Inspection on 07/11/05 for Cranhill

This inspection was carried out on 7th November 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 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

Cranhill 10/09/07

Cranhill 09/10/06

Cranhill 22/06/05

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 Bath & N E Somerset BA1 2YA Lead Inspector Jill Cornelius Unannounced Inspection 7th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cranhill Address Weston Road Bath Bath & N E Somerset BA1 2YA 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) 01225 422321 01225 482637 Mr Charles Otter Mrs Virginia Hughes Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 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 27th January 2005 Date of last inspection 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 DS0000020276.V262537.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report following an unannounced inspection carried out over one day. At the time of the inspection, there were twenty seven residents. The focus on this inspection was to obtain the views of as many residents as possible. Evidence was also gained from records, discussion with staff, and a tour of the building. What the service does well: What has improved since the last inspection? A Quality Assurance Tool has been implemented. This allows the residents that are surveyed by “client questionnaire” to express their opinions and the results of the survey are published. The requirement to have a quality assurance system formalises this process. Recent hard landscaping has provided residents with the option of using larger areas of the gardens. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 The admission process is well managed and residents are given clear information regarding the service. EVIDENCE: Service users are only admitted following a full pre-admission assessment, which is carried out by the manager. The manager stated that visits to service users homes or the hospital are usually arranged. On examination of the preadmission assessments for the latest admission and one admission pending, they contain a full description of the service users needs. Staff members on duty were able to describe care needs of residents. Prospective service users are invited to visit the home prior to admission, they are invited to stay for a meal and meet other service users and staff. An enquiry was made during the inspection and the inspector observed the Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 9 manager inviting the prospective service user to visit the home, during which time an assessment of needs could be carried out. Emergency admissions can be arranged following a full assessment. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 10 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, 10, 11 The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. Residents are looked after well in respect of their personal care needs. Their privacy and dignity are maintained and they can be assured of sensitivity from the home at the time of their death. EVIDENCE: There were detailed assessments and care plans in place. Care plans included evidence that residents had been consulted in the planning of their care. Care plans were being regularly evaluated and reviewed. The care plans reviewed provided the inspector with evidence that the health care needs of the service users were being met. The inspector saw evidence that service users received visits from, the chiropodist, and optician. Referrals are made to dentists and specialist health care services. GPs are requested when medical changes require this. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 11 Service users spoken to stated that they were always helped to obtain access to any health care services they needed. The home has a very clear policy and procedure relating to the end of life personal preferences, staff have supportive links with hospice and other professional staff, the GP and local clergy are readily involved. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 12 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, 14 and 15 Feedback from residents suggests the home remains a friendly, happy and comfortable place to live. Relevant activities are offered but further opportunities may be worth considering in consultation with residents. The meals in this home are good offering both choice and variety and they cater for special dietary needs. EVIDENCE: The residents were complimentary about the care staff and the inspector witnessed staff speaking to people with respect and dignity. Rising and retiring choices are documented during the assessment and referred to in the care plans. These are checked with the residents daily and accommodated in balance with assessed needs. The residents spoken with confirmed this, as did documented evidence in the care plans. A programme of in-house activities is maintained. Awareness of what is available is promoted by a notice in the home and by word of mouth. A number of service users stated that they were “happy with the amount of activities on offer”. Another said how they “enjoy the peacefulness of Cranhill Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 13 and would feel any additional activities would change this”. Discussion took place in relation to promoting additional activities. A local clergyman carries out pastoral visits and a monthly service. The recognised Cora Planner is used to produce an innovative, interesting menu and this is displayed. Individual residents requiring assistance with eating can be helped in the privacy of their rooms. There is extensive choice; residents spoken with were very appreciative of the food served. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 14 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 The home has a satisfactory complaints system in place with evidence that residents feel their views are listened to and acted upon. Adult Protection is taken seriously by the home. EVIDENCE: The home has a clear and robust complaints policy and procedure, the manager deals with any query that is raised promptly, which avoids any serious complaint. Residents spoken with felt able to speak with the matron if required and were aware of other systems in place. A visitor also confirmed this. No complaints have been received by the Commission for Social Care Inspection since the last inspection. The home has clear policies and procedures for Adult Protection and Whistle Blowing, staff receive training on Adult Protection during their induction and qualified staff are aware of the procedures to follow. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 15 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, 20, 24, 25 and 26. The standard of the environment within this home is good providing residents with an attractive and homely place to live. Residents have the equipment they need to maximise independence within the home and their own rooms suit their needs. EVIDENCE: During the inspection the home was warm, clean and furnished in a homely fashion with good amounts of natural light. The garden is large and recent hard landscaping has provided residents with the option of using larger areas of the gardens. Communal areas in the home consist of the hall area, which is very popular with resident’. There is a large comfortable lounge and dining room. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 16 The inspector randomly viewed residents rooms, all showed evidence of personalisation and reflected individual taste. Some residents had bought in their own furniture and rooms contained care equipment such as hoists and recliner chairs where it was needed. Bedroom doors are lockable based on assessed need; many of the residents chose to access this facility. Bathing areas had thermometers to monitor safe bathing: however, there were no up to date recordings of these. Random sampling of temperatures during the visit demonstrated they were within safe limits. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staff at the home are well trained and supported and employed in sufficient numbers to meet the residents’ needs. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. EVIDENCE: The inspector viewed the duty rota for the month of November 2005 from the 5th to the 18th. This evidenced the home complies with the Staffing Notice. Residents confirmed that their call bells were answered promptly and felt that there were adequate numbers of staff on duty. The induction and ongoing training programme incorporates the NTO training targets. The five staff files observed during the inspection evidenced the manager’s commitment to providing up to date robust employment records. Individual training records evidenced staff signatures indicating attendance and training certificates. The training records evidenced training in First Aid, Manual Handling, Understanding Dementia, and “Good Communication”. Qualified staff are also supported with their PREP. The inspector noted that Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 18 there were training sessions advertised on the office notice board to the end of 2005. All staff spoken with demonstrated a high commitment to meeting the needs of the service users. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 19 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, 32, 33, 35, 36 and 38 The leadership, guidance and direction to staff ensure residents receive consistent quality care. Good care practices are promoted and therefore safeguard the health, safety and welfare of the people using this service. Staff are appropriately supervised. Secure facilities are provided for the safe keeping of money and valuables on behalf of the residents but documentation about these items always needs to be detailed. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 20 An annual quality assurance satisfaction survey was carried out in August 2005, by “client questionnaire” for their opinions and that the results of the survey are published. The comments received were largely complimentary, the home has put together a document that identifies the comments made and shows how they were acted on. Supervision notes were viewed for four staff. These contained areas of care practices and training requirements. Appraisals have been formulated by a new QA system. This will be a focus at the next inspection. Resident’s valuables were observed for safekeeping. This highlighted personal possessions which had not been described in detail and a large amount of pocket money kept for one resident. This was discussed and the manager and secretary made the necessary alteration and notified the resident’s family of this. The records of tests to the fire safety equipment were in good order and the health and safety issues were well managed. This was confirmed by the staff members spoken with. The records relating to the temperature of the water are referenced under Standard 25. During the inspection the inspector spoke to residents who said they were “very happy at Cranhill” and the “staff were patient and respectful”. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 21 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 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 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 2 3 3 x x x 3 2 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 3 3 x 2 3 x 3 Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? no 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. 1 2 Refer to Standard 25 35 Good Practice Recommendations Monitor and record bath temperatures to ensure they are maintained within safe limits. Ensure the documents which are intended to support the safe keeping of valuables are checked and kept in good order. Cranhill DS0000020276.V262537.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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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