CARE HOMES FOR OLDER PEOPLE
Craigneil Seaborn Road Bare Morecambe Lancashire LA4 6BB Lead Inspector
Ajam Auckburally Unannounced Inspection 10:00 8 November 2007
th 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 Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Craigneil Address Seaborn Road Bare Morecambe Lancashire LA4 6BB 01524 831011 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 Barry Hinde Mrs Suzanne Marie Hinde Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2nd June 2006 Brief Description of the Service: Craigneil is situated on Marine Road in Morecambe and facing the promenade. The home is a two-storey building and is registered to provide accommodation for a maximum of fifteen older people of both sexes who are aged 65 and over. Accommodation is provided in 13 single and 1 double bedrooms. The double room is used for married couples or people who wish to share. At the time of the inspection a single occupant was using this room. Communal facilities include a lounge and a lounge /dining room. A patio garden area facing the sea front is available for the residents to enjoy. The home is staffed around the clock to meet the needs of the residents. Craigneil is close to some amenities. A small shop and a church are within a few yards of the home. There were 14 residents living at the home at the time of the inspection. Current weekly fees are between £330 and £380 and additional extras like hairdressing, newspapers and private chiropody are paid for by the residents. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Under IBL (Inspecting for Better Lives) Craigneil was assessed as requiring a statutory key visit (inspection) between April 2007 and March 2008. An unannounced key site visit was carried out on 8th November 2007. The inspection lasted 4.5 hours. An expert by experience who is member of the public with experience in the care of people accompanied the inspector on this inspection. Experts by experience are recruited and trained by organisations like Help the Aged. She spoke to the residents and had a meal with them. Extracts from her findings are included in this report. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a friendly atmosphere and with the full cooperation of the staff and the residents. During the inspection, some records were looked at and all the residents and the staff were spoken to. The residents were very positive about the care they receive and the way the staff treat them. Every year we asked the registered person to supply us with written information about the quality of the service they provide and to make an assessment of the quality of their service. A pre inspection questionnaire called the AQAA (Annual Quality Assurance Assessment) is sent for the manager of the home to complete and return. We use this information, in part, to focus our inspection activity. The completed questionnaire gave information about several areas such as staffing, checks that the home has made about the safety and maintenance of the building, equipments, information about residents and other useful information. The AQAA also requests information about good practices and developments. Questionnaires were also sent to residents, the families and other professionals such as district nurses and doctors. By the time the inspection took place, 9 relatives had returned their completed forms. When they were analysed, they showed that no adverse comments were made about the home or the staff. One relative made this comment “The staff care for my father very well and are sympathetic and helpful.” There were 14 residents living at the home at the time of the inspection and there were 2 care staff, a cook and the manager on duty.
Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 6 The number of staff on duty was sufficient to look after the well being of all the residents. The staff were observed to be polite and attentive when talking and dealing with the residents. What the service does well:
Craigneil has been a care home for many years and has a good stable staff group, which provides continuity and stability for residents. We found that staff demonstrated a good awareness of the needs of the residents and observed good interaction between residents, management and staff. Before residents are admitted, sufficient information about the home is available for people to read to help them decide if they would like to stay at the home. Important information needed to support them in every day living is recorded and used to plan the care required. Residents can stay at the home for a trial period to make sure the home has the right facilities and staff to care properly for them. Contracts given to residents outlined the terms and conditions of residence. Resident’s healthcare needs are monitored. The staff work with visiting medical professionals such as doctors and district nurses. Relatives who returned their comment cards as part of the inspection process praised staff for the care they provide to the residents and one comment described staff as ‘very good and caring’. The daily routines are flexible and designed to meet the wishes of the residents. The staff benefit from a good standard of training. It was also pleasing to note that the home continue to meet the national target in NVQ (National Vocational Qualification) training, with 77 of carers holding the qualification at level 2 or above. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The admission processes ensure residents are properly assessed and their needs and preferences catered for. The residents benefit from being able to have choices in their care. EVIDENCE: We (CSCI) examined the records of admission of the last resident admitted to the home. They showed that a preliminary assessment was carried out during enquiry followed by a full assessment soon after. Residents we spoke to confirmed they were given enough information about the home before they came to stay. The service user guide provides helpful, well-presented information in a format, which was easy to read.
Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 10 The service user guide contains information about the care provided, the facilities, the staffing, the complaint procedure and other useful information. A copy of the last inspection report is available for residents and visitors to read. Every resident is given a contract of residence giving the terms and conditions of stay. The manager told us that a member of her team always visits prospective residents who are unable to visit the home, either in their own home or in hospital before admission. The manager said this helps with introduction as well giving and gaining information. Prospective residents or their families are encouraged to visit the home and spend as much time as they need before making a decision. The relative of a short stay resident told the expert by experience that she would like her mother to extend her stay as the care provided was very good. The staff told us that they are given as much information about the new residents as possible so that they can provide tailor-made care. The residents told us that the staff are very good and that nothing is too much trouble for them. The home does not provide intermediate care. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The provision to meet the health and personal needs of the residents is good. Residents are well cared for by a team of dedicated staff. EVIDENCE: We case tracked two residents, one of whom being the last one admitted to the home. This means that we selected two residents and examined the care they received closely. Their assessments and care plans were examined and they were spoken to. The records we looked at show that detailed written information about the residents has been recorded. They include an assessment to identify the
Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 12 needs of the residents and also a care plan which shows how the needs were being met. The physical assessment covers; personal hygiene, mobility, hearing, vision and other areas. The care plans give details of how the assessed needs are met. For example, if someone needed help with personal hygiene, the record will show that this person needs staff to wash and dress her. The care plans are reviewed monthly or as required to meet their changing needs. The residents and their families can be involved in this exercise. The residents told us that they are very well looked after by the staff. They were very positive about the staff and the management of the home. They described the home as being very good. We observed a very relaxed and friendly atmosphere in the home. There were good interactions between the staff and the residents. The expert by experience found that “One resident had fallen and broken her arm and hurt her leg but she has a history of falling so the staff take great care when she is being moved.” “All staff are very attentive to the residents’ needs and treat them with dignity.” “All residents are clean and tidy and there are no smells in the home. Interaction between the staff and the residents is very good.” A stair lift is available to access the first floor. Bath hoists are available to assist residents with getting in and out of the bath. To increase the privacy of the residents, suitable locks have been fitted to bedroom doors. All the residents are white British, but the manager informed us that if a resident from a minority group was to be admitted to the home, she will obtain as much information as possible by researching this group to meet care, cultural and dietary needs. Resident’s health care needs are met by involving health care professionals. GP’s, district nurses and chiropodist visit when required. We examined the medications records and they were found to be accurate. The medications of 2 residents were audit trailed and were found to be correct. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 13 Medications are only dispensed by senior staff who have had training on medications.. The staff are sensitive to the needs of all the residents and do everything to help them remain as independent as possible. The expert by experience found that a resident had an accident in the toilet and he was treated with dignity and taken to his room to change before going back into the lounge. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements to keep residents motivated and to encourage them to remain active. Residents can participate in a wide choice of activities. EVIDENCE: The manager told us that residents are encouraged to remain as independent as they want and able to. Were observed the residents doing their own things. Some were in the lounges and others were in their rooms. They said that they are able to remain as independent as they want or able to. They said that staff are helpful and will provide assistance when required. We spoke to most of the residents and they said that they are very happy living at the home and that everyone is nice and caring. They said that they
Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 15 can do what they like and do not have to join in activities if they do not want to. Activities in the home include Bingo, board games, entertainers etc. The expert by experience stated “residents said that they enjoyed the entertainment in the home and that they were already planning Christmas. The staff told us that they will take residents to the shops or do their shopping for them. Most of the residents said that the shops are too far for them to get to. The residents told us said that there is enough to do if you like to join in communal activities. Several of them said they like to do their own things and join the activities they like. They said that no one is forced to do anything. Residents are supported to continue with their chosen religion. Representatives from local churches visit the home on a regular basis for prayers and communion. Families and friends of residents are encouraged to visit when they want. Some of the residents said that their relatives take them out regularly. The residents said that the food is very good and that they are offered plenty to eat and drink. A set meal is provided at lunchtime when the main meal of the day is served. Alternatives are provided for those who do not like the main meal. Meals are served in the dining room but residents may eat in their rooms if they prefer. There is a good choice of food to choose from at breakfast and teatime. A cooked breakfast is available for those who want it. The expert by experience stated “Tables are set at mealtimes for the residents with tablecloths and matching crockery and cutlery. Meals are cooked on the premises and are very good and dietary requirements are catered for.” Records of meal served examined show that a good variety of meals are offered to the residents. The manager said that within reasons, the home could cater for every taste. She said that food to suit ethnic and cultural preferences would be offered to residents if required. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 16 Residents are offered hot drinks at regular intervals during the day. They said that they find that the regular drink rounds are adequate for their needs, but would ask the staff for a drink if they wanted one at other times. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 17 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are good policies and procedures to deal with complaints and to safeguard residents from harm and abuse. Residents live in a safe environment. EVIDENCE: The management of the home have produced policies and procedures for dealing with complaints and abuse. The complaint procedure is included in the Service User Guide. It is available to residents and their families. A copy of the complaints procedure is displayed and included in the information given to current and prospective residents. The manager said that she speaks to residents and staff on a daily basis and this allows for problems and concerns to be sorted out as they occur. The residents told us that if they had any complaints, they would speak to the manager and had every confidence that their concerns would be dealt with. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 18 The home has an appropriate internal procedure for staff to follow should they suspect or witness an incident of abuse. Staff we spoke to confirmed that they have had received training in respect to the adult protection procedures as part of National Vocational Qualification in care training. All the residents appeared to be safe and free from harm, neglect and abuse. Staff were observed treating the residents with respect and dignity. Residents told us that they are well looked after and that all the staff are kind and helpful. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an ongoing programme of maintenance and upgrading to keep the home pleasant and safe for the residents EVIDENCE: Craigneil is situated in a residential area and facing the promenade in Morecambe. Some amenities are close by, but still too far for frail elderly people to access. The Home is a large converted property with an extension and accommodates 15 residents in 13 single and 1 shared bedrooms. There are two lounges and a dining room which the residents can use freely.
Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 20 A tour of the building was carried out. The home was found to be clean and in good order. The residents said that the staff clean their rooms daily. They said that they can do a bit of their own cleaning if they want. The expert by experience found that residents are encouraged to help to keep their own rooms tidy and if they wish they can help clear the tables after a meal. The laundry room which is situated in the basement has been upgraded. The floor and walls have been replastered and painted. All of the central heating radiators have now been fitted with low heat surface covers to prevent residents from being burnt. The home was found to be free from hazards and the residents were observed getting around the home safely. Some residents were in their rooms and they said that they like to stay in their rooms to read or watch television. The home is well maintained and the colours are light and pleasant. The manager informed us that there is a rolling a programme of maintenance and carpets are changed when necessary. The residents’ general comments were that the home is clean and homely. A stair lift to access the first floor is available for the residents to use independently if they wish. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are good procedures in place when recruiting new staff thus ensuring that they are fit to care for the residents. A team of well-motivated staff ensures that all the residents are well looked after. EVIDENCE: The number of staff on duty has been maintained to a good level to meet the needs of the residents. At the time of the inspection, there were 2 care staff, a cook and the manager on duty. Staff rotas examined show that the staffing level is maintained to a good level for the number of residents at the home. The manager demonstrated a good understanding of the procedures to be followed when selecting and recruiting staff. We examined two staff files and they showed that appropriate checks have been carried out before offers of employment were made. Such checks include
Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 22 CRB (Criminal Records Bureau), POVA (Protection Of Vulnerable Adults) and 2 satisfactory references. Once a new member of staff starts work at the home, she undertakes an induction training programme involving orientation of the home, meeting residents and staff. Training also includes Fire Procedures, Moving and Handling and many other relevant courses. There is a clear commitment to the training and development of all staff at the home and they are all expected to go on the NVQ training programme once they have completed their induction training. Training records show that the staff at the home have attended several courses. These include: Abuse, Moving and Handling, First Aid, Dementia, Medications, etc. CSCI (Commission for Social Care Inspection) recommends that at least 50 of care staff achieved NVQ (National Vocational Qualification) level 2. The percentage of care staff with this qualification is 77 and is commendable. The staff we spoke to said that they enjoy working at the home very much. They told us that the management is very supportive and listens to what they have to say. The residents were happy to tell us that the staff are marvellous and will do anything for them. We observed good interactions between the residents and the staff. They all appeared to be happy and content Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 23 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management team provide a good service to the residents and good support for the staff. The residents and staff benefit from living and working in a well managed home EVIDENCE: Craigneil is owned by Mr Barry Hinde and managed on a day to day basis by his wife Suzanne. She has worked at the home for several years. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 24 We found that the home is being well managed and that the residents are well looked after. The manager told us that her husband spends considerable time doing maintenance work in the home. The staff said that the owner is approachable and that he talks to them when he visits. The home has a written health and safety policy in place, which is supported by a number of associated procedures such as COSHH (Control Of Substances Hazardous to Health) and infection control. Residents and or their families are encouraged to deal with their own finances. Most of the fees due to the home are paid for by direct debit arrangements. Where the home, keeps money on behalf of residents, appropriate records are kept. The manager still needs to complete the Registered Manager’s Award. The inspection was carried out in a friendly environment and residents and staff said that Craigneil is a very good home. Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 25 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 12. Refer to Standard OP31 Good Practice Recommendations The manager should complete the Registered Manager’s Award Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Craigneil DS0000009708.V351427.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!