Inspection on 20/12/05 for Cranmer House

This inspection was carried out on 20th December 2005.

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

Cranmer House 02/10/07

Cranmer House 04/09/06

Cranmer House 14/03/06

Cranmer House 19/01/05

Cranmer House 26/07/04

Cranmer House 06/01/04

Cranmer House 08/09/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Cranmer House Cranmer House Norwich Road Fakenham Norfolk NR21 8HR Lead Inspector Mrs Geraldine Allen Announced Inspection 20th December 2005 09:30 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 Cranmer House DS0000035495.V257980.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. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cranmer House Address Cranmer House Norwich Road Fakenham Norfolk NR21 8HR 01328 862734 01328 856228 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) Norfolk County Council-Community Care Kirsty Dianne Grand Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommodate 21 service users who are older people not falling within any other category. 19th January 2005 Date of last inspection Brief Description of the Service: Cranmer House is a 21 bedded home which is run by the Local Authority in conjunction with the Local Health Trust as a joint provider Unit( JPU). The residential portion of the building only is subject to inspection by the Commission for Social Care Inspection. The Home is situated close to the centre of Fakenham and all local amenities. The home consists of a two-storey building, with the residential care unit being located on the first floor. All bedrooms provide single occupancy with en-suite facilities. Some communal facilities, including the dining room, are located on the ground floor that is accessed via a shaft lift. The home has a newly resurfaced car park, gardens to the front and an enclosed garden. All are accessible to residents. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place during the day of 20th December 2005. Not all of the National Minimum Standards were inspected on this occasion. Those standards not inspected will be assessed at a future inspection. The manager, Ms Grand, completed and returned a pre-inspection questionnaire, providing background information about the home. Questionnaires have been completed and returned to the Commission from current residents, residents who have used the services on a short-stay basis, visitors to the home and also healthcare professionals. In total, 14 questionnaires were received from current and previous residents, 10 questionnaires from current and previous visitors and 4 questionnaires from visiting professionals. The views and some comments from these questionnaires are included in the inspection report. On the day of inspection, some records were seen and Ms Grand provided information. Three staff and 2 residents were spoken to in private, with other residents being seen and spoken to briefly during a tour of the building. Overall, this home provides excellent care that is much appreciated by the residents receiving services. Comments received included: “I am entirely satisfied with the treatment offered to my mother and to myself”. “My mother received care that was second to none”. “An excellent pleasure to be taken care of so well”. “Everything was to a very good standard, I cannot praise enough”. “This is a well run and well organised care home. I have great admiration for the work the staff do”. There was evidence throughout the day that this is a well-run home. Staff were very welcoming and cheerful. Their interaction with residents was seen and this appeared warm, friendly and very respectful. The following parts of the summary were completed in discussion with Ms Grand. What the service does well: There is good communication between Ms Grand and the staff. From discussion with Ms Grand and some staff, it was clear that they all understand what they are trying to achieve and work well as a team toward their common goal. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 6 Ms Grand is very competent and knowledgeable. She knows when to seek advice and guidance from line managers and other agencies to ensure residents are well cared for. The documents used to record areas where residents, staff and/or visitors to the home may be at risk were looked at. These were of a high standard and they have been continuously updated as a result of building work at the home. 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. Cranmer House DS0000035495.V257980.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 Cranmer House DS0000035495.V257980.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): These standards were not inspected on this occasion. EVIDENCE: Cranmer House DS0000035495.V257980.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): 8, 10 Resident’s healthcare needs are met appropriately and in a timely way. Residents feel they are treated well and that staff respect their privacy and dignity. EVIDENCE: Comment cards were completed and returned by the visiting GP, District Nurses and Dentist. A visiting GP was also seen and spoken to at the time of inspection. Evidence consistently showed that staff at the home communicate well and in a timely fashion. The healthcare professionals were confident that staff follow all instructions given to them. Additional comments included: “Excellent, caring, enthusiastic staff”. “Its reputation locally is high”. Residents stated that they feel well carded for and can see a doctor if they need to. Based on comments made during the inspection and also responses to the comment cards, residents feel well cared for and well treated by staff. All residents felt they were treated with respect and that staff tried hard to maintain their dignity. