Inspection on 14/06/05 for Applecroft Residential Care Home

This inspection was carried out on 14th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Applecroft Residential Care Home 31/07/07

Applecroft Residential Care Home 05/05/06

Applecroft Residential Care Home 18/10/05

Applecroft Residential Care Home 17/02/05

Applecroft Residential Care Home 26/10/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE APPLECROFT RESIDENTIAL CARE HOME 48/50 Brunswick Street Congleton Cheshire CW12 1QF Lead Inspector Helena Dennett Announced 14 June 2005 09:30 am th 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 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. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Applecroft Residential Care Home Address 48/50 Brunswick Street Congleton Cheshire CW12 1QF 01260 280336 01260 299862 ACLALouis@aol.com B & L Property Investments Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tracy Leese Care Home 25 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), of places Old age, not falling within any other category (25), Physical disability (2), Dementia (1). APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 25 service users to include: * Up to 25 service users in the category of OP (old age not falling within any other category). * 1 service user in the category of MD(E) (mental disorder over the age of 65). * 2 named service users in the category of PD (physical disability) over the age of 60 within the overall number of registered places. * 1 named service user in the category of DE (dementia). 2 The registered provider, must at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The registered provider must provide staff to meet the dependency needs of service users at all times and shall comply with any guidelines that may be issued through the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 17th February 2005 3 4 Date of last inspection Brief Description of the Service: Applecroft is a privately owned care home located near to Congleton town centre and close to local shops. there is adequate care parking available at the home. Applecroft was formally two private dwellings that have been converted and extended to provide a care home for older people. It is a three-storey building and service users can be accommodated on all floors. Access to all floors is via a shaft lift or stairs. Service user accommodation consists of 25 single bedrooms, some of which have en-suite facilities. The remaining bedrooms have wash hand basins. Alterations designed to upgrade and provide en-suite facilities to a number of bedrooms on the first and second floors was in progress. Day space consists of two lounges and a dining room. There are an adequate number of toilets and bathrooms available for residents. Aids to facilitate independence are in evidence throughout the home, including bath hoists; grab rails and a call bell system. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 5.5 hours. The inspector toured the building, spoke with three residents and one relative, three members of staff and the owner. Seven completed CSCI comment cards were received from residents and two from care managers/placement officers. The comments are reflected throughout the body of the report. What the service does well: What has improved since the last inspection? What they could do better: Although staff have worked to improve the care planning system within the home to make sure that residents’ needs are identified and met, further work must be done so that the care needed by individuals is fully recorded. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 6 The temperature of the water supplied to the baths was again found to be very high and could pose a risk of scalding to residents. Whilst the owner has committed to replacing the boiler and changing the system within the home, a risk assessment must be done and action must be taken to make sure that residents are not at risk. This also applies to the radiators which are uncovered and could be a risk should a resident fall against them whilst they were on. Although the deputy manager stated that fire safety training had been arranged, all members of staff had not done fire training in the past twelve months. A timescale for completion was 31/3/05 following the last inspection. Training on mental health needs should also be provided to staff working in the home so that they can better meet the needs of all the residents. Recruitment procedures are in need of improvement. The proprietor must make sure that thorough checks are carried out for all staff before offering them employment at the home. 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. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 standard(s) 3 & 6. Assessments of people’s care needs are carried out before they move into the home so there is information to show that their needs can be met at the home. EVIDENCE: Four residents’ files were looked at. These contained assessments of people’s care needs, done before they moved in to make sure that these needs could be met at the home. Intermediate care is not provided at this home so standard 6 does not apply. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 standard(s) 7,8,9 &10 Although some improvement had been made to the care plans, further work is needed to make sure that they include information on all residents’ care needs and how these are to be met so residents are safe and well at all times. EVIDENCE: Four residents’ files were looked at during the inspection. The deputy manager stated that staff at the home were in the process of putting new care plans in place for all residents but that they have not finished this work yet. However there was no plan of care in place for a resident who moved in on 2nd May 2005. A risk assessment had not been completed even though the resident was suffering from some confusion. The resident had been weighed on admission and daily records were kept on her health and well-being. In another resident’s file, although the care plans had been completed, there was no plan of care in place to address the mental health needs of the resident. See Requirement 1. