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Inspection on 26/09/05 for Crann Mor Nursing Home

Also see our care home review for Crann Mor Nursing Home for more information

This inspection was carried out on 26th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home continues to provide a homely and attractive environment for the service users. The staff were seen to be caring for the service users in a friendly and respectful way. All service users contacted stated that they felt safe and well cared for in the home. Service users were encouraged to maintain control over their daily life as much as possible. Feedback from service users and visitors was positive. The service users care plans were detailed. They gave clear instructions to the staff about the service users needs and the care that had to be given to meet those needs. The home had a stable team of staff who knew the service users well.

What has improved since the last inspection?

The Service User Guide is given to all service users on admission. The home is developing appropriate activities for the service users. Staff had received fire safety training, and a fire risk assessment had been completed. Water temperatures at all baths were at a safe level.

What the care home could do better:

All service users must receive a copy of Terms and Conditions of residency in the home. The staff should sign their induction records when they have completed a topic. As good practice any minor concerns should be documented, with action taken. The activity programme should be displayed so that service users and their families know what activities are planned.

CARE HOMES FOR OLDER PEOPLE Crann Mor Nursing Home 151 Old Woking Road Pyrford Woking Surrey GU22 8PD Lead Inspector Janet Daulton Announced Inspection 26th September 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Crann Mor Nursing Home DS0000017602.V254816.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. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crann Mor Nursing Home Address 151 Old Woking Road Pyrford Woking Surrey GU22 8PD 01932 344090 01932 344090 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 A M Emambux Mrs M Emambux Care Home 24 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (24) of places Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be admitted from the age of 60 years onwards. Date of last inspection 14th June 2005 Brief Description of the Service: Crannmor is a large two storey detached property, which has been adapted to provide nursing care for up to 24 Older Persons. The home is situated in a residential area not far from the town of Woking. Accommodation is offered mainly in single rooms. There are communal areas consisting of a lounge/dining room and another small sitting area within the home. There are gardens to the front and rear of the property, and there is ample parking within the grounds. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 4.5 hours and was the second inspection carried out by the Commission for Social care Inspection for the year 2005-2006. To obtain a complete overview as to how well the home meets the National Minimum Standards it will be necessary to read both reports. The inspection was carried out by Janet Daulton, Lead inspector for the service. The Registered person, and Manager, Mr. and Mrs Emamabux, were present for all of the inspection. A tour of the premises took place. Four care plans, the complaints log, staff recruitment files, and a sample of safety certificates were inspected. The inspector spoke to most of the service users; the inspector also spoke with some of the staff on duty at the time of the inspection. The CSCI had received written feedback from 6 service users, 10 relatives or visitors, 1 GP and 1 visiting Health care Professional. The comments were generally very positive. Overall this was a good inspection. The inspector would like to thank the staff and service users for their time, assistance, and hospitality during the inspection. What the service does well: The home continues to provide a homely and attractive environment for the service users. The staff were seen to be caring for the service users in a friendly and respectful way. All service users contacted stated that they felt safe and well cared for in the home. Service users were encouraged to maintain control over their daily life as much as possible. Feedback from service users and visitors was positive. The service users care plans were detailed. They gave clear instructions to the staff about the service users needs and the care that had to be given to meet those needs. The home had a stable team of staff who knew the service users well. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 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. Crann Mor Nursing Home DS0000017602.V254816.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 Crann Mor Nursing Home DS0000017602.V254816.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): 1,2, 6 Service users were not provided with all the information about the home, in order for them to make an informed choice, as the service users funded by Social services did not have a statement of terms and conditions for residency within the home. EVIDENCE: The home had a Service User Guide that was given to all service users or their relatives. The inspection report was displayed on the wall, and it was reported to the inspector that many relatives had read it. The majority of service users were funded through Social Services. However very few of these service users had a copy of the terms and conditions at the point of moving into the home. The home does not provide intermediate care. Crann Mor Nursing Home DS0000017602.V254816.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, 8,9,11 The service users health, personal and social needs were set out in an individual plan with all the needs clearly identified and there was documentary evidence of the identified needs being met. Medication was administered safely. EVIDENCE: Service users spoken with were complimentary about the care that they received at the home. All stated that they were comfortable in the home and that the staff were kind and caring. All the written feedback stated that there was satisfaction with the care provided. Care plans were sampled and examined at inspection. There was a very detailed assessment, and a care plan generated from that assessment, and evidence that the care plan was drawn up with the involvement of the service user or relatives. The care plan included appropriate risk assessments. There was evidence of review of care plans. