Inspection on 14/06/07 for Cranleigh

This inspection was carried out on 14th June 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cranleigh 01/10/05

Cranleigh 24/05/05

Cranleigh 09/12/04

Cranleigh 05/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Cranleigh 21 Vicarage Road Cromer Norfolk NR27 9DQ Lead Inspector Maggie Prettyman Unannounced Inspection 14th June 2007 09:00 Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 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 Cranleigh DS0000027297.V343282.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 Adults 18-65. 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. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranleigh Address 21 Vicarage Road Cromer Norfolk NR27 9DQ 01263 512478 01263 512478 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 Simon Fuller Mrs Susan Fuller Mr Simon Fuller Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That the home be registered as a care home only. That the maximum number of service users accommodated should not exceed 8 (eight). That only persons with learning disabilities be accommodated at the home. That only persons up to the age of 65 may be accommodated at the home. 1st October 2005 Date of last inspection Brief Description of the Service: Cranleigh is a care home providing care and accommodation for 8 adults with learning disabilities. It is owned by Mr Simon Fuller and Mrs Susan Fuller. Mrs Susan Fuller is the registered manager. The home is located in the coastal town of Cromer and is close to shops, public houses, beach and other community facilities. The home is a three-storey red brick building with front and rear garden/patio areas. All bedrooms are single rooms and three have en-suite facilities. The communal areas are of a homely nature and provide appropriate facilities for the service users. The range of weekly fees is £600 - £1,200. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the provider, some residents and their relatives as well as other who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and current judgements for each outcome group. The inspection visit took place over the course of 6 hours. Prior to inspection everyone living at the home had returned a confidential questionnaire to the inspector. Other questionnaires were returned from friends, relatives and professionals involved with the home. A tour of the premises took place and some people showed the inspector their rooms. Some people at the home also allowed the inspector to view their personal records. Discussion took place with people living at the home as well as staff and visiting professionals. The inspector also had the opportunity to enjoy lunch with the people who live at the home. What the service does well: Cranleigh is a warm, caring home where people are helped to live their lives in the way that they choose. The manager is a kind, caring and professional person who makes sure that the home is run in the best interests of people who live there. The home is excellent at listening to the people that live there and making sure that they make decisions for themselves. The home makes sure that people have the chance to continue their education or to go to work if they wish. Residents take an active part in the community and use local resources and facilities in their everyday lives. People have excellent support for their relationships and friendships. The daily routines of the home are very flexible and each person has freedom, independence and choice in their life. People really enjoy the food at the home, and have a healthy diet. Staff are kind and caring, and make sure that people have privacy and dignity. People who live at the home choose their own clothes and hairstyles and have freedom of expression. Some of the comments made by people who live at Cranleigh were: “I like living here, I go out, I go to the pictures, and I go to music class.” “It’s good here because I get help. I go horse riding and shopping. I choose my own things.” “I like the cook’s cooking, my room, the staff and the activities I do” Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 6 “I like it because my friends can visit the home” “Staff are kind here. There is nothing I don’t like about the home” What has improved since the last inspection? What they could do better: One requirement and some good practice recommendations have been made at the end of this report; Requirement • The home should improve its documentation of quality assurance procedures to ensure that all systems are effectively monitored Recommendations • • • • • • • A protocol for administering PRN medication should be written A record of minor complaints, comments and compliments should be kept and audited Staff training records should be audited to ensure that training is kept up to date A regular system of staff supervision should be maintained The good practice recruitment recommendations in “safe and Sound” should be implemented People may benefit from having their health care needs recorded in a separate health care plan. People living at the home should be asked if they wish to put a limit on the cost of staff lunches. 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. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People who come to live at the home have their needs fully assessed before they move in. EVIDENCE: Resident’s records were inspected and found to contain detailed information about peoples’ needs and wishes taken into account before they moved in. This included information gained when the homes manager visited the person as well as from their family and care and health professionals who know them. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are involved in decisions about their lives. They are helped to take managed risks and to play an active role in planning the care and support that they receive. EVIDENCE: Examination of people’s care plans showed that they are reviewed and are flexible working documents that enable people to progress and develop their lives in a positive way. People living at the home confirmed that they are fully involved in the way that care is planned for them. A planned review involving a resident, the manager, key worker and care staff as well as care professionals from outside the home took place during the inspection. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 10 Feedback from pre-inspection questionnaires, discussions with people who live at the home and visiting care professionals, as well as observations of staff practice during the inspection demonstrated that people are fully and carefully consulted about their needs, choices and wishes in all aspects of their lives. People who live at the home run their own residents’ group. They confirmed that the home and its staff implement the groups’ ideas, comments and suggestions. The service demonstrated by the home for this standard is exceptional and must be commended. Evidence of risk assessment was seen in people’s files. Observation of people and of the care staff working with them during the inspection demonstrated that daily risks are carefully considered and are discussed with people to enable them to make safe and informed choices. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals’ expectations. EVIDENCE: Inspection of individual care plans, discussions with people who live at the home and observation of activities during the inspection demonstrated that everyone who lives at the home has a diverse, stimulating and challenging programme of adult education and personal development. People are involved in voluntary and paid employment when possible. The home’s service to people for this standard is excellent, and the hard work undertaken by staff and residents must be commended. