Inspection on 29/11/05 for Cranleigh Paddock Older Persons Resource Centre

This inspection was carried out on 29th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Cranleigh Paddock Older Persons... 09/10/07

Cranleigh Paddock Older Persons... 31/01/07

Cranleigh Paddock Older Persons... 06/07/05

Cranleigh Paddock Older Persons... 11/01/05

Cranleigh Paddock Older Persons... 27/07/04

Cranleigh Paddock Older Persons... 05/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Cranleigh Paddock Older Persons Resource Centre Calpe Avenue Lyndhurst Hampshire SO43 7AT Lead Inspector Anita Tengnah Unannounced Inspection 29th November 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.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. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cranleigh Paddock Older Persons Resource Centre Calpe Avenue Lyndhurst Hampshire SO43 7AT Address 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) 023 8028 3602 023 8028 4124 Hampshire County Council Mrs. Sheila May Aplin Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34) of places Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: Cranleigh Paddock is a registered care home providing personal care to 34 service users in the older person category. Hampshire County Council owns the service. Accommodation is provided on ground floor level and is divided in four units. The home is situated in Lyndhurst on the outskirts of Southampton city and close to local amenities and the New Forest. The home has enclosed gardens that are accessible from each unit and to wheelchair users. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken over a day on the 29th of November 2005. The inspection took place over 5 hours and the registered manager assisted in the process. As part of the inspection, a tour of the building was undertaken. The home presented a warm and homely environment. The inspector spoke to 11 service users, 9 staff. The process included examining care records, staff records and discussions with service users, staff and visitors. What the service does well: What has improved since the last inspection? The home has developed a new supervision formula in order to ensure that staff are supervised as part of their daily work and have the opportunity for one to one consultation. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 6 A new care planning system has been introduced and staff updated about the system of care planning. 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 Paddock Older Persons Resource Centre DS0000034267.V269233.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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.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 There is a good pre assessment process in place to ensure that the home can meet the needs of the service users however the lack of care management assessments may be to the detriment of the service users. EVIDENCE: The home has a pre assessment procedure in place. Service users are invited to spend a day at the centre as part of their assessment process. Staff say that this is a good way of gathering information in an informal manner. Information as per the statement of purpose is available to all prospective service users. Care management assessments are sought, however these are not always available. Discussion was undertaken regarding a service user who was admitted as an emergency. Care management assessment did not arrive until days after the admission. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 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 the following standard(s): 7,9,10 Assessments and care plans were in place for most of the service users. However the lack of care plan for one service user and lack of review can be to the detriment of the service users. The record of medication administered is well managed. The management of controlled medication is poor and can be detrimental to the welfare of the service users. EVIDENCE: Care plans were viewed for three service users living in the home. Detailed assessments were completed and the care plans included references to all aspects of daily living, including assistance with personal care, interests and social care needs were recorded. It was noted that not all care plans had been reviewed and updated on a regular basis. This was discussed with the manager and action is needed to ensure that care plans reflect the current needs of service users. There was one service user who had been recently admitted as an emergency. Detailed care plan was in place regarding how her needs would be met at nighttime. However there was no other personal care plans in place to demonstrate how her assessed needs would be met. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 10 The manager discussed that staff are working with relatives in order that personal history of service users can be gained and incorporated in their daily plan. The home has procedures in place to inform staff about the management of medication. A sample of Medication Administration Record (MAR) showed that a record of medication administered was maintained. All medication was stored securely and training/ update in medication is available to staff. The record of returned medication in particular controlled drug was poor. It was observed that on a number of occasions, there were no records of medication that staff say had been returned to the Pharmacy or the service users. A review of the procedure for recording and decanting of medication brought in by service users on respite care need to be reviewed, this was discussed with staff at the time of the inspection. A number of service users spoken to say that their privacy and dignity are respected and that they are treated very well. A number of service users hold keys to their own rooms. It was evident from practices observed that staff attended to service users in a respectful and compassionate manner. Service users said that they enjoyed spending time in the communal lounge and enjoyed the activity programme. Comments included “ I do as I please”. One service users had been out for her daily walk. Other comments were that “Staff are good and helpful”. “ I get up in own time”. “No grumble”. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 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 the following standard(s): 12,14 The meals at the home are well managed to the satisfaction of the service users. The home is supportive in helping service users to exercise choice and control over their lives. EVIDENCE: The home has a planned menu. Nine service users were spoken to with regards to meals and they all commented that meals were very good and choices are offered. Meal at lunchtime appeared well balanced, nourishing and nicely presented. The daily menu for lunch was displayed in each unit. Hot and cold drinks are available at all times. Three service users spoken to confirmed this. The menu has been updated to record the choice of snacks that are available at supper. Service users reported that the food was “very good” and two service users had opted for the salad choice on the day and commented that meals are always very nice. Service users comments were that they autonomy and choice with regards to the activities of daily living. Two service users said that they were going out to Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 12 an event in the community. They both attend the Baptist church for lunch on a regular basis. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 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 the following standard(s): 16,18 The procedures for dealing with complaint and the prevention of abuse are satisfactory. EVIDENCE: The home has a policy and procedure in place regarding complaint. Service users spoken to say that they did not have any complaints as it was “a happy home”. However they would approach the staff if they had any issues. A complaint log was maintained and the manager investigates all complaints. The home has procedures for the prevention of abuse and the Hampshire adult protection procedure. All new staff has an update on prevention of abuse as part of their induction. A number of staff had completed training in adult protection and are aware of the need to report and record all allegation of abuse. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 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 the following standard(s): 19,21,26 The home was warm and welcoming and furnishing was appropriate for the needs of service users. A review of the two toilets in the two units is needed to ensure that they meet the service users needs. The infection control procedure is satisfactory. EVIDENCE: The home was homely, welcoming and clean on the day of the visit. There is an ongoing programme of refurbishment in place. Staff reported that service users bedrooms are decorated as needed. Furnishing was clean and of good standard, appropriate to the needs of service users. A number of areas had been refurbished including a communal bathroom fitted with a ceiling hoist and assisted bath. The doors to the bathrooms have been painted in the same colour and two service users spoken to say that this was easy to find. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 15 It was noted that two toilets in two of the units were not suitable to service users with limited mobility and those who required assistance. Staff reported that more service users need assistance of some sort. The provider must undertake a review of these two toilets and ensure that toilet facilities are accessible and appropriate to the needs of the service users. The home has a laundry and all the service users laundry are undertaken internally. The laundry was clean and washing machines fitted with sluicing facilities. Hand washing facility was available as well as gloves and aprons as part of the home’s infection control procedures. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 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 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): 27,30 The staff have good understanding of service users support needs, this was evident from positive relationships that have been developed. However the lack of ancillary cover at weekends may erode care hours as staff undertake non-care duties. There is a good training programme in place to ensure that staff have the skills to meet the needs of the service users. EVIDENCE: The duty roster shows that there is a separate roster for carers and ancillary workers. Day duty has 5 carers and the Assistant unit manager (AUM) support them. The change in the night cover discussed and there is 3 waking night staff as the night care coordinators have replaced the AUM. The staff have developed good relationship with the service users. Comments form service users included that staff are very kind and their friends. One of them said that they all have “ a banter” and they were treated with respect at all times. Staff reported that there is one staff employed during the weekdays for the laundry. There is no cover for holidays, sickness and annual leave and carers undertake this duty. This was discussed with management and the provider must ensure that there are adequate staff including ancillary staff at all times to meet the needs of the service users. This has the potential of care hours be eroded by non-care duties. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 17 The home has an ongoing training programme. Recent training included a fourday foundation course in dementia. As part of staff development the link nurse for dementia has set up group work for staff to update/ and gain new skills in dealing with service users who have dementia. The training programme included NVQ training where 5 staff is undertaking Level and 5 staff have completed. There is 2 staff that have completed level 3, and two have completed level 4 and the RMA. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 18 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): 35 The home’s procedure for dealing with service users’ personal allowance is well managed and ensures that the service users’ interests are safeguarded. EVIDENCE: A sample of the service users’ financial records seen showed that there is one service user who has Hampshire County Council as appointee. Staff reported that this was handled by the company’s receiver’s office. Invoices are raised and the home’s administrator maintained receipts of all transactions. The home manages small amount of the service users’ personal allowance, a sample of these moneys kept at the home showed that these were accurate. There is a procedure in place where are signed by two staff members all transactions when dealing with service users’ finance. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 2 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2) (b) Requirement The manager is required to ensure that care plans are formulated for all service users on admission. Staff must ensure that care plans are reviewed and updated on a regular basis to reflect any changes in the needs of service users. The manager must ensure that staff adhere to the procedures for returned controlled medication and accurate records are maintained. The provider is required to ensure that there are adequate staff, including ancillary staff at all times to meet the needs of service users. This is a repeated requirement from 11th January, 30th August 2005. Timescale for action 15/01/05 2. OP9 13(2) 15/01/05 3. OP27 18(1) (a) 15/01/05 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cranleigh Paddock Older Persons Resource Centre DS0000034267.V269233.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!