Inspection on 27/06/07 for Cragston Court

This inspection was carried out on 27th June 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cragston Court 20/09/05

Cragston Court 20/04/05

Cragston Court 08/11/04

Cragston Court 13/07/04

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Coalway Lane Nursing Home

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

CARE HOME ADULTS 18-65 Cragston Court Cragston Court Blakelaw Newcastle Upon Tyne Tyne & Wear NE5 3SR Lead Inspector Aileen Beatty Key Unannounced Inspection 27th June 2007 09:30 Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 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 Cragston Court DS0000000420.V337412.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cragston Court Address Cragston Court Blakelaw Newcastle Upon Tyne Tyne & Wear NE5 3SR 0191 286 4443 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) manager.cragstoncourt@careuk.com Care UK Mental Health Partnership Limited (Arc Healthcare Limited) Mrs Nazmah Cadersaib Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Cragston Court is a 20 bed care home with nursing providing care for adults with enduring mental health problems. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is owned by Care UK a large national care provider to a variety of vulnerable adult client groups. The home is situated in Blakelaw a suburb of the city of Newcastle upon Tyne close to local shops and good public transport links. The building is single storey and has 20 bedrooms all of which have en suite facilities. There are also three separate lounge areas, one of which is designated smoking, and a separate dining room. The philosophy of care in the home is to support the residents in their activities of daily living and to provide for their mental health needs. Information about the home is available in the form of the service user guide and statement of purpose for the home. The fees range from xxx to xxx per week. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on one day and was carried out by one inspector. The manager was present and spent time with the inspector. The inspection involved reading records such as staff and residents files, and information provided by the manager. The inspector spoke to staff and residents. There were no visitors present. There were no resident’s questionnaires available at this inspection. The inspection found that the overall standard of care is good in the home. There was one requirements set as a result of this inspection. What the service does well: What has improved since the last inspection? A number of areas in the home have been redecorated and furniture has been replaced. The home is well maintained and comfortably furnished. Residents are now involved in the recruitment of staff which means they have some say in the selection process. Pre admission assessment has been made more thorough so more information is now gathered before admission. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 6 A new activity organiser has been employed. Residents now receive more structured opportunities to join in activities. Menus have been changed to promote a healthy diet. This encourages residents to eat more healthily and improve their general well being. 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. The summary of this inspection report can be made available in other formats on request. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments are carried out before and after admission to ensure that people’s needs can be planned and properly met. Detailed information is available to help people make choices about the service before moving in. A detailed welcome pack is provided to all residents providing them with information about the home including terms and conditions. EVIDENCE: The manager or deputy visits all prospective new residents before they move into the home. A detailed assessment of their needs and any risks is carried out. The two care files examined contained detailed assessment information including a clinical assessment by an appropriate professional. A welcome pack is given to all new residents. It is noted in the care files read that they had received this information. The pack contains the statement of purpose of the home, which was revised in August 2006. It contains all of the Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 9 required information listed in schedule 1 of the care regulations including information about the structure of the home and the proprietor details, the numbers and qualifications of staff employed in the home, the range of needs the home is designed to meet and the age range and sex of people living there, arrangements regarding how their care needs will be reviewed and a copy of the residents complaints procedure. The welcome pack also contains a list of house rules and rights. Details of the human rights act and advocacy services are made available. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Effective care planning and involvement of residents ensures that their needs and wishes are reflected in care plans. Residents are well supported and encouraged to make decisions and choices by fully trained and experienced staff. Good risk assessment tools and appropriately trained staff help residents to take calculated risks as part of an independent lifestyle. EVIDENCE: The care plans of two residents were read. Both contain detailed care plans and evidence that residents have been involved in formulating and reviewing these. