Inspection on 18/04/06 for Cranham

This inspection was carried out on 18th April 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

Cranham 17/04/07

Cranham 14/12/05

Cranham 06/09/05

Cranham 21/01/05

Cranham 29/06/04

Cranham 02/12/03

Cranham 11/08/03

Cranham 11/06/02

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

CARE HOMES FOR OLDER PEOPLE Cranham 226 Cranham Drive Worcester Worcestershire WR4 9PH Lead Inspector Mrs Yvonne South Unannounced Inspection 18th April 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cranham Address 226 Cranham Drive Worcester Worcestershire WR4 9PH 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) 01905 455474 01905 759006 www.heart-of-england.co.uk/care/cranham Heart of England Housing and Care Limited Mrs Margaret Frances Hook Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Old age, registration, with number not falling within any other category (45), of places Physical disability over 65 years of age (45) Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Home may also accommodate two named people over the age of 65 years with a learning disability The Home may also accommodate one named person under 65 years of age with a mental disorder, excluding learning disability or dementia. The Home may also accommodate one named person, under 65 years of age with a physical disability. 14th December 2005 Date of last inspection Brief Description of the Service: Cranham is a purpose built home located in the Warndon area of Worcester city, close to local shops and a bus route. The accommodation is divided into five separate units providing bedrooms and communal lounges, dining areas and kitchenettes. These are all on ground floor level. There are no en-suite toilet facilities in any of the bedrooms. Communal toilet and bathroom facilities are provided. Wheelchair access to some rooms is difficult as doorways do not have a clear opening of 800mm and the rooms are not spacious. The gardens are well kept and accessible to the residents. The home provides a residential care and respite service for up to forty-five older people who may have physical disabilities and/or mental health needs. Information regarding the home is available in the Statement of Purpose, Service Users’ Guide and inspection reports which are available in the reception area, and copies are provided for all prospective residents and on request. The Pre-inspection questionnaire completed by the manager on 06.04.06 stated that the current scale of charges for the home were £360.00 for a single room. Additional charges were made for individual personal expenses such as newspapers, toiletries and hair dressing. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Evidence used to inform this report was obtained from contact with the home since the previous inspection. Questionnaires were sent by the Commission for Social Care Inspection to 20 residents and their next of kin and 10 health care professionals. Responses were received from 20 residents and 3 relatives. During a visit to the home the inspector spoke to five residents and four staff and the deputy manager. A partial tour of the home was conducted and a range of documents inspected. What the service does well: 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. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 6 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 Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 7 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, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information they need to make an informed choice regarding their care and assessments are undertaken to ensure the home is able to provide the service that is required. EVIDENCE: Three residents expressed their pleasure in the home. One resident said that he had visited a friend in the home in earlier years and liked the atmosphere and care. Everyone was visited by someone from the home before they moved in and this ensured the home was able to provide the care they needed. Documents and statements from the manager confirmed this. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff have the information and structures they need to provide the residents with a service that addresses their social and health care needs. EVIDENCE: Three residents said that they did not remember involvement in forming their care plans but the documents had been signed by them all and so had the reviews of their plans. These described in detail how care was to be provided for each person. The residents said that they saw their doctors when they needed to and this was recorded in their care records. Information received by the Commission for Social Care Inspection confirmed that appropriate health advice and care was obtained when necessary. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 9 Medication was generally well managed. However one error occurred on the day of the inspection and two errors were identified in the recording during the inspector’s visit. The manager said that none of the current residents wished or were able to manage their own medication. All staff respected privacy and dignity. They were observed to speak to and assist residents in a polite and kind manner. They were observed to be patient and skilled. Residents described the staff as ‘good’. marvellous’, ‘nice’ and ‘proper angels’. Residents had been offered the keys to their bedrooms when they moved in but those who spoke to the inspector said that they did not need them. A member of staff ensured that the residents had given their permission before she took the inspector to see their bedrooms. A relative commented favourably on the progress made by a resident as they settled into the home and became ‘happier’. She was sure that this was due to the care the resident was receiving. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 10 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, 15, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in leading the life style they choose within their abilities. EVIDENCE: Residents said in their questionnaires, and told the inspector, that they were able to join in a range of activities if they wished. The manager said that a new activities programme was being printed for display and the residents’ records described how each individual passed their time and took advantage of what appealed to them. There had recently been an Easter party and a celebration. The pre-inspection questionnaire listed a wide range of social activities in the home and the community and the individual records indicated if assistance was needed with any religious and cultural requirements. Visitors were welcome and the residents spoke of the pleasure they received when they came. Some people were able to go out with family and staff and they enjoyed the garden and trips to the shops. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 11 Questionnaire responses from relatives indicated that they felt welcome and were consulted and kept informed about their relative’s care. The residents were provided with a menu choice for every meal and residents complimented the catering. One resident stated that the food was so good because one could choose what was liked. Another person considered they were ‘well fed’. Appropriate records had been kept. The manager showed the inspector a manual provided by the catering firm they used. It contained menus with choices and full food value information. