Inspection on 19/08/08 for Carr Croft Care Home

This inspection was carried out on 19th August 2008.

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

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

Carr Croft Care Home 21/02/08

Carr Croft Care Home 12/09/07

Carr Croft Care Home 25/01/07

Carr Croft Care Home 03/08/06

Carr Croft Care Home 17/03/06

Carr Croft Care Home 13/12/05

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOMES FOR OLDER PEOPLE Carr Croft Care Home Stainbeck Lane Leeds West Yorkshire LS7 2PS Lead Inspector Catherine Paling Key Unannounced Inspection 19th August 2008 09:30a 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 Carr Croft Care Home DS0000066259.V369026.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. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carr Croft Care Home Address Stainbeck Lane Leeds West Yorkshire LS7 2PS 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) 0113 2782220 F/P 0113 2782220 Carrcroft Care Home Limited Manager post vacant Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, Code OP - maximum number of places 35 The maximum number of service users who can be accommodated is: 35 21st February 2008 2. Date of last inspection Brief Description of the Service: Carr Croft is a large converted Victorian house, providing personal care for up to 35 older people. Nursing care is not provided and the community nursing service gives support for any nursing needs that can be managed at the home. The garden area to the front has had some landscaping following completion of the extension. People have access to this area. Accommodation is provided in single and shared rooms. Some of the shared rooms have en-suite facilities, as do the new bedrooms in the extension. Communal areas are on the ground floor, with a large lounge/dining area, a smokers’ lounge and other seating areas. The home is situated close to the local amenities of Meanwood. Charges are reviewed twice a year in April and October. The home should be contacted directly for up to date information about fees. Additional charges are made for chiropody, hairdressing, daily papers, toiletries, some activities and transport. Escorts to accompany people for hospital appointments are charged at £7.50 per hour. Information about the services is provided by the home in the form of a Statement of Purpose and Service User Guide. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced visit by two inspectors who were at the home from 09:30 until 16:35 on 19th August 2008. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and in accordance with requirements. Before the inspection we reviewed accumulated evidence about the home. This included looking at any reported incidents, accidents and complaints. We used this information to plan the inspection visit. Following the key inspection in February 2008 we took further legal advice as a result of continued breaches of the Care Homes Regulations. Since then there have been meetings with the provider and a further random inspection in June 2008 where we saw significant progress in addressing identified shortfalls. What we saw at this visit confirmed these improvements. We asked the home to provide some information before the visit by completing an Annual Quality Assurance Assessment (AQAA). We looked at a number of documents during the visit and visited all areas of the home used by the people who live there. We spent a good proportion of time talking with the people at the home and visitors as well as with the manager and the staff. Comments made to us during the day appear in the body of the report. We sent out survey forms before the inspection providing the opportunity for people to comment on the service, if they wish. Information provided in this way may be shared with the provider but the source will not be identified. A small number of surveys were returned and some of these comments are included in the report. What the service does well: The home is very welcoming and people and their relatives spoke well of the staff and the care provided. Staff understand how to promote people’s dignity and independence. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 6 Staff said: • Always let people do as much as they can for themselves. • Give as much encouragement and reassurance as you can. • Always ask people what they want before you do it. People said: • They get you up when you want, you can have a lie in if you want. • They look after you. I would recommend it to anyone. • I enjoy the meals. Mealtimes are an enjoyable and social event offering a high standard of cooking. The chef is experienced and makes sure that people have nutritious meals, catering for individual choices. Everyone moving into the home has their care needs properly assessed before they move into the home so that they can be sure to be looked after properly. Complaints are handled in a professional manner and within time scales as prescribed in our policy What has improved since the last inspection? The provider has worked very hard since the last inspection and there have been significant improvements at the home. There has been a change of home manager, which seems to be having a positive effect on staff and on the quality of life for the people living there. Care staffing levels have improved and the ancillary staff team is established meaning that care staff are giving priority to their caring duties and the quality of life has improved for people living at the home. The opportunities for occupation and outings have also improved and are being enjoyed by the people living at the home and the staff. Staff • • • • • • said: Everybody is happy; it’s not just all about getting chores done. It’s a lot calmer; we have lots more time for people as individuals. We do a lot more now, it’s great, I enjoy organising quizzes. We are encouraged to sit and chat with people. It’s very rewarding. You see the resident’s enjoyment and we enjoy it even more. It’s a good place to work, good teamwork, good support, good management. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 7 Care records are much more informative and person centred. Staff find them more helpful, one said: • They have improved a lot lately; they are much better organised and tell you more about the person and what they want. What they could do better: The provider needs to work closely with the manager to sustain the improvements already made and to continue to build on the good foundations now in place at the home. This will mean that the quality of life for people will continue to improve. The new manager will need support in adjusting to her managerial role and completing the training she needs to do to make sure that she is an effective manager. She needs to provide clear leadership and direction to staff so that improvements continue. Information from the AQAA, saying how the home wants to improve: • Continue to develop links with the local community to offer more opportunities for our service users. The new manager to allocate time for doing this on a regular basis • Access suitable transport for wheelchair users for outings and trips – person co-ordinating the activities to investigate • Give residents stimulation through exercise – Leeds City Council trained trainer to join Carr Croft from September. Request submitted awaiting reply • Improve in documentation of daily records – ongoing staff training • Regular audits to be carried out by the management team in other areas with the aim of working to more than the minimum standards Recommendations that we made appear at the end of the report 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. The summary of this inspection report can be made available in other formats on request. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 8 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 Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply to this service) People who use the service experience adequate quality outcomes in this area. People are provided with enough information to enable them to make an informed choice about the home. The admission process includes preadmission assessments to make sure that care needs can be met. We have made this judgement using available evidence including a visit to this service. EVIDENCE: Information in the AQAA stated – • Planning and support is maintained with all admissions at Carr Croft the transition brings improved quality of life to each individual • Prospective clients, family and friends are given relevant and useful information prior to admission. This enables a fully informed choice to our prospective service users. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 10 • • • Involvement from the Home, the relatives and other health professionals all contribute to care of service users. We offer a few days stay enabling people to make their choice of home A detailed pre assessment form is completed before each admission ensuring we are able to meet the prospective clients needs. There have not been any recent admissions to the home. However, staff showed a good understanding of their role in helping people to settle in when they first move in. They said they encourage them to socialise, meet other people, get to know staff and become familiar with the environment. One said, “We talk to them about their past, explain what our role is and make them feel welcome and comfortable”. People living at the home have had their needs re-assessed as they have changed. For example, risk assessments on falls. The new manager was also aware of the need to re-assess someone whose needs may have changed and the home may not be able to meet their needs any longer. One person was currently in hospital and she said she would meet with hospital and district nurses to get as much information as possible before deciding if their needs could still be met at the home or not. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience adequate quality outcomes in this area. Care plans contain enough detailed information about individual needs so that staff know how to look after people properly. Staff respect the privacy and dignity of the people living at the home. Overall, people at the home are protected by safe medication practices but the lack of staff awareness of policies and procedures puts people at potential risk. We have made this judgement using available evidence including a visit to this service. EVIDENCE: Information in the AQAA stated – • All personal care is based on individual needs • All service users are treated with respect, privacy and all their choices met • Prompt arrangements for professional bodies are maintained and Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 12 How • • • documented the home has improved over last 12mths: Care plans are now more person centred and are more detailed Care files are now more organised and easy to follow-index in place Started end of life care plans People looked well groomed. Attention had been paid to hair. It was styled and looked cared for. People had clean glasses and clothing. The hairdresser is now visiting the home weekly. People were aware of when the hairdresser was visiting and were supported on the day of the visit to have their hair done if they wanted. Staff were thoughtful and kind when interacting with people. They were discreet and respectful of dignity when attending to any personal care needs. They gave reassurance and explanations for any tasks such as assisting with mobility. Staff gave