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 10 The service users health care needs were being met. There was adequate equipment for moving and handling, and pressure sore prevention and treatment. Regular visits were made by health care professionals, and specialists such as chiropody and optician services. Medication records and procedures were examined. Medication was being stored appropriately and administered in line with the homes policies and procedures. There were no service users self-medicating at the time of the inspection. One of the senior staff was completing a palliative care course, to ensure that the home could meet any specific needs of a service user requiring palliative care. Crann Mor Nursing Home DS0000017602.V254816.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 home had made progress on developing the activity provision for service users to enable them to live fulfilling lives. There was active involvement by relatives. EVIDENCE: The social history of service users was documented in the care plan. One of the care assistants provided activities for the service users most afternoons, which included gentle exercise, and a sing-along. A relatives forum, called Friends of Crannmore had recently been formed, and an advert had been placed in the local at area for a pianist to come along on a regular basis to entertain the service users. There was no programme of activities displayed in the home. To fully meet the standard up to date information about activities should be circulated to all service users in a suitable format. The manager informed the inspector that the home was not involved in any financial affairs of the service users, this being managed by relatives or advocates. Crann Mor Nursing Home DS0000017602.V254816.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 Service users are protected by the homes procedures for dealing with complaints EVIDENCE: The home had a clear complaints procedure, and a detailed complaint log was kept. There has been one complaint made to the home since the last inspection. The complaint were seen to be dealt with in an appropriate manner. Minor concerns were not documented, and as good practice it is recommended that these be recorded. Service users and visitors were aware of whom to complain to. Relatives meetings were held twice a year with minutes taken. Staff had received training in vulnerable adults procedures and awareness, and there was an adult protection procedure in place. The home had a policy regarding service users money, ensuring service users safety of money and possessions. Crann Mor Nursing Home DS0000017602.V254816.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): 20,21,22,23,24,25,26 The home presented as a homely and comfortable environment with a good standard of cleanliness. EVIDENCE: During a tour of the home the premises were seen to be well maintained with service users able to access all areas of the home and gardens. The premises were clean with no malodours. There have been no changes to the room sizes. The home was fitted throughout with appropriate aids and adaptations, including assisted baths. Grab rails were fitted in hallways, and in bathrooms and WCs. There was a passenger lift. There were sufficient openings in doorways to allow the passage of a wheelchair. There were call bell systems in the home. The lounge incorporates a dining area, with a small dining table. Most of the service users took their meals at small tables over their easy chairs. The service users spoken with were happy with this arrangement. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 14 All the service users rooms were personalised with some of their own personal possessions. The service users rooms were not fitted with locks. There was a lockable space in the bedrooms. Checks on the water temperatures showed that water was delivered at a safe temperature. Radiators in the home were guarded. Crann Mor Nursing Home DS0000017602.V254816.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): 27,29,30. The numbers and skill mix of the staff met the service users needs. Service users were protected by the homes procedures for recruitment. Staff receive training to enable them to care for the service users in a skilled way. EVIDENCE: The staff rota inspected demonstrated that the staffing numbers and skill mix were appropriate to meet the assessed needs of the service users living in the home. Service users commented that staff answered the call bells within a satisfactory time, day or night. Domestic and laundry staff were employed in sufficient numbers. All interactions observed between staff and service users during the inspection were seen to be caring and respectful. All necessary employment checks were carried out before a new member of staff was employed. A new induction process had recently been implemented; the induction records should be signed by trainer and employee when completed. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 16 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): 31,34,35,37,38 The home was well managed by the Registered Manager, who was aware of her responsibilities to service users and staff. All safety certificates were in place, ensuring, as far as is possible the well being of service users. EVIDENCE: The Registered Manager had the experience to manage the home. There were clear lines of accountability within the home. The Registered Manager informed the inspector that the Deputy Manager would be applying to be the Registered Manager on completion of the Registered managers award. Service users financial interests were safeguarded by the homes policies and procedures. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 17 Staff had received appropriate training in health and safety matters, including moving and handling and fire training. Records were stored securely within the home. A recommendation was made that a general home risk assessment is completed. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 18 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 3 2 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x 3 3 x 3 3 Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 19 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 1 Regulation 5(1) Requirement Each service user must be provided with a Statement of Terms and Conditions when they are admitted to the home The trainer and employee must sign induction records. Timescale for action 30/11/05 2 30 18(1) 30/11/05 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 2 3 4 Refer to Standard 12 16 24 38 Good Practice Recommendations Up to date information about activities is displayed and circulated to all service users in formats suited to their capabilities. Minor concerns are documented. Doors to service users bedrooms are fitted with locks and service users given a key, unless a risk assessment suggests otherwise. A home risk assessment is completed. Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Crann Mor Nursing Home DS0000017602.V254816.R01.S.doc Version 5.0 Page 21 - 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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