Chilterns Home Care Home Service Adults 30 Lindsaybeg Road Chryston Glasgow G69 9DW Telephone: 01236 856030
Inspected by: Morag McHaffie L McIntyre J Fraser Type of inspection: Unannounced Inspection completed on: 8 November 2012 Inspection report continued
Contents
Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 11 4 Other information 22 5 Summary of grades 23 6 Inspection and grading history 23
Service provided by: North Lanarkshire Council
Service provider number: SP2003000237
Care service number: CS2003001182
Contact details for the inspector who inspected this service: Morag McHaffie Telephone 01698 897800 Email [email protected]
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Summary
This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection.
Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service.
We gave the service these grades Quality of Care and Support 5 Very Good Quality of Environment 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good
What the service does well The people who reside at Chilterns are an active part of the community and make daily use of the newsagents, restaurant and health centre when required.
While orientating ourselves with the care home environment the Inspectors were approached by a resident Mrs N to enquire "Are you here about the closure of Chilterns" - "Hope it's not closing".
Further to our conversation the summary of this particular resident was "Need to take me out in a box"
Inspectors were told by other residents during the inspection: "Service users don't want to leave, they love the home".
They have set up Chilterns Steering Group, comprising of residents and all stakeholders of Chilterns care home to actively contest the plans by the local authority for future service delivery for older people. A concern of relatives and residents is that they have previously experienced relocation after the closure of other local authority care homes in North Lanarkshire or some have been resident at Chilterns for 19 years.
Chilterns Home, page 3 of 25 Inspection report continued What the service could do better During this period of uncertainty for all parties, the management and staff should continue to provide the people who use the service and their carers the opportunity to take part in the development and improvement of their service line with National Care Standards, inspection quality themes and statements and all appropriate legislation.
What the service has done since the last inspection Communication is aided by the use of Suggestion Box and a Newsletter, regular meetings supported by the circulation of the minutes and an action plan for the benefit of the people who were using the service, their friends and relatives.
The environment of the care home continued to improve with addition of art work and homely touches and there are discussions for the exterior garden area to be refurbished.
Conclusion The service is registered for 40 persons but is at present offering care to over thirty permanent residents and has capacity to take five persons for varying periods of respite.
The service has continued to score grades that are indicative of a well managed care service.
We will be looking for the management to sustain and continue the development of person centred care and support by a well trained and motivated workforce.
Who did this inspection Morag McHaffie L McIntyre J Fraser
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1 About the service we inspected
Chilterns Care Home is registered for 40 residents in accommodation set over two floors.
The service provides single rooms with partial ensuite facilities. People who use the service have access to shared toilets and bathing facilities, spacious lounges with plenty of natural light, a designated smoking room and a number of dining rooms. The home is well decorated and furnished.
People who use the service have freedom to move around and have access to a passenger lift to access the upper floor and ramp access to the front and rear of the property.
The grounds surrounding the home are well kept offering hard landscaped areas as well as large grass areas with fruit trees and flower borders. Garden furniture was available for people to sit outside.
The care home is situated on a bus route and there are local shops and community amenities in this geographical area of Chryston/Muirhead, North Lanarkshire.
The property is owned by North Lanarkshire Council whose headquarters are situated in Motherwell.
On the day of the inspection Chilterns had 6 vacancies.
Based on the findings of this inspection this service has been awarded the following grades:
Quality of Care and Support - Grade 5 - Very Good Quality of Environment - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good
This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection.
Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.careinspectorate.com or by calling us on 0845 600 9527 or visiting one of our offices.
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2 How we inspected this service
The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care.
What we did during the inspection Social Care and Social Work Improvement Scotland (SCSWIS) is the new regulatory body for care services in Scotland. It will award grades for services based on the findings of inspections. The history of grades that the service was previously awarded by the Care Commission is also available on the SCSWIS website.
