Inspection on 13/01/09 for Cranwood

This is the latest available inspection report for this service, carried out on 13th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 19 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cranwood 14/02/06

Cranwood 20/07/05

Cranwood 01/09/04

Cranwood 07/04/04

Cranwood 16/12/03

Cranwood 24/11/03

Cranwood 06/08/03

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Cranwood 100 Woodside Avenue Muswell Hill London N10 3JA two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Margaret Flaws Date: 1 3 0 1 2 0 0 9 Information about the care home Name of care home: Address: Cranwood 100 Woodside Avenue Muswell Hill London N10 3JA 02088830563 02084420075 cheryle.brandon@haringey.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : London Borough of Haringey care home 34 Number of places (if applicable): Under 65 Over 65 9 25 dementia old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 0 Cranwood is a residential home registered to provide care and support to up to 38 older people. Owned and operated by the London Borough of Haringey, and located in a residential area of Muswell Hill in North London, the home is close to local shopping and transport facilities. Cranwood is split into four units Oakwood, Marrett, Rosebank and the ICB unit. The main aim of the home as set out in the statement of purpose is To work with older people and their relatives in order to give advice, care and support The objectives of the home are to: 1. Provide a comfortable/enjoyable residential care home for all service users 2. Create an environment, which enables service users to retain their individuality, independence, dignity and privacy, as set out in the Charter of Rights for service users. 3. Encourage service users to maintain their previous friendships, skills, hobbies and interests. 4. Allocate to each service user a key worker, Care Homes for Older People Page 2 of 15 Brief description of the care home who will have designated responsibility for helping with his/her personal requirements. 5. Provide activities and a lifestyle for all service users, which will operate within a risk assessment system. 6. Offer a service of the highest quality, in a non-discriminatory, equal opportunities environment. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The current scales of charges are from: - #388.50 per week as from the day of the inspection. Following Inspecting for Better Lives the provider must make informat Care Homes for Older People Page 3 of 15 What we found: The death of a resident in September 2008 has been the subject of a Serious Case Review The home has had the following inspections subsequently CSCI Pharmacy inspection on 9 October 2008 a key inspection on 16 October 2008 monitoring visit 26 November 2008 random inspection and compliance visit 10 December 2008 Following the key inspection on October 2008 the home was assessed as providing adequate outcomes for people who use the service and twenty one requirements were made, including some repeated requirements. A Statutory Requirement Notice dealing with medication management and staff training was served on 20/11/08. At the inspection on 10 December 2008, we found that the following SRN requirements had been met Requirement 2 of the SRN: Controlled Drug (CD) cupboard meeting the requirements of the Misuse of Drugs Regulations 1973 was now fitted and Controlled Drugs were stored and administered correctly. Requirement 4 of the SRN: medication policies & procedures now contain sections that adequately deal with covert administration and Controlled Drugs. Requirement 5 of the SRN: additional documented guidance is now provided where the prescribers printed directions do not adequately define the directions for dosage. The reason for this inspection on 13 January 2009 was to check compliance with the outstanding requirements made in the Statutory Enforcement Notice. The Pharmacists report is below I am writing following the above unannounced joint inspection of the service by a CSCI pharmacist inspector and Margaret Flaws, the homes regulatory inspector, to check compliance with the requirements of a statutory requirement notice (SRN) of 20/11/2008 relating to medication issues following a CSCI pharmacist inspectors unannounced inspection on 09/10/2008. This inspection is further to that on 10 December 2008 when compliance was found not met in relation to the recording, handling, safekeeping, safe administration and disposal of medicines received into the home, and to the medication policy and procedure to be kept reviewed and accurate. We were assisted by the homes manager, Eija Sinitalo and Donna Hamilton, one of the homes three assistant managers and the outcome is as follows. Findings The requirements with regards to the recording, handling, safekeeping, safe administration and disposal of medicines received into the home were inspected and the audit trails of selected items of medication checked to indicate administration was in accordance with the prescribers directions. Conditions for this statutory