Inspection on 18/01/06 for Craigarran Care Home

This inspection was carried out on 18th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Craigarran Care Home 09/02/09

Craigarran Care Home 09/01/08

Craigarran Care Home 08/03/07

Craigarran Care Home 24/06/05

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Craigarran Care Home Margaret Terrace Deaf Hill Trimdon Station Co Durham TS29 6PG Lead Inspector Mr Stephen Ellis Unannounced Inspection 18th January 2006 2:00 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 Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Craigarran Care Home Address Margaret Terrace Deaf Hill Trimdon Station Co Durham TS29 6PG 01429 880550 01429 882100 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) Mr Matt Matharu Mrs Jean Kennedy Brenda Hall Care Home 35 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (35), Physical disability (5), of places Terminally ill (4) Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th June 2005 Brief Description of the Service: Craigarran is a long established care home with nursing, provided by a business partnership of Mr Matharu and Mrs Kennedy, who became the registered providers on 26th January 2005. It is mainly a single storey building (although there are some offices situated on the first floor) built in a rectangle, enclosing an inner garden. It is located near to the centre of town and there is reasonable access for people with mobility problems, from the back and the front. It is principally a care home for older people, including some older people with dementia, plus a small number of people with physical disability over the age of 55 years. Nursing care is provided for those who have been assessed as needing general nursing care. Accommodation is spacious and accessible. All bedrooms are large singles with en suite toilets and wash hand basins. Social and recreational activities are available and visitors are welcome at all reasonable times. All meals and beverages are supplied. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.25 hours. The inspector looked around the building, examined a number of records, and spoke to 12 residents, 3 relatives and 4 staff, including the registered manager. What the service does well: What has improved since the last inspection? Two new bedrooms have been created, each with en suite facilities, increasing the number of registered beds to 35. A new staff room has been made plus a sheltered smoking area for staff. Redecoration of corridors has commenced, creating a more light and airy space. Further work is planned, including the installation of magnetic catches for corridor fire doors. Improvements to car parking and access to the home are underway. Staff training in NVQ has progressed and over 50 of care staff members have achieved NVQ level 2 in care. At least 4 care staff members are working towards NVQ level 3 in care. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 6 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. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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 Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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): 3 and 6. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Intermediate care is not provided. EVIDENCE: Comments received from residents and relatives were complimentary about the assessments of needs carried out before admission. They felt that these assessments were accurate and were satisfied that the home was capable of meeting residents’ needs. These observations were supported by documentary evidence in case files. The services and facilities provided were found to be appropriate for the assessed needs of service users. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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 and 10. Service users’ health, personal and social care needs are well set out in their individual plans of care. There are good arrangements for medicines. Residents’ health care needs are fully met. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Comments received from residents and relatives were positive and complimentary about the arrangements for health, social and personal care. As one relative said: “It’s a good home with lots of strengths”. Another relative said: “I’m quite satisfied; the staff are very good and the manager has the patience of a saint”. Several residents commented on the helpfulness of staff and felt that their individual needs were well understood. They felt they were treated with respect and their right to privacy was upheld. One relative was concerned about the delay over Christmas in the medical treatment of her mother who was unwell. However, these events were outside the control of the home; medical tests were carried out and treatment commenced within four days of referral. Nonetheless, the manager acknowledges the concern expressed and would also like a speedier service where possible. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 10 Care plans that were examined showed that residents’ needs were clearly identified and reviewed at appropriate intervals. The plans of care were detailed and comprehensive, providing a useful guide to care practice. These were regularly discussed with residents and their families where appropriate. A very good standard has been achieved. The manager reported very good links with local Primary Care Trusts, including medical and nursing personnel who visit the home regularly. There are good arrangements for medicines at the home. A monitored dosage system (blister packs) is used. There are good storage and administration procedures. No resident currently self-medicates, although the facility exists, subject to risk assessment. Residents were happy with the arrangements for their medicines. Registered nurses take responsibility for the administration of medicines. Further training in the safe handling of medicines is planned. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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, 13, 14 and 15. Residents experience a satisfying lifestyle that matches their expectations and preferences. They are encouraged to maintain contact with family, friends and the wider community as they wish. They are helped to exercise choice and control over their lives. Catering arrangements are very good, providing wholesome, appetising menus with good choice of meals and beverages. EVIDENCE: Residents said that they enjoyed living at Craigarran. They described the staff as being caring and helpful. They could exercise choice in their daily lives. For example, they could decide what clothes they wore and how they spent their days, including what times they got up and went to bed. They said that there was a varied programme of social and recreational activities, including visiting entertainers, music and movement, board games and reminiscence. One member of staff takes a lead in organising social events. Events held in December included a visiting entertainer and Christmas party. Residents could pursue individual interests if they wished, such as reading or television. A Golden Wedding anniversary was celebrated at the home recently, involving family and friends, with a buffet meal and wine supplied by the home. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 12 Residents said that visitors were always made welcome and could call at any reasonable time. Some residents went out with relatives or friends for part of the day. Many residents said they liked the atmosphere in the home, describing it as being friendly, supportive and caring. They liked the small groups in the various lounges. They were free to sit in any lounge, in their own bedroom, or in the reception area or dining room. All were satisfied with the arrangements for daily life in the home. Many enjoyed listening to nostalgic songs and music being played in the reception area. All the residents spoken to said the catering was very good. There was a good choice and the Cook understood their preferences. Residents mainly dined together in the dining room. They could, however, eat their meals elsewhere and at different times if required. Records are kept of meals served. Carol the Cook and 3 members of staff have done the “Focus on Food” course, which involves nutritional profiling and screening for individual service users. These documents are held in care plans. Staff members were observed to take time to assist residents who required help with their meals. The dining room setting was relaxed and pleasant, including tabletops that were attractively arranged. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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): 18. Residents are protected from abuse. EVIDENCE: Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training to ensure they have the right knowledge and skills to do their jobs competently. A good number of care staff members have completed Protection of Vulnerable Adults training, such as “No Secrets”. However, more training in this important area is planned. Residents and relatives reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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 and 26. Service users live in a safe environment, but some maintenance matters have been delayed. The home is clean, pleasant and hygienic. EVIDENCE: There were no unpleasant odours and the home was found to be clean in all the areas inspected. Care staff members have had training in Fire Safety, Infection Control and Food Hygiene. Paper towels and liquid soap were provided in toilets and bathrooms in wall-mounted containers, to promote hygienic practices (although residents have personal flannels and towels in their rooms). Residents said that they were pleased with the premises, finding them comfortable and homely as well as practical. Key maintenance and repairs are being carried out as required. However, there has been delay in completing some maintenance work or in carrying out smaller tasks. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 15 For example, the fitting of suitable locks to bedroom doors has been delayed for at least 12 months. Also, the fitting of appropriate signs or labels to two toilets off the reception area is overdue and the subject of concern expressed by several relatives. Other concerns expressed by relatives have included access problems due to a work van parked by the front entrance (since resolved), outstanding repairs to a wardrobe, pressure relieving mattress and call point in a bedroom, plus delays in completing work to corridor fire doors. These and some others like them mount up and contribute to a sense of frustration experienced by some service users and/or their relatives. These ‘customer care’ issues, along with early remedial action, should be given priority. