Cheshire House (Care Home) Care Home Service Adults Ness Walk Inverness IV3 5NE

Transcription

1 Cheshire House (Care Home) Care Home Service Adults Ness Walk Inverness IV3 5NE Type of inspection: Unannounced Inspection completed on: 26 June 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 25 5 Summary of grades 26 6 Inspection and grading history 26 Service provided by: Leonard Cheshire Disability Service provider number: SP Care service number: CS If you wish to contact the Care Inspectorate about this inspection report, please call us on or us at enquiries@careinspectorate.com Cheshire House (Care Home), page 2 of 28

3 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 6 Excellent Quality of Environment 6 Excellent Quality of Staffing 5 Very Good Quality of Management and Leadership 6 Excellent What the service does well Cheshire House care home has a friendly, welcoming atmosphere. Service users are very well supported to pursue their own interests and develop full, independent and active lives. The accommodation provided for service users is of a high standard and promotes people's independence while protecting individual privacy very well. The service involves and works well with service users and their families to improve the quality of life for the people who use the service. Feedback from people who use the service was very positive. What the service could do better The management team needed to ensure that service user's records were consistently signed and dated. The service should develop hospital passports and missing person's profiles for all service users and include these in their care files. Cheshire House (Care Home), page 3 of 28

4 What the service has done since the last inspection Inspection report continued The service has introduced a new format for developing support plans for service users which makes them much more individualised and focused on the person's wishes. Staff training has developed since the last inspection to accommodate staff training arising from the changing needs of the people who use the service. Conclusion Cheshire House care home provides a comfortable, homely and safe environment for the people who live there. Staff have developed warm, trusting relationships with service users and provide excellent care and support for people. The service is wellmanaged and benefits from a stable and skilled staff team who are committed to improving the quality of life for the people who use the service. Cheshire House (Care Home), page 4 of 28

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information in relation to all care services is available on our website at This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. Recommendations are based on the National Care Standards, relevant codes of practice and recognised good practice. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. The service is operated by Leonard Cheshire Disability, a national charity supporting people with disabilities throughout the UK. The service provides a care home service for up to 16 people with physical and sensory impairment and / or learning disabilities Other services provided from Cheshire House include a day care support service and an integrated housing support and care at home service. Cheshire House is a single story building, purpose-built to offer a high standard of accommodation and facilities for disabled people. The house is located in the centre of Inverness on the banks of the river Ness and provides very good access to local amenities. The service offers spacious accommodation in self-contained flats and support with all aspects of daily living. Each flat consists of a bed/sitting room with well equipped kitchenette and separate shower and toilet. The accommodation has adjustable equipment to support people with disabilities. All flats have their own front door accessed from the main house and direct access to a landscaped garden area through patio doors in the bed/sitting rooms. Additional toilet facilities are located in the main part of the building as well as an assisted bathroom for service users who wish this. Transport is available for those service users who require it. Cheshire House (Care Home), page 5 of 28

6 The service's manifesto stated: We work for a society in which every person is equally valued. We believe that disabled people should have the freedom to live their lives the way they choose - with the opportunity and support to live independently, to contribute economically and to participate fully in society. The service's values included: valuing the individual working together honesty creativity Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 6 - Excellent Quality of Environment - Grade 6 - Excellent Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 6 - Excellent 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 or by calling us on or visiting one of our offices. Cheshire House (Care Home), page 6 of 28

7 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 We wrote this report following an unannounced inspection that took place on Wednesday 18 June 2014 between the hours of 1030 and 16:30. Feedback was given to the service manager on Thursday 26 June. The inspection was carried out by inspector Elano Ross. As part of the inspection, we took account of the completed annual return and self assessment forms that we asked the provider to complete and submit to us. Before the inspection, we sent out four Care Standards Questionnaires for service users and 10 for staff. At the time of writing this report we had received two response from service users and two from staff. During this inspection process, we gathered evidence from various sources, including the following: We spoke with: the care supervisor service users support workers We looked at: the participation strategy, this is the service's plan for how they will involve service users minutes of meetings involving service user and carers staff meeting minutes staff training records communication records support plans and review records evidence of meetings with outside health professionals accident, incident and maintenance records how staff worked and interacted with service users Cheshire House (Care Home), page 7 of 28