We wrote this report following an unannounced inspection visit by three Care Inspectorate Inspectors, on 8 November 2012 between the hours of 07:30 - 18:00. Feedback was given to the manager who was accompanied by the depute manager on 8 November 2012, 16:30 - 18:00.
In this service we carried out a low intensity inspection. We carry out these inspections where we have assessed that the service may need a less intense inspection. It was also a proportionate inspection, by taking previous inspection grades into account.
As requested by the Care Inspectorate, the service sent us an annual return. The service also sent an electronic self assessment form.
The service provider was supplied with Care Standards Satisfaction Questionnaires for people who use the service and their carers/relatives & friends "How satisfied are you with this care service"? prior to the announced inspection.
Nineteen responses were received prior to writing this inspection report.
In this inspection, evidence was gathered from various sources, including the relevant sections of policies, procedures, records and other documents, including:
- Activities - Aims and objectives - Accidents and Incident recording - Complaints Log - Minutes of Relatives, Service Users and Staff meetings - Participation Strategy
Chilterns Home, page 6 of 25 Inspection report continued - Registration Certificate - Insurance Certificate - Service Users Care Plans - Observation of staff practice - Examination of the environment and equipment.
Discussions with various people: - Care Home Manager - Staff - care, catering, domestic - 6 People who use the service - 1 Relative of people who use the service
Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements.
Details of what we found are in Section 3: The inspection
Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement.
Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org
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What the service has done to meet any requirements we made at our last inspection
The requirement The management must ensure that the providers Administration of Medication policy and procedure is adhered to by all those who carry out this task,ensure that theindividualin receipt has taken their medication and the outcome for the individual and other residents is not compromised. When made aware of the event the Management immediately investigated and took action regarding the Administration of Medication and the health and welfare of their residents.This is to comply with SSI 2011/210 Regulation 4(1)(a) -Welfare of Users - a provider must make provision for the health, welfare and safety of service users. Timescale for Improvement: At point of inspection and be completed within 4 weeks
What the service did to meet the requirement Administration of medication and a Medication Toolbox course have been made available to all staff.
The requirement is: Met
What the service has done to meet any recommendations we made at our last inspection Theme 1 Statement 3:
The management should ensure that all records, including medication, are appropriately kept and have an ease of tracking.
Progress: Pharmacy completed internal audit and provided an outcome action plan.
Part of the audit process of care plans has been delegated to the senior management team to improve quality of information.
The service is upgrading the care plan documentation
Met
Chilterns Home, page 8 of 25 Inspection report continued The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: yes
Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of the headings that we grade them under.
Taking the views of people using the care service into account We received 9 completed questionnaires from people who use the service.
Overall, I am happy with the quality of care I receive at this home?
Strongly Agree = 22.2% Agree = 77.7%
"I have made a decision this is my home for life and would like to remain in this unit until I die"
Taking carers' views into account We received 10 completed questionnaires by relatives and carers of people who use the service response to the question:
Overall, I am happy with the quality of care I receive at this home?
Strongly Agree = 40% Agree = 60%
"I find the care and attention my mother receives in the home is second to none. The staff are always polite and very friendly and always have the time to have a laugh and a joke with me and my family when we visit. I certainly have no complaints about the care my mother receives"
Chilterns Home, page 9 of 25 Inspection report continued "I have to add comment, especially in relation to the overall holistic care my mother (deceased) and our family members received from every member of staff in Chilterns, managerial, admin, care staff and kitchen staff are to be highly commended for the assistance, support, kindness, dignity, respect my mother was shown, the kindness and sensitivity shown to all family members including myself is something I will not readily forget".
"Service is good with competent and caring staff. I am always notified of any problems. My relative is quite happy in this home and I am happy with the care she is receiving"
"Chilterns home is very well managed. I would like to commend each and every member of staff. The kitchen/catering staff also do a great job. My relative is treated as an individual and his needs are always met...... I would like to mention some people in person for their excellent manner and professionalism in which they carry out their roles with kindness and respect: M - for her special way with papa G - for his innovative ideas for all the residents S - for his cheery nature Thank you Chilterns"
"The care my relative receives is very good. She has a clean, pleasant room. Has started to go out to the hairdressers. She enjoys the home and the staff. All of the staff are approachable. Five star recommendation for care"
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3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found.
Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 5 - Very Good
Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The staff members of this service tend to think outside the box with regards to people who use the service being involved in their community or activities that meet their needs.
Six people spoken to all indicated they participated in hobbies and had started new activities since moving into Chilterns.
One lady was waiting transport to go to the Church Coffee Morning which she attended weekly.
Another resident was interested in Archery and was attending an open day on the topic.
A resident, who as a young man was a boxer, had visited a local boxing club and found the whole thing very interesting.
A lady who had previously been a seamstress visited Glasgow North College to see the advancements in technology, current techniques in dressmaking and watch the students fashion show. Also attended a craft fair in Glasgow Exhibition Centre and made a few purchases to continue her crotchet hobby.
There is a person who is an accomplished artist and his art work is displayed in the lounge area. Another resident where her life began in Europe uses her first language to communicate with a member of a religious order in the local community by either visiting them or phoning them. She also regularly dines in a restaurant where she can
Chilterns Home, page 11 of 25 Inspection report continued also use her first language.
The foyer is the central point for access and where the Suggestion & Comments Box is located and has paper and pen supplied to aid responses. There is a digital picture frame in the foyer to welcome visitors and show what activities people who use the service participate in throughout the year.
The noticeboards throughout the building are informative of inhouse and external events: * Residents meetings take place 6 weekly and the minutes are published. Two residents spoken to confirmed they were regular participants at these meetings * There was evidence of thank you cards and testimonials regarding the care home from professional sources and friends of the service * Advertise Advocacy Services * Complaints Procedure for North Lanarkshire Council and the Care Inspectorate * Adverts for internal and external activities * Copy of providers participation strategy
The people who use the service also have access to a computer for personal usage.
The care service has a Brochure, Welcome Pack, Information Leaflets and Newsletter available for prospective service users.
The provider makes use of an annual questionnaire with outcomes available for scrutiny by all interested parties.
People who use the service participate in the development of their care plan. Six monthly care service reviews take place of individuals care plans and are complimented by regular in-house reviews. The review process includes the person who uses the service and their relatives or advocate.
There was evidence that people who use the service had been involved in the ongoing redecoration of Chilterns and choosing new furnishings. Bedrooms were observed to be personalised with various individual items such as pictures, bed-linen, television and telephone if desired.
There are hairdressing facilities for both sexes who use the service. The Hairdresser visits weekly and the care service offers male grooming within a traditional barber themed room.
The manager operates an open-door policy and will arrange to be available at times to suit individuals.
People who use the service are supported by a key-worker and information is
Chilterns Home, page 12 of 25 Inspection report continued available about their roles and responsibilities.
Areas for improvement The minutes of individual reviews were not as explicit as they could be when recording the views and wishes of people who use the service to evidence their participation in the process.
It was observed that the provider's questionnaires were not clearly dated to give an accurate account of when completed, closer analysis of information and actions of the identified outcomes.
The Thank You cards did not have dates when received to evidence current information.
The service has evidence reflecting very good practice against this quality statement and has identified the importance of communication and consultation with all parties through the provider's participation strategy.
There were no requirements or recommendations at this inspection from Theme 1 statement 1.
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Chilterns environment is bright and light throughout. There is a calm atmosphere and people who use the service are offered single occupancy bedrooms with partial ensuite facilities.
The décor throughout the care home was appropriate and had been selected by its users.
The dining rooms and dining experiences were very pleasant with just the noise of conversations by residents and staff.
The lounge areas throughout the home offered a cosy, homely environment to watch the TV or movies or meet with visitors.
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The designated "smoke area" is located in the foyer and opposite the staff room. It has a glass wall so staffs are able to monitor those making use of the facility without invading their privacy. The smoke room is a comfortable and bright area and was observed to be in a good state of repair.