good examples of how they maintain dignity and independence for people. They said: • • • • • Always let people do as much as they can for themselves. Stand back and just guide people. Give as much encouragement and reassurance as you can. Always ask people what they want before you do it. Keep people covered and always make sure doors are closed. Care plans are well completed. They are person centred and focus on people as individuals. They are clear and give a good picture of the person and their needs. The care plans are linked to risk assessments and have good risk management plans in place. These include moving and handling, nutrition, falls and pressure ulcers. This means that staff are well aware of needs and how to minimise any risks to them. Staff were able to accurately describe the care they give as detailed in the care plans and it is clear that staff have a good knowledge of people’s needs. Records showed that people were having a bath or shower as often as they wanted one. Care plans are reviewed and evaluated every month. This involves the key worker and the person who lives at the home. Staff said they found the care plans useful and much improved. One said, “They have improved a lot lately, they are much better organised and tell you more about the person and what they want”. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 13 The new manager is currently auditing the care plans to make sure the standard is good. She said she assesses them and looks for anything that may have been missed or overlooked. Help and advice is sought from health care professionals, such as district nurses to make sure that people get the special help they need to maintain their health. Records are kept of any health appointments and their outcomes so health can be monitored. Weight records are kept for people who may be at risk from being over or under weight. People said they felt well looked after. One said, “Things are ok, they treat us well” and “You can get a bath when you want one”. Another said, “They get you up when you want, you can have a lie in if you want”. Daily notes are written for people who live at the home. Some entries do not always accurately describe how a person has spent their day. For example, “been fine” does not say what a person has done or how they have been supported or cared for. The new manager said she would address this with the staff team. Healthcare professionals said: • A caring, warm environment. Residents feel ‘at home’ at Carr Croft In the interests of making sure that medication practices are safe the manager has decided that only senior care staff will be involved in the ordering and administration of medications. As part of this proposal one senior carer is to take overall charge of the ordering of medications with the support of the local pharmacist. Staff have access to policies and procedures and the manager needs to make sure that staff are familiar with these so that they follow safe practices. Staff involved in the administration of medication have had some level of training. However they should attend additional training courses to make sure that their training follows current best practice guidance. This means that staff will understand how to handle and administer medicines safely. In house audits are carried out to make sure that staff sign for the medication they give or use clear codes if medication is not given for any reason. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. People are supported in maintaining contact with their family and friends and visitors are welcomed at the home. People said that they have enough to occupy them through the day. We have made this judgement using available evidence including a visit to this service. EVIDENCE: Information in the AQAA stated – • All service users have a key worker • Management and staff at Carr Croft encourage family/friends to visit at any time (we do not have visiting time) they are made welcome and refreshments offered • Meals and meal times are regarded as extremely important • Tables are laid appropriately and choices are offered at each mealtime. Meal times are leisurely and social; all meals are varied and nutritious. • All service user’s birthdays are celebrated with a large cake in a nice friendly atmosphere Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 15 • • • The local clergy/church community visit once a month Motivation Classes take place twice a month which are enjoyed by the majority of our residents Saturday afternoon movies with popcorn is extremely popular Improvements at the home over the last 12months: • Weekly activities program followed • Outings are organised on a regular basis • More exercise/fresh air for the service users on weekly activities schedule • A bi-monthly newsletter is produced by staff/relatives for the service users • Local Spiritual healer visits residents weekly • Hairdresser visits weekly Plans at the home for the next 12mths: • More outings to be organised to include shopping trips, a trip to Golden Acre Park etc • Fundraising activities to be organised for service users fund • Garden Party planned for September • A staff, relatives and service users pantomime is planned for December • Further consultation to take place with residents to plan appropriate activities and outings There is a weekly programme of activities in the home. Activities include; pamper sessions, Karaoke, movie and popcorn afternoons, motivation classes, reminiscence work, board games and walking in the grounds. There has been an increase in day trips from the home. A recent trip to a local park and café had been very popular. Many people who live at the home said they had enjoyed it. The manager said future trips are currently being planned to other parks in