8 the environment and equipment. 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 Cheshire House (Care Home), page 8 of 28

9 What the service has done to meet any recommendations we made at our last inspection In the last inspection report a recommendation was made that care plans provide necessary information in a coherent format so that staff can make use of the information, that forms within the care plan were up to date and reviewed six monthly. At this inspection we found that all support plans had been recently reviewed and were now recorded in new outcome focused formats which made them personalised to the individual they belonged to. some forms still needed a signature and or a date when signed. The management team should carry out regular file audits to ensure that this was completed consistently. 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 - Electronic 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 manager of the service. We were satisfied with the way this had been completed and with the relevant information provided for each of the headings that we grade services under. The service identified what they thought they did well, some areas for development and any changes they had planned. The manager told us how young people and staff had taken part in the self assessment process. Cheshire House (Care Home), page 9 of 28

10 Taking the views of people using the care service into account During this inspection we spoke with five people who were currently using the service. They told us that they thought the standard of care the service provided was very good. They said that they could talk to staff and felt that they were listened to. People told us that they enjoyed a variety of activities and had good support from staff if they needed this. All of the people we spoke with told us that they felt 'safe' living in the home. Comments made by service users included: First class I couldn't think of a better place to live I love my flat and the staff are great I feel that the staff are my friends more than staff One service user told us 'it takes a long time for a new resident to settle in here and get used to the freedom and choices they have, but once you do it feels like being part of a family' Taking carers' views into account Relatives or carers were not available to speak with during this inspection. However, we received a Care Standards Questionnaire that had been completed by a relative. They told us they were very happy with the quality of care provided. They told us that they had developed good relationships with staff who showed sensitivity to their relatives needs. They said: I am delighted with the standard of care, the professionalism and dedication of staff at all levels. There is regular communication and I feel that I can contact the managers at any time if I have any concerns about my relatives emotional or physical wellbeing. Cheshire House (Care Home), page 10 of 28

11 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: 6 - Excellent 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 We thought that the service was performing to an excellent standard in the areas covered by this statement. we though this after we: looked at the service's involvement strategy. This is the service's plan for how they will involve service users looked at service users support plans sampled minutes of service user meetings sampled responses to the service's annual customer survey viewed review meeting minutes, and spoke with people who used the service We found that the service had a strong commitment to ensuring that people who use services and their families were able to participate in the service in a meaningful way. The service had a comprehensive involvement policy which detailed a number of ways in which service users and their relatives and representatives could give their views about all aspects of the service and get involved in making changes. The service had an involvement officer to support involvement through facilitation of meetings for service users and offered 1:1 meetings if this was wanted. Concerns and suggestions were followed up with management to achieve a speedy resolution. We could see that meetings were well attended and discussions were held on a range of issues that directly affected service users. Cheshire House (Care Home), page 11 of 28

12 The involvement officer also helped promote involvement through the provision of training and information. One example of this would be the training provided for service users who wished to be involved in the recruitment of staff. We could see that service users, relatives and their advocates were involved in developing and reviewing their individual support plans and risk assessments. It was clear that service users directed all aspects of their daily support including how and when their support was delivered. This provides service users with opportunities to influence and change their support to suit their needs and wishes. The service issued annual satisfaction surveys which invited feedback from service users, families and other professionals involved in the lives of service users. From the sample we saw, the comments from all respondents as very positive. We could also see from the previous survey that an action plan had been developed to address issues highlighted in the survey. A quarterly newsletter was produced by the service which was full of easy to read information about local news and events and interesting information about the Cheshire community. Service users were asked for their contributions to the newsletters which provided further opportunities for them to raise issues, make suggestions or praise achievements of the service. A suggestion box was centrally located and gave opportunities for people, service users, visitors and staff to make comments anonymously if they did not wish to be identified. The complaints procedure was promoted through notices, leaflets and the welcome pack for new service users. Service users were encouraged to participate in the recruitment process and some had received training to help them with this. Service users met with candidates as part of the interview process. This meant that service users could influence staff appointments and offered them choice. Additionally, service users and their carers or representatives were asked to comment on the quality of staffing in the providers annual questionnaires. We could see that staffing was also discussed at service users' meetings. Service users told us that they enjoyed good relationships with staff. They said that they could speak openly with the management team and felt that any issues about staffing they may have would be dealt with quickly. The provider, Leonard Cheshire Disability, had a national service user representation group which promoted the views of service users nationally to the organisation's management board. The Customer Action Network (CAN) elected representatives and each of the services provided in Inverness had opportunities to take on this role. The CAN had representation on national policy making committees. Cheshire House (Care Home), page 12 of 28