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 10 Discussion took place with the deputy manager regarding the need to make sure that the care plans that are put in place identify the needs of the resident and the action to be taken by staff to address these needs and the expected outcome for the resident. Residents stated that they felt their health and social care needs were met by staff. Comment cards all indicated that residents felt well cared for and that their privacy was respected. Residents stated that staff are very good. Staff were seen to knock on residents doors before entering bedrooms. There was evidence that the district nurse and doctor are called when necessary. A relative stated that staff are ’superb’. She went on to say that residents are very well cared for and staff get in the district nurses and GP very quickly when a resident’s condition deteriorates. The medicines are well managed in the main. A room has been set aside for the storage of medication. However due to the fact there are steps, the trolley is stored securely elsewhere in the home. A record of signatures of all staff who administer the medication is not kept. See Recommendation 1. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15. Residents can choose how they spend their time in the home and there are plenty of activities to keep them active and stimulated. However, there is no private phone for residents to use to keep in touch with friends and family. The standard of food provided was good so that residents received a nutritious diet that they enjoyed. EVIDENCE: Three residents spoken with said there were plenty of activities available in the home. Comment cards also indicated that the home provides suitable activities. Activities mainly take place in the afternoon. One resident said that as they had no telephone to use in private they felt ‘cut off’ at times. The resident stated that they could use the homes telephone which is cordless, as needed, but felt this was not always practical and she felt she would be ‘bothering’ staff although staff have not given her this impression. The proprietor confirmed that residents could have a telephone line installed but that they would have to pay for this service. The proprietor also confirmed that residents could use the home’s telephone for calls. See Requirement 2. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 12 The home is a ‘no smoking’ home for staff, residents and visitors. There is one resident in the home who currently smokes and who was told before moving in that smoking is not permitted in the home. However arrangements have been made with the staff to enable the resident to smoke outside the building. The relative spoken with stated they are welcomed into the home. Visiting can take place at any time. One resident goes out every Sunday for lunch. Residents stated that the food was ‘lovely’. They are given a choice at teatime and although there is no choice of main meal at lunchtime, they could have an alternative if they didn’t like what was on the menu. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 standard(s) 16 &18 Residents were aware of the complaints procedure and how to use it. Staff have received training on adult protection to make sure that residents are not placed at risk. EVIDENCE: Residents spoken with confirmed that they had no complaints and that they would feel comfortable approaching the manager if they did have a complaint. The members of staff who spoke with the inspector knew what action to take if they witnessed an incident that caused them concern. Staff have attended training on adult protection. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 standard(s) 19,23, 25 & 26 Although the owner is in the process of upgrading the facilities in the home, not enough action has been taken to deal with the hot water temperatures and radiators to protect residents from the risk of scalding or burns. The home is clean and tidy so making a pleasant environment for residents to live in. EVIDENCE: The proprietor is in the process of refurbishing the home. Work continues on the middle floor where there are no residents currently accommodated. Since the last inspection three rooms have been completed and an en-suite installed. The proprietor of the home installed an specialist bath in the en-suite bathroom for one resident and as a result she is now able to bath herself. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 15 The hot water in one of the bathrooms was tested and found to be 50 degrees Celsius which is in excess of the recommended temperature. This was found at the last inspection and a requirement made to ensure that the temperature of the hot water supplied to baths and sinks does not exceed the safe maximum of 43 degrees Celcius. The owner stated that he intends to replace the boiler and hot water system but has to wait for the warmer weather as it will mean radiators will be switched off. However as a minimum, a risk assessment should be carried out and appropriate action taken to make sure that residents are not placed at risk. See Requirement 3. Radiators are not covered and therefore there could be a risk of burning to residents. This was identified at the last inspection and no action has uet been take to deal with it. The owner stated that he intends to do major works to the system in the summer. However a risk assessment has not been carried out. See Requirement 3. The home was found to be clean and tidy on the day of the inspection. The laundry has been moved to a larger room and new machines have been purchased. These did not appear to have a sluicing facility for washing infected/heavily soiled linen. However the proprietor said he had ordered a machine with a sluice facility and intended to follow this up. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 30 Residents are well looked after by the staff in the home. However, lack of all the necessary checks before staff start work at the home, and lack of training for all staff in fire safety could put residents at risk of harm. EVIDENCE: Residents stated there are enough staff on duty to meet their needs. They were very complimentary about the staff, stating staff were ‘good’ generally and there are ‘enough’ staff on duty. The relative spoken with stated staff are ‘superb’ and that the owner is also ‘superb’. Members of staff stated that they feel a lot more supported under the new management arrangements. They have attended first aid training, abuse training and training on diabetes. None of the staff have undertaken any training on mental health needs even though there are two residents accommodated in the home with mental health requirements. One care manager/placement officers comment card indicates that staff do not have the knowledge to care for the mental health needs of the residents. See Requirement 4. Fire safety training remains outstanding; however arrangements have been made for this to be carried out. See Requirement 5. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 17 Recruitment records were examined. In one file there were no references available, the application form did not ask whether the applicant had a criminal record and there was no up to date Protection of Vulnerable Adults (POVA) check or CRB disclosure on file. A CRB from a previous employer was present in the file. See Requirement 5. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 &38 Although the owner has improved several aspects of the home, tests on portable electrical appliances have not been done and so could put residents at risk. Tests are carried out regularly to make sure the fire precaution systems within the building are in good working order. EVIDENCE: Seven comment cards were received from residents. All indicated that they felt well cared for and staff treated them well. No one wished to be more involved in decision making within the home. Two care manager/placement officers comment cards were received. One indicated satisfaction with the service, the other stated that they felt that the home did not notify them of significant events affecting their well-being. See Recommendation 2. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 19 The relative and staff spoken with were complimentary about the ownerand the changes that have been introduced into the home since he acquired it. The owner is present in the home on a daily basis and is known to the residents. Fire safety training is needed for staff and risk assessments must be carried out in order to prevent any potential accidents that might occur. Fire tests have been carried out. Fire drills are recorded as being carried out, but the names of staff that have taken part are not documented. The deputy manager confirmed she would address this. A fire risk assessment has been done on the building but this does not take into account the risks associated with residents living on the middle and upper floors and the action staff should take in the event of a fire. See Recommendation 3 A contract for the servicing of the lift is in place. The service for the bath hoists and lifting equipment is overdue; however, during the inspection the deputy manager spoke with the engineer who stated they were intending to visit the home this month to carry out the service. There was no evidence that Portable Electrical Appliance tests have been carried out in the past year. See Requirement 7 APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x 3 x 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x x x x 2 APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 21 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 7 13 Regulation 15 16 Requirement A written plan of care must be in place for all residents admitted to the home. The registered person must make sure that a telephone which is suitable for the needs of residents and can be used in private is provided. The registered person must make sure that risk assessments on the hot water and the radiators are carried out and that appropriate measures are put in place to make sure that residents are not put at risk. All members of staff must be offered training on the specific mental health issues relating to residents currently living in the home, to make sure that they can meet the needs of the residents at all times. Staff must not be employed at the home unless two satisfactory references have been obtained, in addition to a Criminal Record Bureau disclosure/POVA check. In exceptional circumstances a POVA first check can be carried out as long as supervision arrangements are in place prior F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Timescale for action 31/8/05 31/8/05 3. 25 13 31/7/05 4. 30 18 31/8/05 5. 29 19 at all times. APPLECROFT RESIDENTIAL CARE HOME Version 1.40 Page 22 6. 30 23 7. 38 23 to the CRB discosure been received by the home. Suitable training on fire prevention must be undertaken by all members of staff in accordance with regulations. Timescale 31/3/05 not met. The registered person must ensure that all portable electrical appliances are checked annually. 31/7/05 31/7/05 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. Refer to Standard 9 33 38 Good Practice Recommendations A record of staff signatures for those members of staff who administer medicines should be kept. The registered person should actively seek the view of service users, visiting professionals and stakeholders on the care provided in the home. The fire risk assessment should be reviewed to include the action staff and residents need to take if a fire occurs on the middle or upper floors of the home. APPLECROFT RESIDENTIAL CARE HOME F51 F01 S45159 Applecroft V224822 140605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT 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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