Inspection on 18/10/05 for 81-83 Crofters Close

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

81-83 Crofters Close 20/11/06

81-83 Crofters Close 23/02/06

81-83 Crofters Close 23/02/05

81-83 Crofters Close 14/06/04

81-83 Crofters Close 15/03/04

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Polesworth Group 68 Long Street

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

CARE HOME ADULTS 18-65 Crofters Close, 81/83 81/83 Crofters Close Droitwich Worcs WR9 9HT Lead Inspector P Wells Unannounced Inspection 18th October 2005 02:45 Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 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 Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 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 Adults 18-65. 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. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crofters Close, 81/83 Address 81/83 Crofters Close Droitwich Worcs WR9 9HT 01905 773993 01905 773993 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) Worcestershire County Council Ms Valerie Goode Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2005 Brief Description of the Service: The home is situated in a quiet cul-de-sac on a residential estate, approximately one and a half miles from Droitwich town centre. There are shops on the estate and a park nearby. The home is operated by Worcestershire County Council and the responsible individual is Stephen Chandler. Mrs Val Goode is the registered manager and continues part-time, as the acting manager of another home run by the County Council. The communal rooms and two single bedrooms are on the ground floor with four single bedrooms on the first floor. The home has a two-person passenger lift. The home provides permanent accommodation and personal care for a maximum of six, highly dependent adults with learning and physical disabilities. At the time of the inspection there were five service users and a vacancy. Some of the service users have lived in the home since they were children. The home had its own unmarked minibus. The aim of the service is to provide a caring and safe home ensuring the privacy, dignity and comfort of each service user. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced inspection that took place during the afternoon of Tuesday, 18th October 2005. For this inspection, time was spent preparing, reading the monthly reports from the Service Manager and 2.5 hours spent at the home. Unfortunately it has not been possible to meet with the manager, since the visit, so some of the previous requirements and recommendations will be discussed with her at the next inspection. The focus of this visit was to meet with the service users and staff on duty. Time was spent with the service users, staff, viewing the communal areas of the home, observing and reading documentation. Also discussing the extension which had just commenced. At the time of writing this report, a new, full time manager had been appointed to the other County Council home. Hence Mrs Val Goode will be working solely as manager of this home. The inspector appreciated the co-operation and time of the service users and staff. What the service does well: This established service provides care and support to five service users. The house is kept bright, clean and safe with a welcoming atmosphere. The service users appeared content and comfortable. Some of the service users were able to indicate that they liked living here and it was apparent that a new service user had settled in well. The service users are supported by experienced staff, the majority of whom have worked at the home for sometime and know the service users well. The arrangements for admitting a service user were most suitable. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: 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. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5 The service had a suitable admissions process to ensure that the needs of a prospective user could be met. The agreement must be introduced. EVIDENCE: A new service user had been admitted and the information, assessment and introduction were discussed with the key worker and the records viewed. It was apparent that a most suitable process had been followed involving the service user and the previous home and carers. Careful consideration was given to whether his needs could be met in this home and arrangements made to ensure his safety. The staff would benefit from further information about the service user’s past life, which the social work team would be able to provide. The current service users were also considered to ensure compatibility. In conclusion this had been a successful admission that met the practice outlined in the standards. The County Council has prepared a contract/agreement, which must be personalised for this home, then introduced and completed for or on behalf of the service users. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 Service user plans were detailed and up to date. The individual’s assessed needs were known to the staff and consistent care was provided. The risk assessments were clear, accessible and covered risky situations. EVIDENCE: Each service user had a detailed plan indicating the care and support they needed and how staff should provide this. On this occasion the new service user’s file was viewed and a clear, detailed plan had been established based on the information gained through the assessment process. Risk assessments were in place for any risky situations that a service user experienced in their daily lives. Consideration could be given to developing the records and checks in respect of nutritional needs (see comments on page 12). Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,17 The service users, with staff support, were able to be involved in activities in and out of the home. The lifestyles and rights of the service users were respected. The service users were offered a choice of meals and drinks with individual preferences catered for. EVIDENCE: The service users are all dependent on staff to support them with their daily care and routines. The staff do ensure that there is appropriate communication and that the service users’ social and emotional development is maintained. The lifestyles of each service user were recorded in their service user plans. All the service users have established day placements for a few days during the week. On other days they are looked after at home by staff. On the day of the visit there were three service users at home – watching television, listening to music, walking about, looking at books, enjoying an activity box and interacting with staff. Staff were also involved in collecting two of the service user from their day placements. The home has its own unmarked mini bus. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 11 Local community facilities are used such as the park, shops on the estate and pubs for meals. Due to staff shortages the service users had not been on holiday this year. However staff advised that there had been day outings to Walsall Illuminations, Safari Park and Weston Super Mare. One service user had been on holiday with their family. Four of the service users have regular contact with their families. Consideration should be given to the fifth service user having an advocate in the absence of family contact. The extension to the home will include additional communal space so when this is completed, the activities in house could be developed to include, for example a sensory room/area. The menus and record of food provided indicated that the service users were receiving a varied diet with homemade main courses. Details of the vegetables and ‘roasts’ served needed to be included. The supper on the day of the visit was tuna pasta bake or cheese and potato pie served with tin tomatoes and corn beef. For desert there was fresh fruit. The staff choose the meals for the service users and know their likes and dislikes. The staff ensured that the service users had with suitable foods (soft/cut up) according too the individual’s needs and preferences. The service users’ had suitably adapted plates, assistance and support at mealtimes. Drinks were available at times when the staff considered service users would like a drink – on arrival home, with visitors. One service user was observed without a drink whilst the rest of the group were sitting at the table with a drink. He may have recently have had a drink but could possibly have been offered a refill so he could join the group/social occasion. It was noted that three of the service users had dietary needs and the inspector was advised that these matters had been discussed with their doctors. However nutritional needs were not fully detailed in the service users’ plans, including reviews and regular weighing. Advice should be sought from a dietician to ascertain whether the home’s menus are appropriate for individual service users. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 The service users’ are well supported by staff with their personal and health care needs, which are appropriately recorded. EVIDENCE: The service users need assistance with all their personal and health care. The personal and health are needs of each service user was detailed in their plan and well known to the permanent staff, which ensured continuity. At this visit a sample plan was viewed. Health action plans were also in place for four of the service users. The health action plan for the fifth service user was about to be completed. Records indicated that the service users had routine check ups with the dentist, optician and with other health care professionals, as needed. The service users were all well, emotionally and physically. Healthcare professionals are involved at an early stage when a problem is identified. For example - a service user with a minor physical problem was being supported at home and had been taken to see the GP. The home had the appropriate equipment for staff to assist the service users with transfers, bathing and toileting. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 13 A health care professional commented that staff had attended training in communication. Although the standard on ageing and death was not fully inspected, it was noteworthy that the manager and staff had coped well with the sudden death of a service user and supported the other service users, the family and themselves. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. However the home is known to have suitable policies and procedures for complaints and protecting vulnerable adults. EVIDENCE: Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The house was homely, comfortable, clean, safe and well maintained for the service users. The rooms and facilities were suitable for the service users. EVIDENCE: The home is situated on a residential estate on the outskirts of Droitwich with amenities nearby. The home was accessible, safe, warm, clean and furnished in a comfortable and homely way. Both floors were suitable for service users with mobility problems as the home had a small shaft lift. On the ground floor is a lounge, dining room, two bedrooms (one with en suite facilities), shower room, small office and sleeping in room. The domestic type kitchen, on this floor, was suitable for the care staff preparing food and drinks for the number of service users. It had appropriate equipment. On the second floor there are four bedrooms, bathing and toilet facilities. The foundations for the extension to the office and lounge had been laid. However at the visit it was apparent that the new build maybe to close to a service user’s bedroom. The manager and the County Council’s property services immediately followed up this issue. The extension is welcomed to give both staff and service users more communal space. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 16 It was observed that the lounge door and a bedroom door were wedged open (both fire doors). If service users prefer the doors to be kept open, these doors must be fitted with holders that are linked to the fire alarm system. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,35 The service users were being appropriately supported and cared for by staff, whom knew the service users well and were experienced. The staff group were suitably trained and there were opportunities for staff to attend refresher courses and further training. EVIDENCE: The home now has a full staff team of experienced and trained workers. The majority of staff knew the service users well and therefore offered consistent support. Two experienced support workers have transferred from other Social Services homes. However due to staff sickness during the last six months, the service had experienced staffing difficulties which had effected staffing levels, activities and holidays for the service users. The service aims at three staff on duty when all the service users are at home. This level of staffing is essential for supporting service users at home, going out and transporting them to day placements. At night there are two staff sleeping in. Rotas were available and reflected the staffing arrangements. Staff meetings had been re-established and minuted. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 18 The home had two part-time cleaners and care staff undertook the catering and laundry duties. The home would benefit from a gardener and maintenance person, as the post is vacant, also administrative support, as previously recommended. The inspector was able to meet with four of the staff on duty and was impressed by their knowledge of the service users and their commitment to training. Six of the ten staff had an NVQ level in care; two staff had completed the LDAF induction programme. Another member of staff had commenced an NVQ level 3 in care. The service will therefore meet the recommended level of 50 of staff having an NVQ level 2 or above in care by 31.12.05. The home has it’s own moving and handling trainer and another member of staff had attended a course on infection control and then cascaded this guidance to staff. The majority of staff had attended a course in first aid. All staff had undertaken food hygiene training in April 2005. Staff who administered medication had received training from the community pharmacist and were waiting for places on the course being arranged by Social Services. All staff had had completed a basic fire training course, and three staff were booked on the fire warden’s course. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 This service is well run by an experienced manager who ensures that the service users’ best interests and safety are paramount. EVIDENCE: The home continues to have an experienced and qualified manager who will be returning to work solely at this home from mid November 2005 (until recently she had been managing two homes for the County Council). This will be of benefit to the service. Standards 39 & 41 were not fully assessed on this occasion. However the following was noted: The manager was introducing a quality assurance programme. Records were being maintained, as required, in a care home. The standard on Safe Working Practices is wide ranging and the following was noted on this occasion: The home had a variety of risk assessments for the service users. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 20 Staff had received training in safe working practices (see comments on page 19). The accident book was available and accidents appropriately recorded. The few minor injuries that had been recorded were also reported to the County Council health and safety department. The records relating to the checks on, and servicing of, fire safety equipment were being kept. Training for staff in fire awareness were held regularly and recorded. Crofters Close, 81/83 DS0000037500.V260794.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crofters Close, 81/83 Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X 3 X X DS0000037500.V260794.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from the last inspection? 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 2 Standard YA5 YA24 Regulation 5 23 Requirement The draft agreement/contract must be introduced. (timescale of 30.04.05 partially met) Fire doors that need to be kept open must be fitted with automatic door release mechanisms. The vacancy of gardener/maintenance person is filled. Timescale for action 31/01/06 31/01/06 3 YA33 18 31/03/06 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 3 4 Refer to Standard YA14 YA15 YA17 YA33 Good Practice Recommendations The activities, including holidays, for the service users should be developed. For service users without families, consideration should be given to arranging for an advocate or friend to have regular contact. The dietary needs of some of the service users should be detailed in their plans and professional advice sought to ascertain that the menus are suitable for these individuals. Consideration should be given to the provision of administrative support. DS0000037500.V260794.R01.S.doc Version 5.0 Page 23 Crofters Close, 81/83 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. 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