CARE HOME ADULTS 18-65
Cranleigh 21 Vicarage Road Cromer Norfolk NR27 9DQ Lead Inspector
Ann Catterick Announced 24 May 2005 13:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 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 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 and Mrs Susan Fuller Mr Simon Fuller Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. That the Home be registered as a care home only. 2. That the maximum number of service users accommodated should not exceed 8 (eight). 3. That only persons with learning disbilities be accommodated at the Home. 4. That only persons up to the age of 65 may be accommodated at the Home. Date of last inspection 09 December 2004 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. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was announced and took place over a period of 6 hrs on the 24th of May. The inspector received the pre inspection questionnaire that had been sent to the home and this gave details of the general situation within the home and any changes since the last inspection. Feedback forms were received from the service users. Since the last inspection one service user has moved into supported living. There have been no complaints about the service. The inspector was able to talk with the manager and staff and spend time with all of the service users as well as look around the building and look at some care plans and other documents. The inspector was able to join the service users at teatime to have an informal chat with both staff and service users. There were no significant concerns and the overall quality of the service provided is very good. What the service does well:
Each service user has a plan of care that ensures that staff are aware of the needs and preferences of service users and know how to provide care in the way that is best for the individual. The plans of care at Cranleigh are very detailed, of good quality and reviewed on a regular basis. A service user was very proud to show the inspector their care plan and the service user was able to see how their confidence and self-esteem had improved over time. The number of staff on duty at any one time depends on the needs of the service users. This means that the service is led by the service users needs and not who is on duty at any one time. The staff group is stable and well trained and all of those staff met seemed to be happy at work having a good relationship with the service users. Service users spoken to seemed to feel in control of their lives and felt involved in the day-to-day running of the home. One service user said that she chaired the residents meetings and another took the minutes. Service users felt that they were listened to.
Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 6 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. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5 The homes policy and procedures around the admission of service users ensure that the home can meet the needs of the service users and this is evident when speaking with the service users who live in the home. Each service user has a statement of terms and conditions from both social services and the home, the latter being signed by the service user. EVIDENCE: The home is clear about the service it can provide to service users and staff are trained in these areas with many completing NVQ level 2 and 3. The manager has a good policy of gathering any current information about specific medical needs of individuals and placing this information on individual care plans to ensure staff have all the relevant information they need. Some service users have independent advocates and information about advocacy services is available to all service users. Statements of terms and conditions were seen on file and include all of the information needed by service users. Some discussion was had concerning the inclusion of the specific costs of the placements, in light of the recent Office of Fair Trading comments and there is opportunity for further debate in this area.
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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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 8 Service users are actively involved in their care plans and this ensures that their changing needs are identified and reflected in the care plans. Service users are encouraged to make decisions about their own lives and this means that service users general life preferences are led by the service users themselves. Service users are actively involved in the general day-to-day life within the home and therefore feel actively involved in what happens on a daily basis. EVIDENCE: Service users are involved in the creation and review of care plans. A service user was very happy to sit and look through their care plan sharing it with the inspector. She could see where the care plan had been reviewed and was pleased to see the progress she had made since admission. Other care plans were seen and included all that was needed to meet the outcome of this standard.
Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 10 Staff encourage service users to be as independent as possible and this was seen when looking at care plans as well as when speaking to service users. Risk assessments are completed when appropriate. The home has regular residents meetings that are chaired and minuted by service users. The home is a small home with a stable staff group, a key worker system and staff who spend a lot of time on a one to one basis with service users enabling service users to express their views and influence the service and the care provided. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14, 15 and 17 Service users are able to engage in local community activities that are suitable and appropriate for their age and this encourages them to be part of the area in which they live. Service users engage in appropriate leisure activities that offer them a range of activities to become involved with in their leisure time. Service users have appropriate relationships with friends and family depending, on individual needs and preferences. EVIDENCE: The home is well established in the local community and all service users access the general range of activities and hobbies within the area that are appropriate to their age and abilities. These include horse riding, swimming, shopping, cinema, music therapy, social clubs as well as many others. Those service users spoken to said that they had lots of opportunities to participate in a variety of activities.
Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 12 Service users have regular contact with family when that is appropriate and what they want. Those service users that want to develop other relationships are enabled to do so with support and guidance. Service users privacy is respected and all bedroom doors are lockable. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Service users physical and emotional health needs are met and this enables service users to have the opportunity to reach their own full health potential when living in the home. The home has a policy and procedures for dealing with medicines that meets the needs of service users and ensures that medication is dealt with in a safe way. EVIDENCE: Service users care plans include information and guidance relating to their health needs. This is completed in detail and often with progress reports to enable these areas to be monitored. It was particularly pleasing to sit with a service user who was very pleased to show evidence of how her health had been seen to improve since being resident within the home. The home has a good relationship with the local health service and ensures that service users have access to all local health services. This was confirmed with service users. The processes for the administration, storage and recording of medication was seen and met with the needs and preferences of service users needs. All staff have training in the administration of medicines.
Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 Neither of these standards were fully inspected on this occasion. EVIDENCE: Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The service users live in a comfortable homely environment that is well decorated and furnished enabling them to have good quality personal and communal space. The home is a clean and hygienic place to live. EVIDENCE: Cranleigh is a small, homely home that is well decorated and furnished. All bedrooms reflect the personality and preferences of the service users and service users were pleased to show their bedrooms to the inspector. Communal areas are well furnished and the lounge has a large television with sky television to give service users a wide choice on what they may choose to watch. The dining area is used at meal times as well as being an area where board games or crafts can be used. On the day of inspection a service user and member of staff were enjoying a game of draughts. The kitchen is an integral part of the home and some service users get involved in the cooking and preparation of meals as well as baking cakes and pastries. On the day of inspection the home was clean and tidy, free from any offensive odours.
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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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 36 The staff working within the home are offered the training that ensures that they are competent and have the skills and knowledge needed to fulfil their roles within the home thus offering a good quality service to the service users. The home has sufficient numbers of staff on duty at any one time to ensure that the individual needs of service users can be met. Staff are provided with both formal and informal supervision that ensures that the competence of staff and quality of care provided is well monitored. EVIDENCE: Fifty per cent of staff have NVQ level 2 or above and some are training for NVQ level 3. The manager supports staff encouraging staff development. All staff now have a training profile. When speaking to service users there was evidence that the staff cared for service users in a professional competent way that met service users needs. The staff group is well established within the home and the stability of the staff group benefits the service users. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 17 The rota was seen and ensures that the amount of staff on duty meet the needs of the service users at any particular time. This meant that the rota changed with the different needs of the service users. This was confirmed by talking to service users and reading care plans. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 and 42 The manager is well qualified and experienced in this field providing an efficient well run home that offers service users a good quality of care in a pleasantly furnished and decorated home. . The health and safety of service users is promoted within the home and the manager aims to meet all of the standards to ensure the home is safe for service users. A requirement has been made with regard the risk assessment and covering of radiators. EVIDENCE: The manager has significant experience in the care or younger adults with learning disabilities. She is in the process of completing her registered managers award and hopes to complete this by October 2005. All of those service users spoken to spoke very highly of the manager and it was clear that the relationship between management and service users and staff is good. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 19 The radiators in the home are not covered and have not been risk assessed. It has been required that these are risk assessed and covered unless the risk assessment concludes that they are of no risk to service users. The manager was happy to do this. The home is planning to have a new boiler in the near future. The laundry room floor is in a poor state of repair and the manager has said that this area is to be refurbished soon. Evidence of this was seen on the business/maintenance plan. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x 3 Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Cranleigh Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 21 no 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. Standard 42 Regulation 13.4.c Requirement The registered provider must ensure that all radiators are risk assessed and covered unless the risk assessment concludes that there is no risk to service users. Timescale for action 01/08/05 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 30 Good Practice Recommendations That the planned refurbishment of the laundry room take place as soon as possible. Cranleigh I55 s27297 Cranleigh v220509 (an) 240505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 3rd Floor - Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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