Inspection on 22/06/05 for Cranhill

This inspection was carried out on 22nd June 2005.

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

Cranhill 10/09/07

Cranhill 09/10/06

Cranhill 07/11/05

Cranhill 27/01/05

Cranhill 18/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Cranhill Weston Road Bath BA1 2YA Lead Inspector Jill Cornelius Unannounced 22 June 2005 10:00 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. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cranhill Address Weston Road Bath Avon BA1 2YA 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) Category(ies) of registration, with number of places 01225 422321 01225 482637 Mr. Charles Otter Mrs.Virginia Hughs Care Home with Nursing 31 Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate 31 Persons over 50 years of age requiring nursing care Staffing Notice dated 09/11/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register May accommodate one named person aged 49 years: the registration will revert when this person leaves the Home Date of last inspection 27/01/05 Brief Description of the Service: Cranhill Care Home is situated in a suburban area of Bath and provides nursing care for up to 31 residents. There is easy access to Victoria Park nearby, also to other local venues and shops by car. The building is an older converted property providing single rooms on three floors with lift access. Communal space is in three areas and the forecourt/terrace area in front of the home is also enjoyed by residents. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. Opportunity was taken to tour the premises, examine records and talk to staff and residents who were able to do so. Most of the residents were seen during the inspection. Four of the residents had visitors who gave their views to the inspector. What the service does well: What has improved since the last inspection? What they could do better: Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 6 Internal improvements to the home have been made but the outstanding matters do not provide the people living in the home with safe surroundings or with access to the gardens. A Requirement was made in relation to completing all outside work to paths. This will promote independence to residents in accessing their choice of seating. A Requirement was made in relation to the carpeting around the hall and corridors of the home being repaired or replaced. 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. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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 Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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) 1, 3, 4. The home’s Statement of Purpose and Service User Guide enable an informed decision about admission to be made by prospective residents. New residents needs are properly assessed and planned for. EVIDENCE: The Statement of Purpose and Service User Guide has been updated since the last inspection. The admission procedure is completed to guide staff on the actions to be taken to ensure that new residents needs are properly assessed and planned for. One resident spoken with was able to provide significant information about his care needs that had been recorded. Staff members on duty were able to describe care needs of residents. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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, and 10. There is clear care planning system in place to provide staff with the information they need to meet service users needs. The health needs of service users are well met. Personal support is offered in a way that promotes and protects residents’ privacy and dignity and independence. EVIDENCE: Individual care records are kept for each of the residents and inspection of the two most recent admissions evidenced, full assessment information had been recorded. This enables the care staff to provide a person centred holistic plan of care. Random case tracking of five care files was observed. There are service user risk assessments for most eventualities. The risks identified are formulated into an action plan via the care needs assessment process to identify the care / management required to reduce the risks identified. Reviews are undertaken monthly with evidence of service user consultation; evidence of good multi disciplinary working taking place on a Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 10 regular basis. Residents spoken with were able to confirm this. Discussion with staff confirmed their knowledge of service users assessed needs. Residents’ confidential records are kept securely. Observation during the inspection showed that staff have a good awareness of how to protect residents’ privacy and dignity. Staff could describe to the inspector situations of care and daily living where service user’s privacy and dignity needed to be respected. They were seen to knock on doors and wait for a response before entering and spoke to residents in a respectful way. Residents spoken with said this was usual practice. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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) 12, 13 and 15 Social activities are available and promoted on a daily basis. Links with the community are good and support service users social opportunities. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: A number of activities are on offer these are planned on a weekly basis. A programme is formulated and is displayed in the hall and available to residents. Choices are actively sought and observation of the minutes from the residents meeting confirmed this. A number of residents living in the home were spoken with. One resident expressed that “they would welcome more scheduled activities” another resident said they “did not want to join in with activities and liked to read quietly in the lounge. Another resident said how they “don’t feel pressurised into joining with the arranged activities”. Two residents said of their delight in the celebration street party for the wedding of Prince Charles and Camilla. Another resident reported their appreciation of the arranged transport enabling her to attend her monthly Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 12 Towns Women’s Guild meeting and said, “I like to keep up my contacts and am delighted that Cranhill enables me to do this”. Everyone commented on the food said how good it is. Menus are balanced and interesting, and flexible enough to accommodate individual preferences. One resident said how “when the choices were not what was wanted the chief would make another option available”. A visitor said how “they were able to join their loved on for meals” Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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 standard(s) 16, 17 and 18 Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: There is a complaints procedure with a formatted document for recording complaints available. This was viewed and found to be correct. The residents are supported to exercise their legal rights and vote. Adult Protection procedures are in place and staff are attending BANES training on the Protection of Vulnerable Adults. Through this they are aware of their responsibilities in this area. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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 standard(s) 19, 20 and 26 Internal improvements to the home have been made but the outstanding matters do not provide the people living in the home with safe surroundings or with access to the gardens. The home is clean, hygienic and free from malodours. EVIDENCE: Since the last inspection the home has continued with their redecoration programme and the lounge and a number of bedrooms have been decorated. Their occupants were happy with the change. The kitchen has new work surfaces as recommended by the inspection from the Environmental Health Department. The work to give access to a number of outside seating areas has been started but is in need of completion. When completed residents will be able to access this. Residents informed the inspector that they “are looking forward to this being completed, there were plans for using the area for summer garden parties”. A Requirement was made in relation to this. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 15 The carpeting on the halls and landings is very worn in places. This not only looks unsightly but will become a trip hazard in the near future. This carpeting must be repaired or ideally replaced. A Requirement was made in relation to this. The home is clean and pleasant and provision is made to control the spread of infection if it occurs. The home has a sluicing facility and sluicing disinfector. Washing bowls and other continence equipment were noted in having build up’s of deposits of hardening residue and residents have commented on this. These are in need of de scaling or replacing. A Recommendation has been made in relation to this. There is appropriate written guidance for the control of infection available to staff. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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 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, 28 and 30 Staff at the home are well trained, supported and employed in sufficient numbers to meet the residents needs. Staff morale is high resulting in an enthusiastic workforce that works positively with service users, improving their quality of life. EVIDENCE: Random checks on the staffing duty rota was viewed for the weeks of June 19th – 26 and 27th –28th.The requirements of the staffing notice and there was a pattern of regular additional care staff working on the morning shifts to support residents care needs. This is a positive practice due to the layout of the home. Residents, their visitors and staff made positive comments about the staff team, many people gave examples of good communication, staff being clear about what is expected of them and practice being consistent between shifts. Eight of 24 care staff hold NVQ2 or above. A further 2 will be completed by the end of August. 1 person is newly started. A continued robust attempt to promote the uptake for all carers to attain NVQ2 by the end of 2005 is underway. Training is well planned and will support the staff in providing for the varied needs of the residents. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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 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) 31,32, 33, 37 and 38 The home is managed efficiently but attention needs to be given to the completion of environmental improvements to better promote and protect the safety of residents and staff. Feedback is actively sought from service users about the service provided through anonymous user satisfaction questionnaires. EVIDENCE: Mrs. Hughes the manager has the appropriate RN1 and Care Management qualifications: has been in the post excess of 3 years and has attended relevant clinical update training. Service users and staff spoken with felt they were well supported and that Mrs. Hughes was accessible. Residents meetings are held and the minutes were viewed. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 18 A client questionnaire has been produced and residents have returned comments such as “very caring staff”, “lovely house, lovely garden and caring staff” Quality Assurance System is currently being set up. The implementation will enable the management to correlate policies procedures with the ethos of Cranhill. This will measure the success in meeting the aims, objectives and statement of purpose of the home. Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x x 3 2 Cranhill D05_D56_S20276_Cranhill_V226047_220605_Stage4.doc Version 1.30 Page 20 yes 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. 2. Standard 19 20 Regulation 23 16 Requirement The worn carpet on the halls landings and stairs must be repaired or replaced Complete all outside work to paths. Timescale for action 21/09/05 21/09/05 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 26 Good Practice Recommendations Remove deposits from bowls and continence equipment or replace. 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