Inspection on 18/05/06 for 57 Crabbe Street

This inspection was carried out on 18th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

57 Crabbe Street 08/03/06

57 Crabbe Street 04/07/05

57 Crabbe Street 22/12/04

57 Crabbe Street 07/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE 57 Crabbe Street 57 Crabbe Street Ipswich Suffolk IP4 5HS Lead Inspector Jane Offord Key Unannounced Inspection 18th May 2006 09:20 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000036814.V295529.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000036814.V295529.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 57 Crabbe Street Address 57 Crabbe Street Ipswich Suffolk IP4 5HS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01473 588508 01473 712869 Suffolk County Council Mrs Pamela D J Purnell Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (13) of places DS0000036814.V295529.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2006 Brief Description of the Service: 57 Crabbe Street is a local authority owned home for older people and is located in a quiet area of East Ipswich, within walking distance of local shops. The centre of the town can be reached by bus. There are three units, Glencoe which is divided into two and provides care to 13 people with special needs, dementia. Killarney and Windermere are longterm care units and provide places for 5 and 8 people respectively. The CSCI is currently assessing an application from the home to include these 13 places as special needs, dementia. The fourth unit, Snowdonia has recently had a variation agreed to provide care for five people with a diagnosis of dementia. Each of the units is self-contained and have a sitting room, kitchen/diner, and bath and laundry facilities. Meals are provided from the main kitchen but residents can cook, with staff, to make cakes and snacks. All bedrooms are single and have an en-suite facility comprising shower, hand basin and WC. There is a central kitchen, which is well equipped, and in addition to providing meals for the residents, they also provide meals for those using the day care facility and also a number of community meals. Residents also have access to a hairdressing service at the home. There are good garden facilities for use by residents. The gardens are well maintained and can be accessed by wheelchair users. Each garden provides seating and cover from the hot weather. For the year 2006/2007 Suffolk County Council charge £368 per week for residential home care. DS0000036814.V295529.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between 9.20 and 16.30. It was a key inspection and looked at the core standards for care of Older People. The manager was available during the day to assist in the inspection process. Two residents files and care plans were seen, two newly appointed staff files, the duty rota, maintenance records, the Control of Substances Hazardous to Health (COSHH) folder and a number of policies and other documents were all inspected. A medication round was observed and the Medication Administration Records (MAR sheets) were inspected. Throughout the day several staff, a number of residents and two visitors were spoken with. On the day the home was clean and tidy. Residents were well dressed and relaxed. Staff were busy offering the residents choices and assistance and all interactions observed were caring and appropriate. What the service does well: What has improved since the last inspection? What they could do better: The two residents’ files seen did not contain a recent photograph of the resident or a signed contract but they had both been in the home less than a month. Weight charts were sometimes completed in stones and pounds and sometimes in kilograms. The Control of Substances Hazardous to Health (COSHH) folder was incomplete. The room used by the handy person needs to be reviewed as it is also used to store all the stock of cleaning agents. DS0000036814.V295529.R01.S.doc Version 5.2 Page 6 The Medication Administration Records (MAR sheets) need to be correctly completed and medication requiring refrigeration should be in a lockable container if stored in a domestic refrigerator. A procedure for ensuring that prescribed creams and topical applications are applied and signed for needs to be devised. When a job application form shows a break in employment history there should be evidence that this has been followed up and the gap is adequately explained. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000036814.V295529.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000036814.V295529.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6. People who use this service can expect to have the information they need to make an informed choice and have their needs assessed prior to admission. This service does not offer intermediate care. EVIDENCE: In the past the service has kept CSCI up to date with the printed information available to prospective residents. The brochures produced are of a high quality and contain good relevant information. The manager has recently revised the information brochure and Statement of Purpose to include the changes in provision of care in Snowdonia unit. Residents and relatives spoken with on the day said they had had the opportunity to visit the home before deciding they would like to live there. One visitor said they remembered the manager visiting their relative in their own home and assessing their abilities and needs before they were admitted to the home. Residents’ files seen contained Social Care assessments of need filled in before admission and sent to the manager. DS0000036814.V295529.