13 Areas for improvement The provider should continue to monitor and maintain the excellent quality of care. The provider should ensure it is rigorous in identifying any areas for improvement and implementing action plans to address these. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Cheshire House (Care Home), page 13 of 28

14 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We thought the service was performing to an excellent standard in the areas covered by this statement. We thought this after we: sampled individual care files including support plans and risk assessments spoke with the care supervisor, service users and staff considered the responses from service users in our Care Standards Questionnaires observed the interaction between staff and service users sampled a number of records including daily recordings and review documents Most service users are registered with the local GP service and attend routine health appointments with support if this is required. Regular input from specialist health services such as community nurses, psychiatry, psychology, SALT etc. was available for those people whose conditions need this. Very good relationships have developed between the service and health care agencies which has resulted in the staff team being able to assess relevant training and support when needed for things like palliative care and dementia. This means that for new residents with conditions that are complex or specific the management team can access specialist training and ongoing support for their staff quickly. This means that the right level of care and support with health needs can be put in place that is consistent with their wishes. This helps to reduce anxiety for people new to the service. Support plans are in the process of change. New support plans were focused on supporting people to achieve good outcomes, for example increasing choice and control in daily life for people. The new support plans promote cooperation and involvement between service users and staff and are highly personalised. This means that each support plan is unique to the individual and ensures that staff know exactly how to support each person in the way that they wish this and that suits their needs best. From our sample of service users support plans we could see that people had full and active lives which supports very good health and wellbeing for people. For example we could see that service users were involved in physical activity on a regular basis, such as walking, archery and swimming. Some also were engaged in volunteering in the community. This helps people to promote self -esteem for people and gives them a sense of purpose. Cheshire House (Care Home), page 14 of 28

15 Service users health needs were noted in their support plans and we saw that there was very good guidance for staff in the health plan on how to support people. Hospital passports had been developed to accompany people if they were admitted to hospital. These documents aimed to guide hospital staff on how to communicate with the service user and to maintain consistency through following their usual routines. Risk assessments were in place to alert staff to issues of risk in a number of areas. These included financial risks, risks to physical health and welfare and behaviours that challenge staff. Risk assessments detailed the control measures that were in place and gave good guidance to staff on what to do and when to intervene in order to protect people from harm. We could see that good health was promoted very well in this service. This was done through promoting healthy eating and activity. Community events that helped promote a sense of wellbeing and good mental health for people were well advertised throughout the service. For example, we saw posters advertising singing for dementia events, reading groups and the annual raft race. This encouraged participation for people at all levels of ability and fostered involvement in the community. Reviews are held at least six monthly and more frequently if there were significant changes in people's health or circumstances. This helps to ensure that the service can continue to meet the changing needs of service users well. There were robust arrangements for administering medicine. Staff received training before being able to administer and were supervised until deemed competent by management. There were weekly, monthly and six monthly audits and a daily check that all was correct. A senior staff had responsibility for medicines within the care home. Areas for improvement The provider should continue to monitor and maintain the excellent quality of care. The provider should ensure it is rigorous in identifying any areas for improvement and implementing action plans to address these. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Cheshire House (Care Home), page 15 of 28

16 Quality Theme 2: Quality of Environment Grade awarded for this theme: 6 - Excellent Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths We thought that the service was performing to an excellent standard in the areas covered by this statement. The methods used by the service to involve service users and their relatives or representatives in assessing and improving all areas of the service, including the quality of the environment, are detailed in Quality Theme 1 Statement 1 Areas for improvement The areas for improvement identified in Quality Theme 1 Statement 1 are also relevant to this statement. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Cheshire House (Care Home), page 16 of 28