requirement were found to be met. Care Homes for Older People Page 4 of 15 With respect to the homes medication policies and procedures not meeting the statutory requirements when examined on 10 December 2008. An updated version of the document was received on 09 January 2009 and outstanding issues were discussed with the homes manager during the inspection on 13 January 2009 and handwritten amendments made. Since then a further copy of the document has been received that incorporate those amendments resulting in this requirement also being met. Lawrie Allum Pharmacist Inspector A further statutory requirement to protect the people using the service from the risk of harm (relating to training of all staff who give medication) has been complied with. The Statutory Requirement Notice of 20/11/09 has been complied with in full by the home. No further requirements were made at this inspection. The home has also provided CSCI with a comprehensive and detailed action plan with information about how all the requirements made at previous inspections will met and other steps taken to safeguard the people using the service at Cranwood and improve the quality of care and management. These actions will be checked at a forthcoming key inspection. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 15 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 3 15(2)(c) The registered person must 30/01/2007 liaise with the placing authority to arrange a review of this specific service user who has complex culture needs. If the specific service user placement is to be terminated then under the home?s duty of care a clear plan of action prior to the individual leaving this service must be in place. The registered person must 30/01/2007 ensure that risk assessments are to be updated accordingly when any changes occur. (For instance a fall). This is to be recorded in full with outcome and support needs and reviewed monthly. The plans must be signed and dated when completed. (Previous timescale of 30/04/06 not met) The registered person must 20/02/2007 liaise with the specific service user?s social worker to organise a further review regarding the individual?s care and linguistic needs and whether or not that Cranwood is a suitable placement. Evidence of this 2 7 12(1) & 13(4)(b) 3 7 15(2)(b) Care Homes for Older People Page 6 of 15 must be clearly documented on the care plan with action/s taken. 4 7 17 The registered person must ensure that copies of the most recent service users reviews undertaken by the placing authority are obtained. 20/02/2007 5 8 17(1)(a)Ssch The registered person must 30/01/2007 3.3(m) ensure that monthly weight charts specifically records why a service user may have lost or gained weight. This information must then be summarised in the monthly summary report to ensure that the service user?s needs in monitored and reviewed appropriately. 13(2) The registered person must 30/01/2007 have in place clear and precise PRN guidelines for the specific service user who is prescribed Paracetomol. An appointment is to be made with the GP to review this medication to ensure whether or not the medicaiton remains PRN. The registered person must ensure that all service users who are prescribed PRN medication have in place clear and precise guidance notes on when this is given. 6 9 7 9 13(2) The registered person must 30/01/2007 update the medicines policy and include a section dealing with the possibility of disguising the medication, if non-administration will seriously endanger a service Page 7 of 15 Care Homes for Older People user?s health. (Previous timescale of 30/04/06 not met) 8 12 17 The registered person must 30/01/2007 ensure that sufficient information is recorded on each service user file pertaining to activities. The information must be detailed and concise stating whether or not the individual had enjoyed the activity The registered person must 30/01/2007 ensure that the complaint raised by the specific service user who complained to the inspector on the day must be fully investigated. A copy of the outcome and action taken must submitted to CSCI. The registered person must 30/01/2007 ensure that all complaint or concerns raised in the `Resident?s Meetings? or any other forum, must be addressed straightaway. Evidence of the action taken must be recorded clearly and communicated with the individual service user appropriately. The registered person must amend the current home?s enviromental risk assesement to include a section relating to the location of Call points. 