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 10 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, 13, 14, 15 Residents feel their lifestyle within the home generally matches their expectations. Residents are able to have visitors when they wish and can entertain them in private. Residents spoke about being able to make choices in their day-to-day living. Most residents stated that they enjoyed the food at this home. EVIDENCE: Residents spoken to described their lifestyles and how it matches their own expectations. Those spoken to explained how they like to spend their time and they way in which staff support them to do so. Residents stated that they could have visitors when they wish and visitors were seen throughout the inspection. Residents said they could entertain their visitors in their own room if they wished or can use any of the communal areas in the home. There was some reference to how the building work at the home has affected the ability of residents to spend time where they wish, particularly whilst the dining room was being refurbished. Residents described the kind of choices Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 11 they make around their daily living and confirmed that staff respected expressed choices and supported them to make choices if necessary. A main meal was not sampled on this inspection. Sample menus for 2 weeks were provided and showed that the home offers a varied, choice menu that also caters for special diets such as diabetic and vegetarian. Those residents spoken to said that they enjoyed their meals although one felt the portions were too large at times. All returned comment cards showed that residents enjoyed their food, although one stated they would like more fish on the menu and another that they would like to see “a more varied menu”. The newly refurbished dining room provides a comfortable place for residents to gather to enjoy their meals. The room and furnishings are colour co-ordinated and the tables were attractively decorated. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 12 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 complaints procedure in place that is known by residents and visitors to the home. Residents are protected from abuse by good practice and well-trained staff. EVIDENCE: Records were seen regarding 2 complaints made and investigated by the home. The records showed that Ms Grand consulted appropriately with her line manager and thorough investigations were undertaken. During the course of the inspection, issues around adult protection and the involvement of the Commission in potential adult abuse matters were discussed. Ms Grand responded to the complaints in accordance with the homes complaints policy and procedure document. The home has a robust approach to staff training in adult abuse and protection matters. Those staff spoken to demonstrated a good understanding of protection issues and confirmed they had attended training that had been helpful to them. The home also follows best practice regarding Criminal Records Bureau and Protection of Vulnerable Adults checks (CRB/POVA). All staff are subject to CRB & POVA checks at the time of their appointment. Please also see standard 28. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 13 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, 24 & 26 The home is safe and well maintained. Arrangements are in place to ensure a safe environment whilst building work takes place. Residents bedrooms are comfortable and personalised with their own possessions. On the day of inspection, the home was clean, tidy and no unpleasant odours were detected. EVIDENCE: A tour of the home took place and consideration was given to arrangements for the maintenance of safety for residents, staff and visitors during this period of development. Ms Grand described the steps taken to keep accessible areas safe, in consultation with the architects, representatives of the local Authority and on-site contractors. Risk assessments have been completed and these were seen and were appropriate. Site meetings have been taking place on a frequent and regular basis, when elements of risk to residents and staff have been considered. Based upon the amount of significant work being undertaken at this home, the impact to residents especially has been minimal and the Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 14 residents spoken to agreed they had experienced little inconvenience. Ms Grand and the staff team are commended for this. Residents were spoken to in private in their own rooms. The rooms were spacious and arranged the way the residents wished. Each bedroom had ensuite facilities and the residents appreciated these. The rooms contained many personal features, for example pictures, photographs and ornaments. Both residents said they liked their rooms and were happy to spend time there doing the things that interest them. During the inspection, it was noted that the home was clean and tidy. It was expected that there would inevitably be dust about due to the building work, however this was not the case outside of the current construction areas. The domestic staff are commended. No unpleasant odours were detected during the inspection. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 15 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 & 30 There are sufficient, competent staff on duty to meet the needs of the residents. Residents are in safe hands, with staff who receive training that reflects safe practice. The home has a recruitment process that is in line with recognised best practice. Staff receive training that is appropriate to the needs of the residents. EVIDENCE: Some of the care activities taking place at this home are not subject to the Care Standards Act 2000 and Care Homes Regulations 2001, for example the attached day centre and nursing unit. Whilst the day centre is staffed independently, there is some crossover of care staff between the home’s care and nursing units. Staff rotas were provided by the home and these showed that the home employed care staff in sufficient numbers at the time of inspection. Comments received by residents, visitors and healthcare professionals confirmed that there were staff available whenever needed. One resident stated that staff always “pop in” to chat and make sure all is well. Residents confirmed that call bells were answered promptly. The home also employs ancillary staff in sufficient numbers. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 16 Evidence was seen that the home employs agency staff from time to time. Ms Grand said that one agency was used exclusively. Issues around evidence of the agency staff competence were discussed. It was suggested that Ms Grand obtain confirmation from the agency that the staff supplied to the home have been subject to satisfactory CRB/POVA checks and appropriate statutory training. Ms Grand dealt with this during the course of the inspection and a verbal undertaking was obtained from the agency that written confirmation of these matters would be forwarded. Because of changes taking place at the home, it is understood that a review of staffing levels will be completed and proposals submitted to the Commission in due course. Information provided by the home shows that 57 of care staff have attained NVQ at level 2 or above. The programme of NVQ training is continuing. Newly appointed staff receive a very comprehensive induction that is properly recorded. This was seen for a recently appointed carer. All staff have received adult abuse and adult protection training. During discussion, staff demonstrated sound knowledge on these matters. The home follows a robust procedure when recruiting new staff. The procedure is based upon recognised best practice, which includes two written references, a thorough and recorded interview and full CRB/POVA checks. One staff file was looked at in detail and contained all the information required to ensure residents are protected. However, during discussion around the obtaining and storing of CRB/POVA disclosures, Ms Grand confirmed that the copies on staff files are photocopies of the individuals’ disclosure and not of that returned to the Local Authority. As a result, copies of disclosures will only be available for inspection purposes as a result of the goodwill of staff. It is recommended that the current practice be reviewed to see if photocopies can be sent from the Local Authority. See recommendations. Ms Grand provided details of previous and planned staff training. This included staff training profiles with details of when updates were due. In addition to statutory training requirements, the training available is extensive and appropriate to the needs of the residents. The home is commended. Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 36, 37 & 38 The home is managed and run by a well qualified and competent manager. The residents benefit from the ethos, leadership and management of the home. Staff receive regular supervision that is recorded. The records seen showed that best practice is used and the home follows policies and procedures. The health and safety of residents, staff and visitors to the home is protected. EVIDENCE: Ms Grand is a qualified nurse who, during the course of the inspection, demonstrated a clear understanding of the specific needs of people needing residential and social care. The home is currently going through significant change, both structurally and also in terms of the client group. Ms Grand has Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 18 been clear about how the matters should progress and she has successfully conveyed this to the staff. As a result, there is a happy and relaxed atmosphere, where residents feel safe and well cared for. Staff receive recorded supervision that commences at the time of induction. All new staff have at least 1 mentor during the induction period. Subsequent supervision takes place on both a 1-to-1 and group basis. Staff stated that they appreciated their supervision sessions and felt they were helpful to enable discussion of any issues they may have. Various records were seen, including staff files, risk assessments, staff rotas, menus and complaints. All were in good order and were up to date. Entries were legible. Records were stored appropriately, with confidential records kept in a locked cabinet in Ms Grand’s office. Information contained within the pre-inspection questionnaire showed that equipment was maintained appropriately. As previously stated, risk assessments relating to the building were seen and appropriate measures were in place to safeguard residents, staff and visitors. During the tour of the building, alcohol gel was observed left on handrails in corridors in 2 separate areas of the home. Reference to Control of Substances Hazardous to Health data sheets showed the alcohol gel should be stored in a cool and ventilated area and it is questionable if the proximity to radiators would cause deterioration. In addition, the risk of ingestion of this substance is present, albeit minimal. It is recommended that the storage and access to alcohol gel be reviewed. See recommendations. There was some discussion around the fire risk assessments and the anticipated new fire regulations due in 2006. Ms Grand described the arrangements now in place following full consultation with the Fire Safety officer. All staff are to receive evacuation training in February 2006. The fire emergency folder was seen and Ms Grand confirmed that this document was updated each evening to ensure all details, including details of those residing at the home, was up to date. Cranmer House DS0000035495.V257980.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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 4 9 X 10 3 11 X 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 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 x X x 3 3 3 Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 20 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. 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 Refer to Standard OP29 Good Practice Recommendations It is recommended that consideration is given to how copies of CRB/POVA disclosures are obtained. It is suggested that copies ought to be supplied from the Local Authority to ensure the home is not dependent on copies being provided by staff. It is recommended that the storage of and access to alcohol gel is reviewed to prevent deterioration of the product and the risk of ingestion. 2 OP38 Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 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 © 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 Cranmer House DS0000035495.V257980.R01.S.doc Version 5.0 Page 22 - 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. 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