Inspection on 06/03/06 for Crabwall Hall

This inspection was carried out on 6th March 2006.

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 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

Crabwall Hall 20/10/06

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

CARE HOMES FOR OLDER PEOPLE Crabwall Hall Parkgate Road Mollington Chester Cheshire CH1 6NE Lead Inspector A Gillian Matthewson Unannounced Inspection 6th March 2006 09:30 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 Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 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. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crabwall Hall Address Parkgate Road Mollington Chester Cheshire CH1 6NE 01244 851202 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) Avery Healthcare Limited Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of 32 service users in the category OP (Old age, not falling within any other category) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and shall comply with any guidance that may be issued by the Commission for Social Care Inspection 27/09/05 3. Date of last inspection Brief Description of the Service: Crabwall Hall is a two-storey care home standing in extensive grounds. It enjoys a rural setting off the A540 in the village of Mollington, and is approximately 2 miles from Chester city centre. Sited on a former dairy farm, the premises were purpose-built to incorporate one of the original farm buildings as a feature of the home. There are adequate car parking facilities available. Residents are accommodated on both floors. Access between floors is via the shaft lift or the stairs. Residents accommodation consists of 32 single bedrooms all of which have en-suite facilities, telephone sockets, call points and an internal telephone. The majority of bedrooms meet or exceed the room size standards. There is a large lounge/dining room and separate lounge on the ground floor, and a library/study on the first- floor. Additionally, there is another small sitting area by the lift on the first-floor. Communal toilet/bathroom facilities comprise 5 toilets, 4 bathrooms, one shower-room and a hairdressing salon. The home has extensive gardens and grounds that are fully accessible to residents. There is also a large patio area adjacent to, and accessible from, the home’s ground-floor lounge and dining areas. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out on Monday 6th March 2006 and lasted for four hours and thirty minutes. An assistant manager was on duty together with the agreed numbers of senior, care and ancillary staff. Thirty two people were living in the home at the time of the inspection. During the visit eleven residents, one visitor and the staff on duty were spoken with. A range of care, health and home records were examined and a tour of the premises, including all communal areas, bedrooms, bathrooms and laundry was undertaken. Since the last inspection the home has been bought by Avery Healthcare Ltd. The registered manager, who was also the previous proprietor, retired on change of ownership. Although residents said they missed her they had no complaints about the change and remained extremely positive about the standards of care. At the end of the inspection feedback was given to the Responsible Individual, Ian Matthews who is the Commercial Director of Avery Healthcare Ltd. What the service does well: The staff members working at the home provide a good quality of care to the residents that live there. The residents spoken with confirmed this opinion by making a number of positive comments regarding Crabwall Hall. These included “I am very lucky to have obtained a place here”, “I love looking out at the countryside and that staff will take me for a walk in the grounds”. Good relationships were seen to exist between residents and staff. Residents considered that routines within the home were flexible and that this gave them control over their lives and enabled them to be more independent. A variety of activities/social events are provided. Catering within the home is well managed and all residents said the food was very good. They also said that they were offered choices at mealtimes. Standards of décor, furnishings and fittings are commendably high throughout the home, as are standards of hygiene and cleanliness. Recruitment procedures and staffing levels ensure that residents’ needs can be met. There is a good system in place for the management of any residents’ monies handed over for safekeeping. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 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. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were assessed at this inspection. Standard 3 was assessed as being met at the previous inspection. Standard 6 is not applicable. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. All residents have a care plan that shows how their individual needs are being met. The systems used to identify and meet an individual residents needs are good. Residents’ privacy and dignity are maintained. EVIDENCE: The two care plans seen as part of the case tracking process provided staff members with the necessary information for them to meet the residents’ needs. There was written evidence to confirm that care plans were being reviewed on a monthly basis or as necessary. The care plans seen contained evidence of consultation with residents or their families/advocates. Records relating to support from other professionals such as GP visits, community nurses, optician, dentist and chiropodist were available. It was evident that the health and well being of residents was carefully and appropriately monitored, and an appropriate record of health care needs and actions taken was kept. Medication was stored in a locked cupboard and a medicine trolley that only senior care staff had access to. Medication administration record (MAR) sheets Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 10 were completed with the amounts of medication received and medication administered. There were a few gaps on some of the MAR sheets that implied that prescribed medication had not been administered at those times, but there was no explanation as to why. See Requirement 1. The assistant manager was observed administering medication at lunchtime in an appropriate manner. The home did not have any Schedule 2 controlled drugs at the time of the inspection, but did have Temazepam in stock, which is required to be stored in a controlled drugs cabinet. It was stored in a locked chest within the medicine trolley. The Commission advise that controlled drugs are not stored in a mobile trolley. See Recommendation 1. All personal care was carried out in the privacy of a resident’s bedroom or one of the bathrooms. Residents spoken with confirmed that they had been able to express their opinions and wishes about their daily routines and that staff were flexible. Staff members were observed interacting with residents in an appropriate, dignified and respectful way; they were seen to address residents appropriately according to their recorded wishes. Residents had use of a telephone in private and personal mail was delivered unopened. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15. Routines at the home are flexible to suit residents’ individual preferences and there are opportunities for recreational activity. The meals are good and offer both choice and variety. EVIDENCE: Residents confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend time and with whom. Staff members were observed to knock on the door and to await permission before entering a resident’s bedroom. The residents spoken with made wholly positive comments during the inspection; these included “Nothing is too much trouble”, “Staff are wonderful”, “ There are no restrictions”. A monthly programme of activities is provided and all of the residents are given their own personal copy. The one provided during the inspection listed on a daily basis what events or activities had been arranged for the month. Residents confirmed that various religious denominations conduct services in the home and they are free to attend if they wish to do so. A beauty and massage therapist visits the home on a regular basis, and residents are able to purchase various treatments. There is also a visiting hairdresser. Newspapers and magazines are delivered daily to order and there is a trolley shop that Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 12 goes round the home at weekend. On the day of the inspection the residents were looking forward to the evening entertainment, which was to be three singers performing ‘Songs from the Shows’. Meals could be taken in the dining room or in the privacy of residents’ own rooms. The menus had the flexibility to meet individual needs and choices. At lunchtime residents were provided with the menu for the following day in order that they could make their choices. There was a choice of two main courses at lunchtime with a sweet, and soup with a selection of sandwiches or a hot snack at teatime. All of the residents that commented said that the food was very good and that choices were available. One resident said “the food is marvellous”. Residents had access to a small kitchen and were able to prepare their own drinks or snacks if they wished. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents are able to voice their opinions and are confident that appropriate action would be taken to address any problems or complaints. EVIDENCE: There is a written complaints procedure for the home; this is included in the Statement of Purpose and Service User Guide. A complaints book is available in the reception area. Residents were aware of their right to complain if they were unhappy with any aspect of the service they received at Crabwall Hall. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24 & 26. The home provides excellent facilities to meet the needs of the residents accommodated. Standards of hygiene and cleanliness are very high. EVIDENCE: A tour of the premises indicated that this standard was exceeded. The home both externally and internally is maintained to a very good standard and standards of décor, furnishings and fittings were commendably high throughout the home, as were standards of hygiene and cleanliness. All bedrooms had en suite facilities. There were seven additional toilets, four bathrooms and two shower rooms. Three of the bathrooms were assisted and both showers had wheelchair access. All bedrooms were equipped with a call system, remote controlled television, BT external telephone socket and also an internal telephone for talking to staff. There were also grab rails and other aids provided as necessary. Bedrooms seen during the inspection were personalised, comfortable, well-furnished and contained items of furniture belonging to residents’. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 15 The home was found to be clean and tidy on the day of inspection. The laundry was appropriately equipped. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Recruitment procedures and staffing levels ensure that residents are protected and their needs can be met. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff were adequate to meet the needs of the residents within the home. The staff members seen on the day were cheerful and friendly and residents were complimentary about staff attitude and competence. Comments included “they are very pleasant”, “you can give them a good report”, “the staff are wonderful” and “they are very kind and helpful”. Seven out of twenty eight care staff have an NVQ Level 2 in Care and one has nearly completed the course. This does not meet the standard that 50 of staff are trained to this level. See Recommendation 2. Three staff files were examined. All the required information and documentation had been obtained prior to employment, but the staff files did not contain a recent photograph of each staff member. See Recommendation 3. Staff files also did not contain any evidence of induction apart from the basic information provided on the first day. The two most recently employed care staff on duty were interviewed about their induction. Both said that they had worked two shifts on a supernumerary basis with a senior carer and introduced Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 17 to the residents and the home’s routines. There was no documentary evidence that staff had received training or achieved the Skills for Care induction standards. These are; understand the principles of care, understand the organisation and the role of the worker, maintain safety at work, communicate effectively, recognise and respond to abuse and neglect and develop as a worker. However, given the nature of the positive comments from residents it was clear that staff were meeting most of the standards. See Recommendation 4. Other recent staff training had included the following; fire safety training in December; medication, health and safety and moving and handling training in January; first aid training in February. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35. Residents’ monies are well looked after. EVIDENCE: There was an acting manager in post who was on holiday at the time of the inspection. An assistant manager was in charge on the day. The registered provider had advertised for a new manager. Most residents managed their own financial affairs, but the home held cash for six of the residents who had requested this service. Each resident’s money was kept in a separate compartment of a box, which was locked away. Only three staff had a key. A balance sheet was maintained for each person detailing credits and debits and a running balance. Receipts were kept. All were audited and found to be correct. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 19 Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 4 4 3 3 3 4 X 4 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X x Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement The registered person must ensure that any reasons for nonadministration of medication are recorded on the MAR sheet. Timescale for action 17/03/06 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 OP9 OP28 OP29 OP30 Good Practice Recommendations It is strongly recommended that Temazepam be stored in a controlled drugs cupboard that is affixed to a wall. Steps should be taken to increase the number of staff who are trained to NVQ Level 2 in Care. Staff personnel files should contain a recent photograph of the member of staff. Staff induction records should demonstrate that each member of staff has achieved the Skills for Care induction standards within the first three months of employment. Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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. Extracts may not be used or reproduced without the express permission of CSCI Crabwall Hall DS0000065424.V281909.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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