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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 and 30. Staffing numbers and mix of skills are appropriate for the needs of residents. Staff members are trained and competent to do their jobs, with just over 50 having NVQ level 2 or above. The home’s recruitment policy and practices support and protect residents. EVIDENCE: Residents and their relatives said that staff members were helpful and caring in meeting residents’ needs. Residents did not have to wait long for assistance when it was needed. The home is staffed in accordance with the guidance issued by the previous regulatory authorities. At the time of the inspection there were 28 people being accommodated: 17 with nursing needs and 11 without. Typically, there are 5 care staff on duty each morning (8 am to 1 pm) plus at least one registered nurse; 4 care staff plus 2 nurses on an afternoon (1 pm to 4 pm) and 4 care staff plus 1 nurse in the evening (4 pm to 9 pm). At night, there are 2 care staff and one registered nurse on duty. In addition, there is an activities organiser (20 hours per week) although the post holder is currently on long-term sick leave. Most of the registered manager’s hours should be supernumerary, to enable the registered manager to carry out management duties as well as maintain and develop clinical skills. At present, this is not always happening. Administrative, domestic and catering hours were satisfactory. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 17 There is also a full-time maintenance officer, although the post holder is currently on sick leave. Good programmes of staff development and training were evident, including NVQ levels 2 and 3, infection control, fire training, palliative care, dementia awareness and “focus on food”. Further training is planned, including safe handling of medicines, moving and handling, protection of vulnerable adults and first aid. Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training so that they have the right knowledge and skills to do their jobs competently. Most care staff members have completed Protection of Vulnerable Adults training. Residents reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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): 31, 33, 35 and 38. The manager of the home is fit to be in charge, of good character and able to discharge her responsibilities fully. The home is run in the best interests of residents. Residents’ financial interests are safeguarded in those situations where the home is involved. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager is experienced and competent in her role. Residents and staff spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable and caring. She expects to commence training and assessment for the Registered Manager’s Award at NVQ level 4 during 2006. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 19 Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home helps look after residents’ monies, such as pocket monies, clear individual accounts and records are maintained. Comments received from staff and management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety, infection control and food hygiene. This helps reinforce the registered provider’s written policies on Health and Safety. Health and Safety issues are also discussed at quarterly staff meetings, impromptu staff meetings and at shift handovers, wherever appropriate. Residents and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. Some relatives expressed concerns about a number of issues that, individually, were comparatively minor. However, when added together, the concerns became more significant. As previously reported, this level of frustration suggests that the provider’s customer care policies and practices need to be reviewed and improved. For example, the home’s annual survey of residents’ satisfaction could be brought forward, with the findings and provider’s action plan being reported within the home. There is also a need for the registered provider’s representative to report on the findings of his monthly, unannounced visits to the home, in keeping with regulation 26 of the Care Homes Regulations 2001. Copies of the report should be sent to the Commission for Social Care Inspection and the home’s manager. Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP24 Regulation 12 Requirement Suitable locks are still required to be fitted to bedroom doors. The timescales for completion were 01/06/05 and 01/11/05. Fire doors, including bedroom doors, must only be held open with devices approved by the Fire Service, such as electromagnetic catches. The timescale for completion were 01/04/05 and 01/10/05. Two toilets off the reception area need to be relabelled to avoid confusion. More attention should be given to ‘customer care’ issues, especially when the home is undergoing significant changes. The registered provider’s representative is required to report on the findings of his monthly, unannounced visits to the home, in keeping with regulation 26 of the Care Homes Regulations 2001. Copies of the report should be sent to the Commission for Social Care Inspection and the home’s DS0000062500.V271519.R01.S.doc Timescale for action 01/05/06 2. OP19 23 01/04/06 3 4 OP19 OP33 23 12, 24 01/03/06 01/03/06 5 OP33 26 01/03/06 Craigarran Care Home Version 5.0 Page 22 manager. 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. Refer to Standard OP31 OP31 Good Practice Recommendations The registered manager is expected to achieve a relevant management qualification during 2006. It is desirable for the registered manager to have more supernumerary hours so that she can combine management duties with her nursing work with service users. The new staff room is likely to benefit from improved ventilation, and the fitting of an extractor fan should be considered. 3 OP19 Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Craigarran Care Home DS0000062500.V271519.R01.S.doc Version 5.0 Page 24 - 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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