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 11 Care plans are detailed and written in a way that is easy to understand. There is evidence that residents have attended reviews and that contribute to discussions regarding their care. Residents receive a copy of their care plans. Care records contain personal details and information about the history of the resident. There is a checklist to the front of the file listing the contents. In each file checked there was a contract, key worker contract, psychiatric history, pre admission and admission assessment information, assessments from the source of referral such as hospital and care programme approach documentation. Residents are encouraged to make decisions. This is done by inviting them to meetings, and using questionnaires. A residents meeting was held on the day of the inspection and was reasonably well attended. There is evidence of residents exercising choices in their daily lives such as going out independently or deciding to spend time alone in their room. Risks are clearly assessed and documented. Care plans highlighting a specific risk may also have a contingency plan in place in case of things not going to plan. These assessments are very detailed and are broken down into specific areas. For example, an activities risk assessment records information such as whether the person is safe on outings, can do exercises, swimming, dancing, household chores and around smoking and alcohol consumption. These risks are then broken down further, for example, relating to outings, what are the specific risks? Such as uneven steps, communication problems, traffic awareness, using transport, fairground rides and attractions and criminal activity. Residents spoken to say that they felt well cared for and confirmed that they are involved in decisions about their care. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a broad range of activities for people to be involved in taking into account their individual needs and preferences. Residents are given good support from staff to remain involved within the local community. Staff understand the importance of helping residents to maintain appropriate personal relationships and do this very well. Residents are encouraged to make their own decisions and well-trained staff promote and respect these rights. A varied menu is provided and residents enjoy their meals. Mealtimes are an enjoyable part of the day. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 13 EVIDENCE: A new activity coordinator is in post who works twenty hours per week. A good variety of activities are available although there has sometimes been reluctance by some residents to take part in the past. The manager reported that the activity coordinator has had some success with encouraging some of the reluctant participants who are now joining in more and enjoying what they do. Activities may be one to one or in a group setting. There are regular trips such as visits to restaurants and cinema, the library or the shopping centre. Residents are encouraged to maintain links with the local community and attend coffee mornings at the local community centre. Contact with family and friends is encouraged and some people go out for overnight stays. There are regular barbeques in the garden are in the summer and takeaway meals brought into the home. A list of all activities is kept and those planned are pinned to the notice board. All residents have a care plan relating to activities and associated risk assessment. Residents spoken to say that they felt there was enough to do. A number of people were preparing for a weekend camping trip, which they were looking forward to. Individual activities are organised around the specific needs and interests of residents. One resident is doing a university degree for example. A new chef has been employed since the last inspection. Menus have been changed and there is a new focus on healthy eating. Residents spoken to say they are still getting used to the new menus and expressed some concerns that the new chef does not know how to cook plain English food. Others were happy with the meals provided. Menus are still being adapted and the residents meeting addressed this issue. The kitchen is well stocked and clean and well maintained. There are adequate supplies and fresh fruit and vegetables are delivered twice a week from local suppliers. Food that had been opened is wrapped and labelled and stored in the fridge. Cleaning schedules are up to date and the temperatures of food and fridges are checked regularly. There is evidence of menu choices being given and orders are taken the previous day. The new chef demonstrates a good awareness of special diets and supplementing food. All cooking is carried out using sugar substitute; this means that diabetics are able to have the same dessert as everyone else. The induction for the chef involved them spending time at another larger home which is good practice as this is the first time they have worked in a care setting. Residents have their own kitchen for making drinks and snacks. Fruit is always available. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff provide a good level of personal support to residents in line with their own needs and preferences. The physical and emotional needs of residents are clearly identified with clear plans in place to meet these needs. Good procedures are in place that protect residents receiving medication in the home. EVIDENCE: An assessment is carried out and regularly reviewed regarding the level of support required by residents. Records show that the level of support required varies and that residents are consulted about their routines, clothing and appearance. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 15 All residents are self caring in Cragston Court and the level of physical care provided is minimal. The home is staffed by registered mental nurses. Advice is sought from relevant professionals when necessary such as GP, or Psychiatrist. There are good medication procedures in place. Medicines are supplied by a local chemist and nurses are responsible for managing ordering and receipt of medicines. The nurse on duty was able to describe the process well. A random check of a controlled drug found the correct amount in stock. The manager audits medication records and will identify any gaps in records and bring this to the attention of the nurse responsible. It was confirmed by the CSCI pharmacist that these cannot be retrospectively completed by the nurses rather a note should be made on the reverse of the form. They were impressed by the system in place and vigilance of the manager. There is a policy in place regarding the death of residents in the home. This includes practical information such as pain relief, nutrition, oral and personal hygiene and specialist equipment. There is a verification of death policy. It was confirmed that a terminally ill resident could stay at the home if their needs could be met. Specialist care would be provided by visiting professionals meaning the resident could die in the home if they chose to do so. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place for ensuring that the views of residents are listened to and acted upon. Appropriate procedures are in place to make sure that residents are protected from abuse neglect and self harm. EVIDENCE: Every resident has been given a copy of the complaints procedure. It is also on the wall at various locations around the home and in the welcome pack in each bedroom. Residents may bring any concerns to the attention of the manager at any time or during residents meetings. The manager is aware that some residents still appear to forget about the procedure so it may be a regular agenda item as a prompt. Relatives are also made aware of the complaints procedure. There have been no formal complaints since the last inspection. Some concerns are recorded in the meeting minutes. Policies and procedures are in place regarding adult protection. Staff are aware of these and have received training and are booked to receive further training from Newcastle social services. The manager is also attending Multi-agency Safeguarding Training course. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. EVIDENCE: A number of areas in the home have been redecorated since the last inspection. A rolling programme is available for the decoration of rooms. All mattresses have been replaced and there are plans to replace all bedside cabinets and chests of drawers in October- November 2007. A tour of the premises was carried out. Communal areas including the smoking lounge are clean and tidy. Bedrooms are very nicely personalised making then homely and nothing like the hospital environment a number of people have been used to. The garden area is well maintained but the surrounding land is overgrown and unsightly. The handyman is responsible for maintaining this area and it is acknowledged that this has been difficult due to the prolonged Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 18 very wet weather. It is, however, a very large area, and the handyman also carries out all of the redecoration and repairs and safety checks in the home. It is recommended that some professional help is provided for maintaining the grounds, or some additional hours made available to the handyman who is currently struggling to fit everything in. Otherwise the home is well presented. Residents said they are happy with the home except that the TV’s don’t get as many channels as they should. There are new cleaning schedules in place. The home is cleaned by domestics care staff and residents. The standard of cleanliness varies in some bedrooms but residents are encouraged to maintain a reasonable standard. Choices or residents about how they live their lives. Privacy is respected unless it becomes an issue of safety and staff will intervene. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is excellent. Staff are well trained to enable them to be competent and adequately qualified to support residents. Recruitment procedures are robust and protect residents from the risk of abuse or neglect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a strong emphasis on the importance of training in the home. Statutory training is provided and the manager is skilled at seeking out new learning opportunities for staff. A training schedule was available for inspection detailing training completed and training due. The home has been awarded its first accreditation towards becoming a “Centre of Excellence” by Leeds Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 20 University. All staff either hold NVQ level two or above or are working towards it. Two staff files for the newest members of staff were checked. Both contained all of the required information including references and criminal records checks. Residents meet applicants and then contribute their opinions as part of the recruitment process. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well run in the interests of residents. There are good systems in place to ensure that the views of residents underpin all self monitoring in the home. There are good health and safety procedures in the home that are followed by staff. EVIDENCE: Naz Cadersaib is a highly qualified and motivated manager. During the first part of the inspection, the manager was not present. The staff member on Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 22 duty was very knowledgeable and it is clear that the home operates well in the absence of the manager. The manager is very experienced and committed to providing the highest standard of care possible. Her attitude towards providing the best for the residents is also extended to staff who she endeavours to support to develop new skills and to share their views. Resident’s surveys are carried out regularly and residents meetings are used to gain the views of residents and to remind them of the existence of some policies and procedures such as complaints and privacy. In addition to working towards becoming a Centre of Excellence, the manager is also the Royal College of Nurses representative regarding equality and diversity issues. This demonstrates that she is constantly gaining new skills and developing areas of special interest. There are good safety procedures in the home. The handyman carries out most maintenance checks. These include alarm tests, emergency lighting, and fire fighting equipment, water temperatures of boilers and taps and checks pipes and radiators for signs of damage. A safety tour is carried out and areas visually inspected for damage or hazards. This includes external paved areas and walls, and windows and doors. The home has CCTV in operation outside the building. There were no hazards identified by the inspector during this inspection. Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 X 3 X X 3 X Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 24 NO 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. Standard YA24 Regulation 23 2 (o) Requirement The overgrown garden areas must be tidied and maintained to a satisfactory standard. Timescale for action 27/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northumbria House Manor Walks Cramlington NE23 6UR 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. Extracts may not be used or reproduced without the express permission of CSCI Cragston Court DS0000000420.V337412.R01.S.doc Version 5.2 Page 26 - 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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