17 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths Inspection report continued We thought that the service was performing to an excellent standard in the areas covered in this statement. We thought this after we: looked at health and safety, fire safety and maintenance records toured the premises and garden spoke with the care supervisor, staff and service users The premises provided an attractive, spacious and homely setting with very good disabled access to all areas of the home so wheelchair users and people with impaired mobility could come into and get around the home and garden without difficulty. This meant that service users could receive friends and visitors in the home with ease and get outdoors independently. Trust Housing own the premises and were responsible for the repair of all fixed and structural items within the home. The provider, Leonard Cheshire Disability, was responsible for internal repairs and decoration. We found that there was an effective system in place for reporting faults and most repairs were followed up and completed quickly. Records showed that routine maintenance and servicing was carried out on all equipment including assisted bath, hoists, gas and electrical equipment. This helped to ensure that services and equipment were safe and in good working order. Equipment that was broken or irreparably damaged was discarded and replaced with new products. There were systems in place to record accidents and incidents both manually and electronically. Electronic records were audited by the provider. The management team monitored accidents and incidents to assess if additional safeguards could be put in place to prevent reoccurrence. Staff had completed training in safety and protection issues, such as first aid, moving and handling, fire safety and adult protection. Staff skills, very good staffing levels and a consistent staff team helped to made sure service users enjoyed a safe environment and were and were supported to develop good strategies for maintaining personal safety. Named staff had delegated responsibilities for specific tasks such as health and safety, infection control and risk assessment. The service carried out routine health and safety, premises and fire safety checks that helped to inform the manager about issues as they were developing and enabled her to prioritise essential maintenance, repairs and routine upkeep. Cheshire House (Care Home), page 17 of 28

18 There was a robust system for ordering, storage and administration of medication. Staff competency to administer medication was regularly assessed. This helped to keep staff practice and knowledge up to date and minimise risks of medication errors. The garden was well maintained and provided a pleasant place for service users to sit out and enjoy sunshine and fresh air. We observed reminders to service users and staff to use appropriate sun protection when outside and ensure that people had good access to cold drinks. Areas for improvement In the self assessment for the service the manager had identified that there was a need for the service to carry out a night-time evacuation to assess what was needed to ensure people were safely evacuated from the building in an emergency. This should be done at least annually to ensure that the service can be sure that they have the resources available to support people safely taking account of their changing levels of need. The provider should continue to regularly review the premises risk assessment to ensure that there are appropriate systems and arrangements in place to minimise risk and to ensure the environment is safe and people are protected Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Cheshire House (Care Home), page 18 of 28

19 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 We thought that the service was performing to an excellent standard in the areas covered by this statement. The methods used by the service to involve service users and their relatives or representatives in assessing and improving all areas of the service, including the quality of staffing, are detailed in Quality Theme 1 Statement 1 Areas for improvement The areas for improvement identified in Quality Theme 1 Statement 1 are also relevant to this statement. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Cheshire House (Care Home), page 19 of 28

20 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued We thought that the service was performing to a very good standard in the areas covered by this statement. we thought this after we: spoke with a number of staff, including support workers, the management team and admin support spoke with service users sampled staff training records, supervision records and personal development plans (PDPs) viewed the training plan for the service Staff we spoke with clearly enjoyed their work and were committed to supporting the people they work with to lead full and active lives. They were enthusiastic about their ongoing professional development and confirmed that they received the training they need to enable them to support individual people well. Staff that we spoke with commented on how good the organisation was to work for. They told us that their managers were supportive and listened to their ideas for training. We could see that there was a comprehensive induction in place. Induction included essential core training in several areas, for instance in health and safety, food hygiene and moving and handling. The service had a mentoring system to support new staff through induction and probationary period. This helped new staff to become familiar with organisational policies and procedures and to build their confidence and competence in delivering support well. Staff told us that the management were very supportive of staff requests for additional training. Records we sampled showed that the service had developed a comprehensive training programme that was tailored to meet service users needs and enabled staff to keep up to date with changes in best practice. This supported staff to renew and refresh their knowledge and skills. Staff who support people with specific needs received additional training to help them to meet these needs effectively. For example some staff received training on autism awareness, or epilepsy. Staff had opportunities to gain suitable professional qualifications through the Scottish Vocational Qualifications system and most staff were registered with the Scottish Social Services Council (SSSC). This means that staff are competent, of good character and work in a professional way. Cheshire House (Care Home), page 20 of 28

