Inspection on 25/07/05 for Craighaven Residential Home

This inspection was carried out on 25th July 2005.

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

The inspector 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

Craighaven Residential Home 05/08/08

Craighaven Residential Home 15/08/07

Craighaven Residential Home 14/11/06

Craighaven Residential Home 02/03/06

Similar services:

Coton Hill House

Doddington Lodge

Far Croft

Churchill House Nursing and Residential Home

Field Farm House

Church Terrace Nursing & Residential Home

Fountain Court

The Forbury

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

CARE HOMES FOR OLDER PEOPLE Craighaven Residential Home 4 Heath Terrace Leamington Spa Warwickshire CV32 5LY Lead Inspector Louise Thompson Unannounced 25 July and 3 August 2005 th rd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Craighaven Residential Home Address 4 Heath Terrace Leamington Spa Warwickshire CV32 5LY 01926 429209 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Craighaven Limited Ms D Gibbs PC 35 Category(ies) of DE(E) 35 registration, with number of places Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection first inspection Brief Description of the Service: Craighaven provides care and accommodation for 35 older people and has specialist dementia care registration.The home is located in a residential street in the Milverton area of Leamington Spa, approximately 1 mile from the town centre. There are local shops, a post office, pub, hairdressers and churches located within half a mile of the home. Doctors’ surgeries, dentists, chiropodist etc, are readily available and within easy access of the home. Craighaven provides accommodation on two floors, and there are four lounge areas. The home has a variety of equipment and adaptations including handrails, grab rails, mechanical and electrical hoists, adjustable beds, raised toilet seats and wheelchairs. There is a public telephone available. Service users can if they choose make arrangements to have their own telephone installed in their own private room.The home is set in its own grounds and benefits from a safe garden area which is attractive well maintained and accessible. There is a variety of garden furniture. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two visits. First visit was between the hours of 9.30 am and 5pm. The second visit was between 11.30 and 1pm. Staff co-operated fully with the inspection. The manager was present at the second visit. The inspection process involved a tour of the home, talking with the deputy manager and manager, examining records and care plans, observation of care practices along with discussions with residents, staff and relatives who were visiting on the day of the inspection. Current residents were unable to express their opinions on the service. Craighaven has recently changed ownership and a new manager has been appointed. This was the first inspection of the new registration. The manager demonstrated that she has a good understanding of the areas in which the home needs to improve and is developing a suitable action plan to ensure that these are addressed. What the service does well: What has improved since the last inspection? What they could do better: Assessment and care planning must improve so that the staff are able to know what to do for each resident. The recording and storage of medicines needs review to ensure that medicines are given and stored correctly. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 6 The refurbishment of current bathing facilities and improvements in décor throughout parts of the home are necessary to ensure a safe and comfortable environment for people living in the home. Proper employment checks are necessary to ensure that applicants are suitable to work with the residents. Menus should be developed and choices made available at mealtimes so that the home is able to meet individuals’ needs and food preferences. 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. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Care plans need improving to ensure that the arrangements for health,personal and social care needs of residents are identified and planned for. Shortfalls have the potential to place residents at risk.Systems for the mangement and administration of medicines are improving .Staff practice in maintaining privacy and dignity are good. EVIDENCE: Individual care plans are available for each resident and are based on a person centred model. Files of four residents were viewed. Assessment details recorded on admission to the home were incomplete for three of the files observed. Care plans were brief and lacking in specific detail. Daily entries in care records identified changing care needs, which were not always reflected in resident care plans. Daily statements for one resident recorded several falls over a period of time. This was not reflected in the risk assessment or care plan. Daily statements for a further resident recorded changing behaviours for which advice was sought from the community nurse. This was not reflected in the care plan. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 10 Monthly evaluations by keyworkers do not adequately reflect the residents current care changes/needs. Risk assessments for moving and handling, risk of falls and nutrition were on three files viewed these were not fully completed in some cases. Discussion with staff suggested that needs were being addressed even though there was lack of specific care plans. This approach is dependent upon good verbal communications and staff memory. The new manager said that she was aware of the problems with the current care plans and intends to implement new care documentation. Current residents are unable to express their opinion of the services provided. One relative who was visiting told the inspector that she was happy with the care provided and that her husband was well looked after. The inspector spent time in the lounge observing care delivery and staff/resident interactions. The residents were all appropriately dressed and appeared well cared for. Residents observed were showing signs of well-being and interacted well with the staff. Staff observed were kind and caring. Access is available to health professionals outside of the home, which includes the Chiropodist, GP, District nurses and the Dentist. Systems for the management and administration of medications were observed and the following issues of concern were discussed with the manager. • Some medications are currently stored in locked filing cabinets and access to keys is unrestricted. • Medications entering the home are currently not recorded. • Omissions were observed on some MAR sheets. • MAR sheets for some medications state give as directed, and medication prescribed as required did not specify reasons for their administration. Staff were observed treating the service users with dignity and respect during the inspection. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Meals are nutritious but menus are lacking in choice and variety and residents’ preferences may not be met. EVIDENCE: The inspector observed lunchtime during the first day of inspection. The meal was attractively served and tasty. There were no alternative choices at lunchtimes and an inspection of records demonstrated that menus lacked sufficient variety and choices. Staff told the inspector that they were aware of each resident’s likes and dislikes. Staff told the inspector that menus had recently been reviewed. The meal at lunchtime was lasagne. Care records of two residents observed during the inspection stated that the residents disliked meat. There was no alternative meal choice for these residents. The kitchen area was clean and tidy. Staff told the inspector of the plans to move the office area out of the kitchen and refurbish and improve the current facilities. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Vulnerable adults policies and procedures need further development to ensure that people living in the home are protected from abuse. EVIDENCE: A procedure for responding to allegations of abuse is available this requires review to reflect local authority guidance for staff. Staff told the inspector of the action that they would take should they suspect or witness abuse confirming that they are aware of what to do. Training records indicate that not all staff have had an update in the protection of vulnerable adults. Dates for this training is planned in early December. There have been no reported allegations of abuse. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is in need of some improvements to provide a well-maintained environment with sufficient, suitable equipment and facilities, which ensures safe and comfortable surroundings are provided for residents. EVIDENCE: Craighaven provides care and accommodation for 35 older people and has specialist dementia care registration. Communal lounge and dining areas are provided on the ground floor. Access to upper and lower floors is by stairs or stair lift.The home is set in its own grounds and benefits from a safe garden area which is attractive well maintained and accessible. The current owner has recently purchased Craighaven. In the short time since change of ownership attention has been given to the outside décor. The manager told the inspector of future refurbishment plans for the home, which include the replacement/refurbishment of bathroom facilities. Resident rooms will be refurbished as they become available. One room on the ground floor has been refurbished and redecorated to a good standard. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 14 The home was clean and tidy and there were no obvious odours at the time of the visits. The home does not have a sluice facility the manager is considering where this may be situated within the home. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Staff levels and skill mix are maintained and sufficient in number to meet the residents’ needs. The procedures for the recruitment of staff require review to ensure the protection of the residents. EVIDENCE: Duty rotas observed demonstrated that agreed staffing levels and skill mix were being maintained. Some staff were doing additional shifts to provide cover. The deputy manager said that working time agreements were held on staff files. Domestic and laundry hours have been increased by the new owner/manager. This is evident in the standards of cleanliness and hygiene observed during this inspection. Staff said that the increase in ancillary staff hours ensured that care staff had more time to spend with residents. The staff files of three recently appointed staff members indicated that the previous manager had not completed all the necessary recruitment checks to ensure the protection of residents. Two references were only available on two of the three files viewed, gaps in employment were not recorded and one file contained no evidence of personal identification and training. The work permit arrangements for one staff member was unclear. The new manager had completed an audit of staff files prior to the inspection and had identified shortfalls and was in the process of obtaining this information at staff appraisals. A number of Criminal Record Bureau Checks (CRB), which were outstanding, have been requested. The manager said all staff have received new contracts of employment. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 35 The newly appointed manager has a clear vision for the home and a good understanding of the areas in which the home needs to improve. Procedures for the management of resident monies ensure that financial interests are safeguarded. EVIDENCE: The current manager has recently been appointed and registration has been approved by the CSCI. Conversations with the manager demonstrated that she has a good understanding of the areas in which the home needs to improve and is developing a suitable action plan to ensure that these are addressed. Staff told the inspector that changes are being implemented following discussion with the staff and that they are informed and involved in the planning of these. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 17 Residents manage their own finances with support for family or legal advisors. Records for the management of resident pocket money accounts were examined and were satisfactory. Access to the safe is restricted and money is kept in separate wallets. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x 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 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x x x 3 x x x Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 19 NA 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 OP 7 Regulation 15 Requirement The registered manager must ensure that care plans and risk assessments are current and set out in detail each service users health, personal and social care needs. Care plans should be reviewed monthly. The registered manager must provide suitable cupboards for the storage of medications and review the security of keys to medication cupboards. The registered manager must ensure that a record is maintained of medications received into the home. Accurate records must be maintained of medications administered. Medications prescribed as prn must indicate reasons for administration. The registered manager must review the menus and ensure that alternative choices of meal are available to meet residents needs. The registered manager must review the vulnerable adult procedure. Staff must be made aware of changes to this policy and Timescale for action 30.10.05 2. OP 9 13 30.10.05 3. OP 9 13 30.8.05 4. OP 15 16 14 31.09.05 5. OP 18 12 , 13 31.12.05 Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 20 6. OP 19 23,13, 16 7. OP 29 17, 19, Schedule 2 training provided to staff as appropriate. The registered manager must provide the commission with a timed action plan for the refurbishment of the home. The registered manager must ensure that recruitment procedures are robust and that staff files contain evidence of all information as specified in Schedule 2 of the Care Homes Regulations 2001. References and Criminal Records Bureau disclosures must be obtained prior to commencement of employment. 30.9.05 30.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 15 Good Practice Recommendations The inspector recommends the use of photographic menus to assist residents to identify their choice of meal. Craighaven Residential Home E53 S63561 Craighaven V240017 250705 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa Warwickshire CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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