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 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 the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that any issues that concern them can be raised and will be responded to and their personal finances are managed in their best interests. EVIDENCE: A copy of the complaints procedure was in the Statement of Purpose and Service Users’ Guide for the home. Residents confirmed in the questionnaires and to the inspector that they knew who to take their concerns to and would not hesitate to do so. In the past twelve months seven complaints had been received by the home and on investigation six had been partially founded and appropriate action had been taken in response. The staff and their records confirmed that they had been appropriately recruited and references and checks had been made to ensure they were suitable to work with vulnerable people. Two of the three staff interviewed had had training in recognising and responding to suspicions of abuse and the deputy confirmed that there was an ongoing training programme in action. Where necessary residents’ personal monies were well managed for them to safe guard their interests. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 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 the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. To safe guard the health and welfare of those in the home the maintenance programme should be speeded up, with priority being given to the health and safety matters EVIDENCE: It was observed that the home was clean and free from offensive smells. Two of the three bedrooms seen were well decorated and furnished however the third was in poor decorative order. Personal property individualised each room and the equipment needed by each person was available. The residents and staff confirmed this. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 14 A programme of redecoration was in progress and the manager confirmed that this would address the needs in the communal rooms especially the kitchenettes where the fittings were damaged and posed a health and safety hazard. A requirement had been made in the previous report that the kitchenettes be made safe. The timescale to effect these repairs had expired and the work had still not been carried out. This is serious and the requirement will be repeated in this report. Controls had been fitted to the radiators in each bedroom so that the occupant could adjust the heating to suit their personal preference. The laundry was untidy but well equipped and stocks of personal protective equipment, liquid soap and disposable towels were readily available throughout the home to assist staff in the control of infection and protection of those in the home. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient appropriately recruited staff receive the training they need to enable them to look after the residents who live in the home. EVIDENCE: Most of the questionnaires considered that there were sufficient staff however one person said that staff were always rushing and another person said that sometimes she had to wait for help. No evidence of undue haste or pressure was observed during the inspector’s visit and the staff that were interviewed considered that the home was well staffed. There were no positions vacant at the time of the visit. Only three staff had left since the last inspection. There was a gender mix among the staff team and this enable the residents to choose a same sex carer if they wished. A training matrix indicated that staff were receiving relevant training and a training programme was providing refresher courses when necessary. The staff that were interviewed confirmed this. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 16 Of a team numbering 30 care staff, one person was qualified to National Vocational Qualification in Care level 3 and a further eight people were qualified to level 2. The deputy said that eight other staff were currently on courses. Once these eight people have successfully completed their courses the team will have in excess of 50 of the care staff qualified. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 17 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, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interests of the residents with due attention to their individual needs and the health and safety of everyone in the building. EVIDENCE: The registered manager was temporarily managing two homes while recruitment was undertaken for the other home. Cranham continued to be well managed by the senior team with her overall supervision. Staff confirmed that they were supported and well managed by the manager and the deputy. There was open and ready access to them for support and guidance. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 18 Interaction between the deputy and the residents was observed to be respectful, patient and kind. Residents were comfortable in her presence. The deputy had qualified to National Vocational Qualification in care level 3 and was currently studying to achieve National Vocational Qualification in Management level 4. Staff and residents have opportunities to attend meetings and make suggestions for the continued development of the service. Quality assurance questionnaires were distributed to all residents on a rolling programme. Inspection of the responses confirmed that the results were analysed and responded to. Resident confirmed that they had completed the documents according to their own wishes. Various systems, such as the care records, accident records and complaint records were monitored and audited by the manager and provider on a regular basis to ensure quality was maintained and improved. Residents’ personal monies were well managed and their interests’ safeguarded. The Fire Risk assessment was drawn up in October 2004 and the Fire Log indicated that the safety systems were being checked in accordance with the guidance provided by the Hereford and Worcester Fire Authority. Since the last inspection fire safety training had been increased and it was seen that a monitoring sheet was maintained to ensure everyone undertook the training at the required intervals. The deputy manager said that in addition to in-house training an external trainer would be leading a training session in May and again in October this year. The training matrix indicated that staff were receiving training in health and safety topics that enabled them to provide care in a skilled and safe manner. The Maintenance Log demonstrated that equipment and services were regularly checked and serviced to maintain a safe environment for everyone in the building. Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 19 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 3 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 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 3 X 3 3 X 2 Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 20 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 OP9 Regulation 13 Requirement Medication must be administered in accordance with the policy and procedure. All references topical medicines in records must clearly name the product. The controlled drug register must be maintained to provide an accurate audit. The cupboards in the kitchenettes must be made safe. Timescale for action 18/04/06 2 OP9 13 18/04/06 3 OP9 13 18/04/06 4 OP19 23 18/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Cranham DS0000018645.V288498.R02.S.doc Version 5.1 Page 22 - 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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