The care home is sited in the heart of the community on the town green. It is surrounded by well kept and mature plants.
The care plans sampled were: * Person centred * The first paragraph encapsulates the individual and there is a good quality photograph of the person * Minutes of reviews * Changes recorded within care plans * Risk assessments for falls and moving and handling * Involvement of other health professionals * Use of and visits to the local health practice to see doctor, diabetes clinic, review medication * People who use the services have an allocated keyworker and discussions between both parties regularly take place and are recorded * Where required certificates were in place to identify Power of Attorney, Mental Welfare Commission best practice guidance and the Adults with Incapacity Act
Service has an electronic nutritional screening tool. Nutritional guidance tool is completed to assess the individual's dietary intake, ability to eat & drink, mental health conditions, digestive function and medical condition.
Body Mass Index tool is completed monthly as well as the individuals Dependency levels and scores.
All staff have received training for the administration of medication and this is reviewed six monthly. Individual's medication is stored in "Pods" in the privacy of their own bedroom with pre-printed record sheets. These records were completed as per the best practice guidance to protect the individual.
The staff team have developed solutions for the administration of medication to meet the daily needs of each individual, for example using alarm on their pager for reminders to take medication every three hours.
There was good interaction between staff and people who use the service and we observed choices being offered at all times, for example attend activities, read the daily newspaper which is delivered to the care home, access the garden or visit the local shops.
Chilterns Home, page 14 of 25 Inspection report continued Areas for improvement At the time of the inspection the service was changing the documentation used in the care plans to meet the requirements of the provider.
There were no areas for development, requirements or recommendations from this inspection from Theme 1 Statement 3.
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
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Quality Theme 2: Quality of Environment Grade awarded for this theme: 5 - Very Good
Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths Please refer to Theme 1 Statement 1 Areas for improvement Please refer to Theme 1 Statement 1
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
Statement 2 We make sure that the environment is safe and service users are protected. Service strengths Access to the care home is via a keypad door entry system and powered automatic door.
The registration certificate and insurance policy are displayed along with the Complaints procedure in the foyer. The care service adheres to its staffing schedule set by the regulator in partnership with the provider.
All visitors are asked to sign the Visitors book located in the foyer.
The service is registered for 40 persons and offers single rooms with partial ensuite facilities. On each floor the care service offers a warm and homely decorated shared bathroom and shower facilities.
Records indicate that all users of the service are offered the choice to have a key to their bedroom and staff will have a master key for use in an emergency. There is a locked cupboard for the storage of valuables in each bedroom. Individuals and their families can personalise the bedrooms. People who use the service can also have a
Chilterns Home, page 16 of 25 Inspection report continued phone in their bedroom.
People spoken to were satisfied with the standard of cleanliness and the attention to their belongings including the laundry of their clothes.
There is a designated pantry "Tea Bar" area accessible to people who use the service and their visitors with beverages, biscuits and fruit throughout the day.
The garden has ease of access from the building and offers protected seating and access to equipment for the more able-bodied who wish to potter in the garden.
The service has its own transport for outings and it is suitably situated for people to access public transport.
Chilterns has implemented best practice guidance for persons with Dementia, cognitive or visual impairment by installing: * name plates on doors * decor and floor-covering * signage throughout the home
For use in an emergency evacuation of the premises the bedroom door signs indicate a "traffic light ys stem" and this is understood by staff and emergency services alike regarding the individuals dependency levels.
A number of health and safety checks and records are kept to meet the various pieces of legislation for a care home for older people, for example Environmental Health, Fire Safety, Health and Safety including the Public Lift. Areas for improvement Even in this period of uncertainty this care service continues with its refurbishment programme.
There were no areas for development, requirement or recommendations from this inspection for Theme 2 Statement 2.