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. People who use this service can expect to have their health needs met, be treated with respect and have a care plan in place however they cannot be assured that the present medication practice will protect them. EVIDENCE: The residents’ files seen contained information about the past medical history of the resident and covered areas of need or assessment such as mobility, continence, diet, tissue viability, special equipment needed, allergies, current injuries i.e. bruises, with a body chart to indicate where they were located, and medication. In one file there was also a brief life history and record of the resident’s final wishes. Neither file seen had a recent photograph of the resident. The care plans covered personal care, communication, fears and phobias, eyesight and hearing, medication, diet and night needs. One intervention recorded for night care was, ‘would you like a drink in your room when you wake up? Yes, tea with two sugars in a two handled mug’. As a result of a nutritional assessment one resident was having regular weight checks. The weights were being recorded in a mixture of stones and pounds and kilograms which made it difficult to see any trends in weight loss or gain. DS0000036814.V295529.R01.S.doc Version 5.2 Page 10 The records had details of health professionals who supported the resident such as GP, chiropodist, community nurse, hearing aid department and dentist. There were records of visits by or to the other professionals. Visitors and residents spoken to all said they only had to mention a problem and the staff contacted the required person for advice. A medication round was observed at lunchtime. Most residents have a lockable cupboard on the wall in their rooms for their own medication and MAR sheets. Staff were observed knocking on doors before entering residents’ rooms and in one case a resident had locked their room and the member of staff asked for the key and permission to unlock the room. Staff carry the keys to the cupboards. Medication was offered sensitively and residents’ wishes were respected if they refused to take it. Some signature gaps were noted in some of the MAR sheets. On Snowdonia unit a bottle of liquid medication was stored in the domestic refrigerator door together with milk and other beverages. In the en suite rooms of some residents were records of prescribed creams and topical preparations used by them but there was no evidence they had been applied. DS0000036814.V295529.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. People who use this service can expect to be offered meaningful activities and choice about how and with whom they spend their time. They can also expect to receive a well-presented and wholesome diet. EVIDENCE: Residents spoken with said there was always something being planned to keep them entertained. Fifteen of them had recently been to the Spa theatre in Felixstowe for a show and an outing to Bressingham was planned for later in the year. Other activities included ‘Bring a bottle Bingo’, ‘Crabbe Street’s Caribbean Night’ and entertainers who visit the home. Carers organise games of dominoes, skittles and cards. There are exercise sessions and supervised cooking sessions in the units’ kitchenettes. The home has a Snoozelum room that some residents enjoy for the quiet it provides. Some residents prefer their own company and have televisions and music centres in their own rooms. The gardens are secure and attractively maintained. There are bird feeders and a stocked pond that has been protected with a fitted metal grid. There are a number of secluded areas that have seating and there is level access for wheelchair users. One resident said they had enjoyed being outside in the brief spell of sunny weather there had been. Daily records confirmed that, ‘XXXX sat in the garden with other residents this morning’. DS0000036814.V295529.R01.S.doc Version 5.2 Page 12 Visitors spoken with said there were no restrictions on visiting and the staff always made them feel welcome. One visitor said they had the run of the little kitchen when they were there and made drinks for their relative and helped with the washing up. They often stayed for meals with their relative. They said ‘it is home from home’. Another visitor said ‘when my time comes this is where I want to be’. All the residents and visitors spoken with were complimentary about the meals. They said the food was well cooked and presented with a wide choice. The main lunch offers two dishes with a fish dish or salad available as well. Supper also offers two dishes with the alternative of cooking a light snack in the unit kitchenettes if preferred. On the day of inspection the main meal was steak and ale pie with vegetables and mashed potato. The pies looked appetising and had been prepared with home made pastry. The kitchens were visited after lunch and were clean and tidy. The food stores were seen and were well stocked with fresh ingredients including fresh herbs. The refrigerators’ and freezers’ temperatures were all within safe limits for food storage and left over food was covered, labelled and dated. The cooks spoken with said they cater for special diets and take account of residents’ preferences. One resident seen had a very small appetite and their relative said the cooks were very good at preparing something to tempt the resident. DS0000036814.V295529.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. People who use this service can expect to have any complaints taken seriously and to be protected from abuse. EVIDENCE: CSCI have not received any complaints about this service since the last inspection and the manager said the service has had no complaints either. The service has a commitment to improving and the manager said they would take any complaint seriously and investigate it following the Suffolk County Council complaints procedure known as ‘Having your say’. The staff training records seen showed that staff had had updated training in Protection of Vulnerable Adults (POVA). All staff spoken with whether carers or ancillary staff were very clear about their duty of care and the actions they would take if they had any cause to suspect a situation was potentially abusive. DS0000036814.V295529.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 26. People who use this service can expect to live in a clean, well-maintained home with their own possessions around them. EVIDENCE: All areas of the home on the day of inspection were clean and tidy with no unpleasant odours. The décor and furniture was attractive and suitable for the purpose of the building. There is a system in place for staff to notify the handy person of any repairs or replacements needed. The handy person has not been in post very long but staff commented on the improvements already achieved particularly in the garden. The handy person said that there is a programme of redecoration of rooms if they become vacant. They have the skills to do minor furniture repairs and have had some training to manage electrical problems and the boiler. A fire alarm test done on the day of inspection showed that one bedroom closure was not functioning. The maintenance company were called and attended promptly to repair the defect the same day. DS0000036814.V295529.R01.S.doc Version 5.2 Page 15 Residents’ rooms seen looked attractive and had a lot of personal belongings in them. There were a large number of family photographs, pictures, ornaments and some small items of furniture that some residents had chosen to bring with them. The home has a housekeeping team to maintain cleanliness and manage laundry. One visitor said they were very satisfied with the standard of cleaning. Their relative’s room was cleaned every day and there was never a problem with their personal laundry. The laundry was visited and looked tidy and organised. The washing machines have a sluicing cycle and soiled linen is taken to the laundry in alginate bags to minimise the risk of infection. COSHH regulations were displayed on the wall. DS0000036814.V295529.