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 12 Discussions with people living at the home as well as observation during the inspection demonstrated that community links are maintained and that community facilities are regularly used. People exercise their right to vote if they wish. Discussion with residents as well as diary records demonstrated that activities outside the home take place at weekends as well as during the week. Pre-inspection questionnaires, people’s care records as well as discussions with people living at the home and visiting care professionals demonstrated that people are supported to maintain and develop family, friendship and personal relationships. Friendships are carefully supported and people living at the home bring friends home for meals and social activities. The support network “About with Friends” is actively involved, and people living at the home describe having lasting and enjoyable friendships and relationships. Discussions with people living at the home, examination of care records and observations during the inspection demonstrated that the homes routines are flexible, person centred and individual. People came and went as they pleased and expressed freedom of choice. People participated in household chores and cooking in a positive and cheerful way. Staff were observed to interact directly with residents at all times and to offer support and guidance according to individual needs and wishes. People are supported to have pets if they wish. The residents asked the inspector to enjoy enjoyed a well-cooked, hearty meal prepared in part by one person living at the home. People chatted easily over the meal and said how much they enjoy the food at the home and how it reflects their individual and group choice. It was a friendly unhurried and relaxed occasion. The main meal of the day is at lunchtime, with people preparing light suppers of their choice in the evening. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into daily practice. EVIDENCE: Observation of care practice during the inspection demonstrated that people have their personal care needs met in a dignified and person centred way. People said that they choose their sleeping and rising times and bathe when they wish. People express individuality and choice by their dress and hairstyle. Care plans demonstrated a caring and practical approach to the delivery of personal care support. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 14 People’s individual records demonstrated that their health care needs are carefully attended to. Appointments and records demonstrated that people fully access health care services. People do not have a separate plan of health care support. People living at the home may benefit from having their health care needs separately recorded. A recommendation has been made in this respect. Drugs kept at the home were found to be securely stored and accurately recorded. People are supported to be self-medicating if appropriate. Records of staff training in the administration of medication were seen. The home could improve its practice by providing a protocol for PRN medication administration. A recommendation has been made in this respect. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, have their comments and complaints listened to. Training and good practice helps protect people from abuse. EVIDENCE: The home has received no formal complaints since the last inspection. A copy of the complaints procedure is displayed in the homes hallway. People living at the home said that they feel confident to draw matters to the manager’s attention that they are not happy about or that they wish to change and that action is taken to respond to their wishes. The home would benefit from recording daily comments and compliments to enable an overall analysis of patterns and trends. A recommendation has been made in this respect. Evidence of staff training in adult protection matters was seen. Records demonstrated that people living at the home are protected from financial abuse. Residents pay for staff lunches when they take them out on 1:1 outings. Currently no amount is agreed as a maximum expenditure. A recommendation has been made in this respect. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home’s environment enables people to live in a safe well maintained and comfortable home, which encourages independence. EVIDENCE: A tour of the premises demonstrated that the home is safe, comfortable, bright, airy and clean. Heating and ventilation is suitable. It is close to local amenities and it suits the lifestyle of people living there. All areas of the home are accessible to the people that live there. Furnishing and decoration is homely. People showed the inspector their own rooms, which are individually decorated to people’s tastes. Inspection of records demonstrated that fire regulations are adhered to and that a programme of maintenance is in place. The home is clean fresh and hygienic. Laundry facilities are suitable. Observation demonstrated that infection control procedures are maintained. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff working at the home are trained, skilled and in sufficient numbers to meet the needs of people who live there. EVIDENCE: Records demonstrated that all staff working at the home have gained, or are in the process of gaining NVQ training. Observation of staff during the inspection demonstrated that they know and understand their roles and tasks. Interaction between staff and residents was seen to be direct, warm, trusting and friendly. People living at the home confirmed that they like the staff that work with them and that they listen carefully to their needs and wishes. Examination of staff files demonstrated that the recruitment policies and procedures of the home meet the standard required. A copy of “Safe and Sound”, detailing further good recruitment practice was left at the home by the inspector. A recommendation has been made in this respect. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 18 Inspection of training records demonstrated that staff have been given a wide range of training. Some mandatory training has recently lapsed and needs to be updated. This issue could be addressed by the home keeping an overall training audit. A recommendation has been made in this respect. Supervision records demonstrated that although some individual supervision is given, it is not as regular as the standards recommend. A recommendation has been made in this respect. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. Quality assurance systems at the home could be improved. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager of the home is competent and qualified. She is responsible for achieving the aims and objectives of the home and implementing all policies and procedures. Feedback from pre inspection questionnaires, discussion with people living at the home and observation during the inspection demonstrated that the home has a strong ethos of openness respect and consultation. The manager leads by example and staff were observed to demonstrating excellent standards of interaction and support. Examination of quality assurance systems demonstrated that the home could improve recording and documentation in this area. Some elements are in place, but a more detailed system needs to be developed to ensure that all aspects of the home are considered. A requirement has been made in this respect. Observation of the work practices at the home during the inspection demonstrated that the home is run in a safe way. Hazardous substances are appropriately stored and records demonstrated that health and safety requirements are maintained. Some staff training has recently lapsed; the manager stated that refresher courses are planned in the near future. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 4 2 X X 3 X Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 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. 1 Standard YA39 Regulation 24 Requirement A documented system of Quality Assurance must be developed by the home so that all systems are effectively monitored. Timescale for action 31/12/07 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 3 4 5 6 Refer to Standard YA20 YA22 YA35 YA36 YA34 YA19 Good Practice Recommendations A protocol for the administration of PRN medication should be developed to ensure consistency of administration. A log of minor complaints comments and compliments should be kept to enable patterns and trends to be identified An overall training audit should be maintained to ensure that mandatory staff training is up to date at all times. People should receive recorded individual supervision in line with the standards It is recommended that further good recruitment practice identified in “Safe and Sound” is implemented It is recommended that the home consider developing individual health care plans so that people’s health care needs are separately documented. Cranleigh DS0000027297.V343282.R01.S.doc Version 5.2 Page 23 7 YA23 Residents should be asked if they wish to make a maximum limit on what they pay for staff lunches on 1:1 trips out. 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