21 Staff also confirmed that they received regular supervision and annual appraisal to support their work and professional development. Formal supervision was recorded with practice issues and training needs noted. Staff confirmed that informal support and supervision was readily available from the management team. Additional support mechanisms included regular staff and team meetings. We could see that progress on any actions from meetings was followed up at the next meeting. From the staff training records we sampled, we could see that the service had a training plan which included all essential and mandatory training. The Care Supervisor confirmed that Personal Development Plans for staff highlighted individual training needs. This helped to ensure that staff were appropriately trained and competent in their practice. Areas for improvement The manager should review the system for identifying, planning and recording training to evidence all the training provided to the staff group. For example training sourced from local health professionals and training events delivered locally. In the self assessment for the service the manager had identified as an area for improvement that all staff should have a good knowledge of the National Care Standards and staff should have training on autism. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Cheshire House (Care Home), page 21 of 28

22 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 6 - Excellent 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 We thought that the service was performing to an excellent standard in the areas covered by this statement. The methods used by the service to involve service users and their relatives or representatives in assessing and improving all areas of the service, including the quality of staffing, are detailed in Quality Theme 1 Statement 1. Areas for improvement The areas for improvement identified in Quality Theme 1 Statement 1 are also relevant to this statement. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Cheshire House (Care Home), page 22 of 28

23 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 Inspection report continued We thought that the service was performing to an excellent standard in the areas covered by this inspection. we thought this after we: sampled relevant documents such as quality audits and monitoring reports spoke with staff and service users considered the responses we received from returned Care Standards Questionnaires, Self Assessment and Annual Return documents considered the actions taken by the service in response to suggestions made to improve the service We found that the service had a number of quality assurance systems in place that included internal and external processes. We could see that regular monitoring visits were carried out by the provider. This involved quality audits to check how the service was performing against specific quality indicators and talking to service users, relatives and other people involved with the service, such as health professionals and social workers to get their views about the service. We could see that where issues had been identified, an action plan was in place to address these. Monitoring visits were carried out by senior managers which meant that the provider knew about and fully supported any changes required. Additionally, monthly and indepth six-monthly audits were carried out by the manager for medication and Health & Safety within the service. Results from these were sent to senior management. Service users, their families or representatives and staff were involved in the process for quality assurance through participation in the provider's quality monitoring systems service user and carer meetings, and the completion of an annual survey.the service have a customer support facilitator whose role is to consult with service users and their relatives or representatives on a regular basis about the quality of the service provided and feedback findings to the management team and the provider. A Quality Survey is sent out annually to service users, their relatives and representatives and others involved in the life of the service by an independent marketing company and they collate and analyse the responses This provides opportunities for people to be very open in their comments and suggestions about the quality of all aspects of the service. Cheshire House (Care Home), page 23 of 28

24 External monitoring included monitoring visits by the Local Authority Contracts and Commissioning and independent assessment by Investors in People on a regular basis. The organisation, Leonard Cheshire Disability,had achieved gold award status from Investors in People. Cheshire House based in Inverness was one of the services assessed by Investors in people for the award. Staff and service users were aware of the complaints procedure and the good practice relating to the use of advocacy where necessary. We could see that no complaints had been made about the service. Areas for improvement The service provider should continue to build on the excellent opportunities for service users and other stakeholders to be involved in quality assurance systems used to assess the service. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Cheshire House (Care Home), page 24 of 28

25 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 the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). Cheshire House (Care Home), page 25 of 28

26 5 Summary of grades Quality of Care and Support Excellent Statement 1 Statement Excellent 6 - Excellent Quality of Environment Excellent Statement 1 Statement Excellent 6 - Excellent Quality of Staffing Very Good Statement 1 Statement Excellent 5 - Very Good Quality of Management and Leadership Excellent Statement 1 Statement Excellent 6 - Excellent 6 Inspection and grading history Date Type Gradings 30 Apr 2013 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 1 May 2012 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 28 Jan 2011 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed Cheshire House (Care Home), page 26 of 28

27 7 Jul 2010 Announced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 15 Jan 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed 14 Jul 2009 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 16 Mar 2009 Unannounced Care and support Not Assessed Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership Not Assessed 20 Oct 2008 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Cheshire House (Care Home), page 27 of 28

28 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 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: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: Cheshire House (Care Home), page 28 of 28