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. People who use this service can expect to be cared for by correctly recruited staff who are properly trained to do the job. EVIDENCE: Two staff files were inspected and only one contained evidence of identification documents in the form of photocopies of passport, birth certificate and driving licence. In discussion with the manager it was clear that identification from the other file had been seen but due to a difficult personal situation the member of staff could not access the documents for photocopying. The manager undertook to supply CSCI with the evidence as soon as possible. The same file only contained one reference and again the manager agreed to supply CSCI with the evidence, as they knew a second reference had been provided. Each file had the applicants’ job application form and a record of the interview notes in it. One application showed a gap in employment history but there was no evidence it had been explored with the applicant. The manager said that the applicant had attended college abroad but that they had not recorded the conversation nor checked with the college that the person had attended as they said. The files contained a recent photograph and evidence of induction training covering infection control, fire procedures, a tour of the building and introduction to residents. DS0000036814.V295529.R01.S.doc Version 5.2 Page 17 Staff spoken with confirmed that they had updates of training in fire awareness, food hygiene, POVA, care of the dying, pressure area care and medication administration. The training files seen had evidence that the training had been done. The commitment to training means the service has achieved the required level of carers with NVQ level 2 and continues to encourage carers to achieve further qualifications. The home links with Otley College to access courses in dementia awareness, infection control and medication administration. DS0000036814.V295529.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38. People who use this service can expect that the manager is competent and will protect their health, welfare and finances and supervise the staff appropriately. EVIDENCE: The manager has twenty-four years experience in working in care homes. They have managed 57, Crabbe Street for the last five years. They have qualifications in nursing, social work and as an NVQ assessor. Their most recent qualification to support the work in the home and the residents is a qualification in dementia care mapping. Maintenance records and fire hazard reporting records were seen and looked comprehensively completed. There was an entry to record action taken to improve fire safety by removing some chairs that had been positioned blocking fire extinguishers. The site logbook of engineers’ repairs was seen and showed that items that were faulty were speedily attended to or replaced. DS0000036814.V295529.R01.S.doc Version 5.2 Page 19 Time was spent with the administrator who explained the system used by the home to manage residents’ personal finances. As a local authority home money is kept in a central account but individual balances are available. Receipts are kept and statements are offered to residents or filed in their financial records. There is an audit trail. The handy person has an office that is also a cleaning products store cupboard. The space is limited and not suitable for repairing large pieces of furniture. There were a number of containers in the office of products that were not detailed in the COSHH folder that was inspected. There was evidence in the residents’ files seen that they had been given the opportunity to sit on an interview panel for new staff so that they could feel involved in the appointment of people to the home. One of the carers confirmed that this had happened although one or two residents had declined the invitation. Examples of residents’ and relatives’ questionnaires were seen and contained very positive comments about all aspects of the service. There was evidence in the staff files of supervision contracts and staff confirmed that they had regular supervision. In one of the team surveys seen a member of staff had commented, ‘I can always ask for extra supervision time if I need it’. DS0000036814.V295529.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 3 X 3 DS0000036814.V295529.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NONE STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Timescale for action Mar sheets must be completed to 18/05/06 show medication has been administered or an appropriate code used to indicate why it was not given. Medication needing to be 18/05/06 refrigerated must be stored in a lockable container if stored in a domestic refrigerator. A procedure must be put in place 18/05/06 to evidence that prescribed creams and topical preparations are applied as required. Identification checks made 31/05/06 during recruitment must be evidenced in staff files and available for inspection. If an application gives an 31/05/06 incomplete work history there must be evidence that it has been followed up. Requirement 2. OP9 13 (2) 3. OP9 13 (2) 4. OP29 19 (1) (b) (i) Sch. 2 19 (1) (b) (i) Sch. 2 5. OP29 DS0000036814.V295529.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP8 OP38 Good Practice Recommendations Weight records should be consistently in either stones and pounds or kilograms. Consideration should be given to more appropriate accommodation for the handy person to work from. DS0000036814.V295529.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000036814.V295529.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!