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
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Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good
Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service Strengths Please refer to Theme 1 Statement 1 Areas for improvement Please refer to Theme 1 Statement 1
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths The provider, North Lanarkshire Council, has a recruitment policy and procedure which ensures all checks are completed prior to staff commencing. New employees receive an induction course and shadow an experienced member of staff.
Staffs receive core and specialised training and all members of staff have applied to register with the Scottish Social Services Council
Catering staff are in the process of completing Scottish Vocational Qualification Level 3.
Courses provided during 2012 have included: * Dementia Awareness delivered by Stirling University * Reablement regarding goal setting and retaining daily living skills * Movers and Shakers for use in activities exercise programme * Outcome Focussed Supervision
Chilterns Home, page 18 of 25 Inspection report continued * Self Directed Payment * Administration of Medication and this is supported by Medication Toolbox
Staff complete evaluation forms a the end of each course and their competency levels are monitored by their line manager through the supervision process.
Areas for improvement The management team should continue through supervision and personal development meetings to identify the training requirements of staff to meet the dependency needs of the people who use the service and the services continued improvement.
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
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Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good
Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths Please refer to Theme 1 Statement 1 Areas for improvement Please refer to Theme 1 Statement 1
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths North Lanarkshire Council publish policies and procedures.
Staffs receive supervision and personal development meetings as well as access to staff meetings where they can influence the agenda.
The management team have a suite of inhouse developed computer programmes that record the audits completed at Chilterns Care Home. They also attend a variety of meetings with internal departments, external agencies that make use of the flat attached to the care home as well as the local community. There were minutes and agenda for these meetings.
People who use the service and their carers participate in the assessment and care plan reviews as well as residents meetings. These were evidenced by written records of who attended and decisions agreed. They are also invited to give their views and opinions through the providers and Care Inspectorates satisfaction questionnaires.
Chilterns Home, page 20 of 25 Inspection report continued The Inspectors were invited to sit in on a review which was informative and person centred.
The service completes monthly or timescale determined audits for various areas of work including Accidents & Incidents, Care Plans, Complaints, Compliments, Falls and Medication.
There was evidence that external agencies also complete audits Environmental Health, Pharmacy and General Practitioner for the benefit of people who use the service.
The health and welfare of people who use the service is also protected through the checks completed by the maintenance staff and environmental risk assessments carried out. Certificates and maintenance records indicate that specialised equipment such as hoists and wheelchairs, fire and water and public lift are all part of the maintenance review process. Areas for improvement There were no areas for development, requirements or recommendations from this inspection for Theme 4 Statement 4.
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0
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4 Other information
Complaints No complaints have been upheld, or partially upheld, since the last inspection.
Enforcements We have taken no enforcement action against this care service since the last inspection.
Additional Information
Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1).
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5 Summary of grades
Quality of Care and Support - 5 - Very Good
Statement 1 5 - Very Good
Statement 3 5 - Very Good
Quality of Environment - 5 - Very Good
Statement 1 5 - Very Good
Statement 2 5 - Very Good
Quality of Staffing - 5 - eryV Good
Statement 1 5 - Very Good
Statement 3 5 - Very Good
Quality of Management and Leadership - 5 - Very Good
Statement 1 5 - Very Good
Statement 4 5 - Very Good
6 Inspection and grading history
Date Type Gradings
13 Dec 2011 Unannounced Care and support 4 - Good Environment Not Assessed Staffing Not Assessed Management and Leadership 4 - Good
15 Jul 2011 Unannounced Care and support 4 - Good Environment 4 - Good Staffing Not Assessed Management and Leadership Not Assessed
31 Jan 2011 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed
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8 Nov 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed
18 Mar 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed
20 Oct 2009 Announced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good
4 Mar 2009 Unannounced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good
17 Oct 2008 Announced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good
All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission.
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To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527.
This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: www.careinspectorate.com or by telephoning 0845 600 9527.
Translations and alternative formats This inspection report is available in other languages and formats on request.
Telephone: 0845 600 9527 Email: [email protected] Web: www.careinspectorate.com
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