Inspection Report

Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Chelfham House Residential Home Chelfham House, Chelfham, Barnstaple, EX31 Tel: 01271850373 4RP Date of Inspection: 14 May 2014 Date of Publication: June 2014 We inspected the following standards as part of a routine inspection. This is what we found: Respecting and involving people who use Met this standard services Care and welfare of people who use services Met this standard Safety and suitability of premises Action needed Staffing Action needed Assessing and monitoring the quality of service Met this standard provision | Inspection Report | Chelfham House Residential Home | June 2014 www.cqc.org.uk 1 Details about this location Registered Provider Mr Mark and Mrs Karen Hammond Registered Manager Mrs Wendy Plant Overview of the Chelfham House is registered to provide care and support service for up to 41 people who have a dementia type illness. The home is situated in Chefham just outside Barnstaple in North Devon Type of service Care home service without nursing Regulated activity Accommodation for persons who require nursing or personal care | Inspection Report | Chelfham House Residential Home | June 2014 www.cqc.org.uk 2 Contents When you read this report, you may find it useful to read the sections towards the back called 'About CQC inspections' and 'How we define our judgements'. Page Summary of this inspection: Why we carried out this inspection 4 How we carried out this inspection 4 What people told us and what we found 4 What we have told the provider to do 6 More information about the provider 6 Our judgements for each standard inspected: Respecting and involving people who use services 7 Care and welfare of people who use services 9 Safety and suitability of premises 11 Staffing 12 Assessing and monitoring the quality of service provision 14 Information primarily for the provider: Action we have told the provider to take 15 About CQC Inspections 17 How we define our judgements 18 Glossary of terms we use in this report 20 Contact us 22 | Inspection Report | Chelfham House Residential Home | June 2014 www.cqc.org.uk 3 Summary of this inspection Why we carried out this inspection This was a routine inspection to check that essential standards of quality and safety referred to on the front page were being met. We sometimes describe this as a scheduled inspection. This was an unannounced inspection. How we carried out this inspection We looked at the personal care or treatment records of people who use the service, carried out a visit on 14 May 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider. We reviewed information sent to us by other authorities. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. What people told us and what we found We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service caring? Is the service effective? Is the service responsive? Is the service well led? This is a summary of what we found. On the day of our inspection there were 35 people living at Chelfham House. The summary is based on conversations with five people living at the service, three relatives, five staff and the registered manager. We looked at records of people's care and quality monitoring systems used with the home. We also spent time observing how care and support was being delivered to people. Following the inspection we spoke with the community nurse team who make regular visits to the home. If you want to see the evidence supporting our summary please read the full report. Is it safe? We found the service was not always safe because there were not enough staff on at all times to meet the complex needs of people living at the service. We have made this judgement based on our observations of how people were supported during the inspection visit, looking at staff rotas and by talking to staff about people's needs. We found that on | Inspection Report | Chelfham House Residential Home | June 2014 www.cqc.org.uk 4 the day of our inspection, some people did not get their medication until 11.30 am. We have been assured however that this was unusual. We saw people had to wait for staff to assist them with eating their meal. We found staff were rushed and could not always provide quality time to people. The provider did not have a tool to assess the dependency needs of people therefore we were unclear about how they had decided on the levels of staffing. We found some areas of the home posed a potential risk to people, which meant they could be unsafe. For example we saw not all windows had been restricted. Some vanity units were chipped and would not be able to be cleaned in a way which would ensure against infection control. We found wardrobes had not been secured to walls and could easily be pulled over and cause an injury to people. The registered manager said she would address the environmental issues as a matter of urgency. Is the service caring? We found people were being supported by a staff group who showed a great deal of caring. Our observations showed although staff were busy, they provided people's care in a respectful and dignified way. Relatives we spoke with were very complimentary, one said ''I am so grateful, this home is very, very good. I feel they have given me my mother back.'' They explained their relative had been very sick prior to coming to the home and over time has improved, put on weight and ''getting back to being more contented and settled.'' Another relative we spoke with said '' You could not wish for better care, the staff are all very caring, they work very hard and they always put on a lot of entertainment.'' Is the service responsive? The service was responsive to people's needs and wishes. For example where people's needs had changed, care plan information had been updated and equipment had been considered. Where people had injured themselves following a fall, medications reviews had been considered and well as ensuring the environment was safe, free from clutter and pressure mats being used to alert staff if people got up unaided from their bed for example. Is the service effective? The service was effective because it was clear from the discussions we had with visiting relative and the community nurse team, that staff knew and understood people's needs. When needs had changed healthcare teams were consulted and the approach appeared proactive in seeking the least restrictive way of supporting people. The Deprivation of Liberty safeguards had been appropriately used to ensure people's rights were upheld, but that the service continued to meet people's needs. Is the service well led? The service was well led by a manager and team of staff who have continued to develop their knowledge and skills with ongoing training. Systems were in place to ensure people's views were listened to and where possible relatives were included in the running of the service as there was an active relatives association, which met with the manager monthly. | Inspection Report | Chelfham House Residential Home | June 2014 www.cqc.org.uk 5 You can see our judgements on the front page of this report. What we have told the provider to do We have asked the provider to send us a report by 21 June 2014, setting out the action they will take to meet the standards. We will check to make sure that this action is taken. Where providers are not meeting essential standards, we have a range of enforcement powers we can use to protect the health, safety and welfare of people who use this service (and others, where appropriate). When we propose to take enforcement action, our decision is open to challenge by the provider through a variety of internal and external appeal processes. We will publish a further report on any action we take. More information about the provider Please see our website www.cqc.org.uk for more information, including our most recent judgements against the essential standards. You can contact us using the telephone number on the back of the report if you have additional questions. There is a glossary at the back of this report which has definitions for words and phrases we use in the report. | Inspection Report | Chelfham House Residential Home | June 2014 www.cqc.org.uk 6 Our judgements for each standard inspected Respecting and involving people who use services Met this standard People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run Our judgement The provider was meeting this standard. People's privacy, dignity and independence were respected. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Reasons for our judgement People who used the service understood the care and treatment choices available to them. Most people living at Chelfham House lacked the capacity to understand treatment choices, but we saw examples of where staff worked with people in a way to help them maintain autonomy and make choices about everyday aspects in their lives.

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