20/02/2007 9 16 22 10 16 22 11 19 13(4) 12 30 18(2) The registered person must 30/01/2007 ensure that induction training undertaken is recorded on file. Page 8 of 15 Care Homes for Older People 13 36 18 The registered person must 30/01/2007 ensure that staff have regular and recorded supervision at least six times a year and that supervision records are kept in individual staff files. The registered person must 20/02/2007 ensure that Legionella testing is undertaken and a copy of the certificate is kept on file. 14 38 13(4) Care Homes for Older People Page 9 of 15 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 The Registered Person must 28/02/2009 ensure that the home reviews its admissions policies and procedures and indicates how it will meet the needs of people admitted for respite care amd for emergency care. Admission must be carefully planned and peoples care needs assessed 2 7 14 The Registered Person must ensure that all residents, including residents coming inot tohe home on respite and emergency admissions a, have robust care plans and risk assessments which fully reflect their needs and are regularly reviewed. Residents must have planned care 28/02/2009 3 7 12 The Registered Persons must 27/02/2009 ensure that a review of its falls management system is done to ensure that reviews of residents risk of falling take place in a timely way, in with peoples changing Page 10 of 15 Care Homes for Older People needs. The reviews should include actions to be taken to reduce the risk of falls. Falls risks must be minimise to protect people living in the home 4 7 17 The Registered Persons must 27/02/2009 ensure copies of the most recent service users reviews undertaken by the placing authority are obtained. Previous timescale of 20 02 07 not met Up to date reviews must inform care 5 12 16 The Registered Person must 27/02/2009 ensure that they review the homes activity programme and resources, to ensure that they provide good quality individual or group activity opportunities and options for going out into the community. This should include researching best practice for individual and group programmes for people with dementia Residents must be offered ways of meeting their interests and community links 6 16 22 The Registered Person must 27/02/2009 ensure that an outstanding complaint is resolved quickly and and CSCI informed of the outcome. Complaints must be dealt and resolved within timescales 7 21 23 The Registered Person must 28/02/2009 ensure that a new bath chair is purchased for Summer Unit Page 11 of 15 Care Homes for Older People Sufficient and appropriate health and safety equipment must be kept on site 8 22 23 The Registered Person must ensure that another hoist is purchased. Sufficient and appropriate health and safety equipment must be kept on site 9 26 23 The Registered Persons must 27/02/2009 ensure that the home reviews its cleaning procedures, domestic staffing arrangements and management systems to ensure a high standard of hygiene is in place to protect the people living there. Health and safety standards must be maintained 10 27 18 The Registered Person must 28/02/2009 ensure that there is a review of the staffing arrangements and a clear system developed for assessing the dependancy of the residents and responding to their changing needs staffing levels must match the changing needs of residents 11 30 18 The Registered Person must 28/02/2009 ensure that staff training procedures are reviewed so that all staff in the home are kept up to date with all areas of core practice and have timely access to internal training staff must be regularly trained to meet peoples needs 27/02/2009 Care Homes for Older People Page 12 of 15 12 37 17 The Registered Person must ensure that care files are always kept securely locked away. Data protection laws must adhered to 28/02/2009 13 38 12 The Registered Person must ensure that there is a policy in place for dealing with incidents and this policy should include guidance for staff on how incidents are managed and how staff and residents are supported Staff and residents wellbeing and safety needs must be addressed 28/02/2009 14 38 13 The Registered Person must 28/02/2009 ensure that legionella testing is undertaken and a certificate obtained and kept on file in the home. Previous timescale of 20.02.07 not met Health and safety must be protected 15 38 23 The Registered Person must ensure that at least one fire drill each year is done at night Health and safety must be protected 31/03/2009 16 38 23 The Registered Person must ensure that all fire equipment must be easily accessible Health and safety must be protected 28/02/2009 17 38 16 The Registered Person must ensure that good practice in food storage is maintained 28/02/2009 Care Homes for Older People Page 13 of 15 Health and safety must be protected 18 38 13 The Registered Person must ensure that the COSSH cupboard keys are kept securely Health and safety must be protected Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 28/03/2009 1 19 Review the use of the communal space, conservatory temperature control and use of the garden in the dementia unit Materials stored in a visitors room be removed to enable visitors and residents to use it. Senior staff undertake a course in dementia care mapping to build their capacity to deliver best practice dementia cae. Fire risk assessment to be reviewed six monthly Be clear which fire points are being tested on each fire drill 2 3 4 5 19 30 37 38 Care Homes for Older People Page 14 of 15 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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