroke care updates are also provided. NVQ training is available and staff are encouraged to complete this, at present 40 of care staff have an NVQ qualification. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The overall management of this home is good with effective systems in place to protect residents. EVIDENCE: The Registered Manager is a Qualified Registered General Nurse and has the experience to run the home effectively with support from the Chief Executive and a senior charge nurse and senior sister. The management structure of the home is strong, competent and has clear lines of accountability. The feedback from residents, relatives and staff indicated that they felt supported and were able to approach the management team at any time. The ethos of the home is to focus on the residents and the staff were observed doing this. Regular staff meetings and resident/relative meetings are held and records of the meetings are kept. The staff surveys mentioned the staff meetings and how beneficial they were and the staff felt that areas of Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 22 improvement they put forward were acted for the benefit of the residents. These form part of the quality assurance systems in the home. One resident mentioned that they attended the resident meetings and thought it gave them the opportunity to discuss the running of the home and areas that could be improved. Residents’ financial interests are safeguarded by the homes policies and procedures. All staff spoken with were aware that they must not be involved in any financial matters of the residents, they also said that they would not accept money or gifts from residents. The residents spoken with said they had no worries regarding their financial status, and felt they were supported in managing their affairs efficiently. It was confirmed and the staff training records show that all staff are kept updated on the Health and Safety policies, the manual is available to all and clearly defined. Staff were able to discuss the training they received and said that they were kept up to date with changes to policies in connection with fire safety and health and safety. The staff are issued with certificates yearly for Manual Handling, twice yearly for Fire Safety and Food and Hygiene. The home has a comprehensive set of policies and procedures, which govern the running of the home. All relevant legislation and procedures are in place in respect of Health and safety. Evidence was seen of regular supervision sessions and all staff spoken with and those that completed staff surveys confirmed that they receive regular supervision. Throughout the inspection good practice was observed in regards to ensuring the safety and well being of the residents when being moved around the building. The accident forms were seen and had been correctly completed with appropriate referrals made as necessary. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 3 3 Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP10 Regulation 12(4) Requirement That all service users are treated in a manner, which respects their privacy and dignity. That all invasive nursing procedures have a policy and procedure in place for staff to follow. Timescale for action 21/08/06 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 OP19 Good Practice Recommendations That the medication audit is continued to identify poor practice and protect service users. That the maintenance and redecoration programme is robust. Chaseley DS0000013972.V307156.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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 Chaseley DS0000013972.V307156.R02.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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