the city. Staff are enthusiastic about organising activities. A garden party is currently being planned for September and a pantomime show for Christmas. A newsletter is produced every two months. This involves staff at the home working with a relative of someone who lives at the home to make sure events and news from the home is communicated to people. Staff said they felt they now have more time to be involved in activities and generally more time to spend with people socialising and chatting. Comments included: • • • Everybody is happy; it’s not just all about getting chores done. It’s a lot calmer; we have lots more time for people as individuals. We do a lot more now, it’s great, I enjoy organising quizzes. DS0000066259.V369026.R01.S.doc Version 5.2 Page 16 Carr Croft Care Home • • • We are encouraged to sit and chat with people. It’s very rewarding. You see the resident’s enjoyment and we enjoy it even more. There’s more time for just playing a game or having a chat. Activity records are kept for people who live at the home. These are not kept individually for people on their own files. Some records did not accurately reflect what people had been involved in. The new manager agreed to change this and make sure the records were completed in full for everyone. The atmosphere in the home is calm and life seems to go at the pace of people who use the service. Staff said they did not feel as rushed as they used to and felt they gave people plenty of time when carrying out any tasks. Seating is arranged well in the lounge areas. It looks cosier, more comfortable and encourages people to chat and socialise in small groups. One person’s chair however was positioned in such a way that they may not have been able to see the television clearly. Staff said this person liked to watch television. A choice of two meals is available at lunchtime and teatime. Staff said that menus are arranged based on likes and dislikes of people. Staff also said that special diets are catered for. The lunchtime meal was a fruit cocktail starter, followed by a choice of pasta with sauce or chicken kiev potatoes and vegetables. The dessert was peaches and strawberries and cream. People said they enjoyed their lunch. It was clear that people could have something different from what they had chosen if they wished. Some people needed a bit of encouragement and support to eat. It is recommended that staff sit down with people when giving this support. This means it is done more discreetly and protects dignity. The dining room tables have been set out to encourage more socialisation over meals for people. They are covered with attractive cloths and have a table decoration. Salt and pepper pots were not however, prominently displayed for people to use. This meant that people were unaware of them and didn’t ask for them. What people said: • • • • • I enjoy the meals. The food is good on a morning. When the chef’s here he does alright, not so good at other times. I am happy and settled living here Certain staff need to be more approachable Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience adequate quality outcomes in this area. There is a complaints procedure and people feel that any concerns will be taken seriously. People feel safe at the home. We have made this judgement using available evidence including a visit to this service. EVIDENCE: Information in the AQAA stated – • 75 complaints have been resolved within 28days • Deal professionally with all complaints according to our policy. All service users, families and friends are aware of our complaints procedure, which is available on the notice board. • Listen informally to little ‘niggles’ and take appropriate action. • Records of all complaints are kept. • Legal Rights Protection and Abuse Protection is assured at Carr Croft. • Advise is sought from appropriate bodies as and when required • Independent advocates are involved if necessary to ensure all service users are safeguarded. Improvements at the home in the last 12mths: Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 18 • New complaints recording documentation now in place • Developed contacts with Age Concern to advise in residents’ matters Plans at the home for next 12months: • New manager to attend Adult Protection training with Leeds City Council • Organise staff training in this area to update knowledge The managers training in safeguarding procedures has yet to be confirmed. Once she has completed this training she will be able to train the staff. There is a whistle blowing policy for staff and we suggested that contact details be added to help staff should they need to use the policy. What people said: • If not happy I would talk to the gaffer, there’s two of them. Staff were aware of the different types of abuse and the need to report any concerns. This makes sure people are protected. Some staff did not know where the contact number for the local authority was kept. They did however say they would find it. It is recommended that this number is made readily available in the home so that staff can report concerns to organisations outside the home if they need to. Some staff have received training on safeguarding adults and more training is planned for those who still need this. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. People live in a safe, comfortable and well-maintained environment. We have made this judgement using available evidence including a visit to this service. EVIDENCE: Information in the AQAA stated – • “All rooms are safe, homely, spacious, comfortably, decorated, furnished and up- holstered to a high standard. The Home is odourless, clean and pleasant. Access to indoor and outdoor communal areas is safe. Toilet, washing and bathing facilities are provided and meet the needs of the service users. • Lockable storage in rooms is available for personal items • Specialist equipment if required by service users is provided to maintain Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 20 • • • their safety and promote their independence. Service users are encouraged to bring their own memorabilia with them. Risk assessments are in place for all areas of the Home. Infection control is understood by staff and maintained”. Improvements at the home over last 12months: • “Paintings and ornaments have been purchased for the lounge areas • Large screen plasma had been installed in the main lounge area • Flower decorations and plant make the communal area more attractive and homely • New crystal lamp, bookshelf and new side tables have been purchased for the communal areas • Flower baskets in the entrance welcoming guests and visitors • Old shower on ground floor replaced and new non-slip floor covering now in place • Carpets replaced in many bedrooms • All bedrooms now have new style curtains Plans at the home for next 12months: • “New garden furniture to be purchased for the front patio area • Safety fence with hand railings to be installed around the patio area giving a safe environment • Hand rails to be installed by the front steps leading to main entrance • Stainless steel kitchen units and sink to be installed • Floor covering to be replaced in kitchen” There have been a number of improvements to the environment making it more homely and attractive for people. The people living at the home enjoy the addition of the plants in the entrance area. There are some spacious and fully assisted bathing and shower facilities in the newer part of the home. The showers in the original building have limited access for the current client group. We saw a range of specialist beds and other equipment in use at the home. The gardens and patio at the front of the home give an attractive outlook. However, the outlook from rooms at the rear of the building is not so good as this part of the grounds have yet to be landscaped. We discussed the security of the building with the manager and our concerns that the front door is unlocked and people have free access to the home. The Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 21 manager agreed that this was an area that should be reviewed with a view to locking the door whilst making arrangements for those people who are able to go out unsupervised. Staff had good knowledge on infection control and what they do to prevent the spread of infection. All staff said they had received training. Disposable gloves and protective aprons are readily available for staff. Staff said there are always plenty and they don’t have to ask for them like they used to. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. A trained and competent staff team looks after people. People are protected by robust recruitment procedures. We have made this judgement using available evidence including a visit to this service. EVIDENCE: Information in the AQAA stated – • “Staff rota’s are prepared in advance in a clear format taking into account service user dependency levels • Sufficient staff in all areas are on duty during 24 hours • Rota’s are prepared to ensure we have a good mix of skills, age, ethnicity and experience on the floor at all times • Over 50 of care staff is qualified to NVQ level 2, with many others enrolled on an NVQ training programme • Full recruitment check are made for all staff (CRB checks plus two satisfactory references) • All staff receive induction training”. How we have improved: • “Staffing levels have increased in all areas Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 23 • • • Staff training maintained and is ongoing Induction training in small groups for all new starters has proved to be very successful Staff retention rates have improved”. The provider has worked hard to improve the staffing levels in all areas including the establishment of an ancillary staff team, which provides very good support for the care staff. This means that the staff can give priority to their caring role and this has improved the quality of life for the people living at the home. The duty rotas showed that when there had been shortfalls through sickness, cover had been provided. One particular week showed a significant amount of sickness and we discussed with the manager ways of effectively monitoring staff sickness with the aim of reducing it where possible. What people said: • • The staff are very good, we all get on well. They are very nice, treat us well. What staff said: • • • • • • • • It’s a good place to work, good team work, good support, good management. Very happy with the staffing levels we have now. Usually we have enough staff, can be short if someone is sick, usually get cover though. We now have bank staff to cover staff shortages. Feel satisfied with my training. Not had any training recently but am due to go on some in next few months. Not had supervision recently, but can always ask for a chat or advice. Feel I am now getting the training I need, didn’t feel this before. Staff interacted really well with people at the home. There was a good rapport and atmosphere. Staff always responded to requests for any assistance in a positive and timely manner. It was not clear how training needs have been identified for staff. There appears to have been a fairly random approach to staff training. The manager said she was hoping to address this by making sure people had regular supervision meetings where their training needs would be discussed. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 24 Some people have done dementia awareness training. They spoke very highly of this and gave excellent examples of how this training had affected their practice. We also observed staff putting these skills into practice with people. ‘Back to basics’ training has proved to be successful in helping staff to properly understand how to look after people in a respectful way. Other training was planned for the coming two months in such topics as adult protection, catheter care and palliative care. Future training for staff needs to include medication training, infection control and National Vocational Qualification (NVQ) in care. We looked at the recruitment files of two people who had recently been employed at the home. Records showed that all the required checks were completed before staff started work at the home. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience adequate quality outcomes in this area. The management of the home is reasonably well organised and practices promote and safeguard the health, safety and well being of people living at the home. We have made this judgement using available evidence including a visit to this service. EVIDENCE: Information in the AQAA stated • “A new manager has been appointed at Care Croft and has been in post for four weeks Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 26 • • • • • The management team are caring and very approachable maintaining good relationships with all professionals, families and relatives The management ensure that service users are safe guarded and their best interests maintained Clear policies and procedures are available for staff to follow in all areas Promotion of health safety and welfare of service users and staff are promoted and protected The Home is run in a professional yet caring and comfortable manner aiming to accomplish more than the minimum standards”. How we have improved at the home in last 12months: • “New style of management now in place with more responsibilities being delegated an shared with senior staff • Staff feel more empowered and supported • Relaxed and happy atmosphere in the home” The newly appointed manager has worked at the home for a number of years most recently as the deputy. This is her first experience of managing a home. She has an NVQ at level 2 in care and is experienced in care. She provides continuity for people and knows the home well. As manager she will have to achieve an NVQ at level 4 in care and complete the registered managers award (RMA). She will have to develop her knowledge of the NMS and relevant legislation so that she fully understands her responsibilities as manager of the home. As manager she will also have to submit her application to be registered as manager as soon as possible. The manager is committed and enthusiastic about her role in continuing to improve the service and quality of life for the people living at the home. She is well supported by the provider and they work well together. The provider has written to people to inform them about the changes in the management arrangements. The provider was away at the time of the visit and so progress regarding the managerial changes was ‘on hold’. For example, the manager and her deputies do not have job descriptions as yet. There had not been any staff meetings or meetings with relatives or people living at the home. The manager said that all these arrangements would be made on the providers return from holiday. What • • • • staff said: The new manager is good at her job, easy to talk to and is fair. She puts things across in a positive way. Shows you what to do in a nice way. She is encouraging and makes you feel comfortable. DS0000066259.V369026.R01.S.doc Version 5.2 Page 27 Carr Croft Care Home • • • We feel listened to by the manager and the owner; you feel you can make suggestions. She is approachable and fair, doesn’t shout at you. Feel 100 comfortable with manager. Staff gave good examples of what they do to make sure they work safely. They spoke about accident recording, using safety equipment such as hoists and lifting belts. They also said they use wet floor signs and keep areas and doorways obstacle free. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 28 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP7 Good Practice Recommendations Work should continue to make sure that records provide good clear and specific information for staff so that they know how to look after people properly. Records should also consistently provide evidence of the care given to people. This should include a detailed daily record. This is to make sure that people are getting the care they need. 2 OP9 Staff should attend additional training courses on the administration of medication to make sure that their training follows current best practice guidance. This means that staff will understand how to handle and administer medicines safely. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 30 3 OP12 The provision of suitable activities and stimulation for people should continue and include those less able people. This is to make sure people at the home are not bored and will have more stimulation and occupation 4 OP18 Contact numbers for the local authority contact team should be readily available in the home so that staff can report any safeguarding concerns to organisations outside the home if they need to. All staff should have training on safeguarding adults. This is to make sure that people at the home are protected at all times 5 6 OP19 OP27 The suitability of the shared rooms for occupancy by two people should be kept under review. There should be a system to identify the training needs of staff. This will make sure that staff are properly trained to look after people properly. Carr Croft Care Home DS0000066259.V369026.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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