Inspection on 10/05/07 for Cranvale

This inspection was carried out on 10th May 2007.

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

The inspector 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

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Cranvale 36 Buntingbridge Road Barkingside Ilford Essex IG2 7LR Lead Inspector Jackie Date Key Unannounced Inspection 10:00 10th -15th May 2007 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 DS0000067402.V337170.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. DS0000067402.V337170.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranvale Address 36 Buntingbridge Road Barkingside Ilford Essex IG2 7LR 020 8554 0244 020 8518 6650 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) www.sanctuary-care.co.uk Sanctuary Care Ltd Mrs Irene Prasad Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places DS0000067402.V337170.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Forty elderly people who may have physical or sensory disabilities or mental frailty related to the ageing process, but who are not mentally ill, within the meaning of the Mental Health Act. To include one named person under 65 years of age with learning disabilities 8th November 2005 Date of last inspection Brief Description of the Service: Cranvale is a 40 bedded home for older people offering permanent and respite stays. It is one of five Sanctuary Care homes in Redbridge. The home is in Barkingside close to local shops and transport. There are 32 single rooms and 4 double rooms. The home is accessible to wheelchair users. There is a well kept garden that some of the residents enjoy sitting in. There are three lounges and a dining area plus a small visitors/smoking room. Bathing and toilet facilities are suitable for the needs of older people. The residents enjoy activities such as music, day trips and bingo. The basic charge per week for each service user is £498-85. This information was provided in the pre inspection questionnaire received in May 2007. Information about the service provided is contained in the service users’ guide. DS0000067402.V337170.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over the course of two days. The first day of the inspection was unannounced and started at 9:20. It took place over seven hours. A second arranged visit took place a few days later. The purpose of this was to be shown around the home by residents and then to meet a group of residents to get their views on the service and their experience of living in the home. Care staff were asked about the care that residents receive, and were also observed carrying out their duties. All of the shared areas and some of the bedrooms were seen. Staff, care and other records were checked. Feedback questionnaires were sent to residents, relatives and staff. Responses were received from 23 residents and/or their relatives and also from 13 staff. Feedback was also received from a visiting healthcare professional. This was a key inspection and all of the key inspection standards were tested. The Commission has not received any complaints about this service. Sanctuary Care took over responsibility for the home in April 2006 and became the registered provider. This was the first inspection since this happened. Ashley Homes were previously responsible for the service prior to that date. The inspector would like to thank the residents and staff for their input during the inspection. What the service does well: The home is fully staffed and there is a stable staff team that residents say are kind and caring. Agency staff have not been used for more than two years. More than half of the staff team have got NVQ qualifications and have had the training needed to help them to provide a good service for the residents. There is a relaxed atmosphere in the home and relatives are welcomed. Families can have meals with their relatives and are invited to any celebrations or events organised at the home. Activities and entertainment are organised. Residents have been on holiday, for pub meals, shopping trips and day trips to France. This exceeds minimum standards. Staff, residents and relatives all have the opportunity to discuss the service and to make suggestions about future changes. DS0000067402.V337170.R01.S.doc Version 5.2 Page 6 Staff feel that they get a lot of help and support and that this enables them to provide a good service that meets the residents’ needs. When asked, “what does the home do well” a group of residents responded “everything”. Also “staff are kind, they are always around when you need them. We would recommend Cranvale”. The psycho geriatrician said that staff seem to know the residents and that residents are treated appropriately. He has not had any complaints. He also said that the home is receptive to ideas. 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. The summary of this inspection report can be made available in other formats on request. DS0000067402.V337170.R01.S.doc Version 5.2 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 DS0000067402.V337170.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Information is obtained to enable the staff team to decide whether or not the home can meet prospective residents’ needs. Prospective residents and their relatives can spend time in the home to find out what it would be like to live there and to enable the resident to make a choice about living in the home, within their capacity to do so, and to be confident that the home meets their needs. Residents and their representatives have a written and costed contract/statement of terms and conditions and will therefore be clear about the service that they are entitled to. DS0000067402.V337170.R01.S.doc Version 5.2 Page 9 EVIDENCE: There is a Statement of Purpose & Service Users guide. These were updated last year to reflect the transfer of the service to Sanctuary Care. Residents spoken to said that they had been given of copy of the guide. Each resident has a contract with the provider and a copy of these were seen in residents’ files. Referrals are made by Social Services department and they provide initial assessment information. This may be from information that they have gathered or from assessments made by hospital staff. Assessments are then carried out by the manager and/or deputy manager before an individual moves into the home. At this time the prospective residents and/or their relatives are provided with information about the home and encouraged to visit. The assessments cover all of the required areas and include health, mobility, and nutrition, religious, cultural and spiritual needs. Examples of this were seen in residents’ files. From this assessment information an initial basic care plan is drawn up to enable staff to provide appropriate care for an individual when they move into the home. A resident said that she had visited the home before she moved in and had liked it so she decided to move in. Another said that she had not been well enough to visit but that her son had. Feedback from one resident was that “staff helped me through a difficult time when I first moved in”. The home does not provide intermediate care. DS0000067402.V337170.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The staff team are able to meet the needs of residents and support them in a way that they prefer, through gathering detailed information and good care planning arrangements. Residents receive personal care that meets their individual needs and preferences. The principles of respect, dignity and privacy are put into practice. This exceeds minimum standards Residents receive good quality health care. Medication is appropriately administered by staff that have been trained to do this. At the end of their life residents are supported kindly and sensitively. EVIDENCE: DS0000067402.V337170.R01.S.doc Version 5.2 Page 11 All of the residents have care plans, which give details of their needs and how to maintain their independence as far as possible. This includes health and personal care. They also contain information about residents’ likes and preferences. For example “prefers to have a shower ”, “leave the bedside lamp on at all times during the night ”, “prefers female carers”. The care plan of one resident stated that it had been agreed that the resident will be assisted into the bath and then left to relax and soak, staff will return later to give assistance. She is given the waterproof buzzer so that she can summon assistance if needed. Another resident confirmed that she did not require physical assistance and that she used the shower independently when she wished. Some of the toilet doors have electronic push buttons to open them and this also enables some residents to be more independent. Another resident described how distressed and embarrassed she had been the first time somebody had assisted her to bath but said that the staff had been very kind and re-assuring. Residents and/or their relatives are asked to read and sign the care plans. Each resident has a nominated keyworker and photographs of the keyworker have been put into residents’ rooms so that they and their relatives know who the keyworker is. Care plans seen had been reviewed regularly and updated when require. They therefore contained up to date information to enable staff to meet residents’ needs. One relative spoken to said “ my mum is looked after well, it was the best thing that happened for her when she moved in here”. Another relative said “staff are always in the vicinity and keep an eye on her, they also keep an eye on her diet”. Residents are registered with local GPs. The optician and dentist make regular checks. The district nurse visits as and when required to provide nursing support. Residents’ weight is monitored and dietary needs addressed. Manual handling assessments are made. Medical information is recorded and the outcome of visits to the doctor or hospital and any follow up action is recorded. Residents are supported to attend doctors and hospital appointments. On the day of the inspection two of the residents had hospital appointments. One resident was accompanied by her daughter and the other by a member of staff. There are two residents with diabetes and the district nurse visits to administer their insulin. Care plans for these residents contain information on the action to be taken in the event of either person experiencing difficulties due to a change in their sugar levels. One care plan also identifies the need for the resident to have a small snack every two hours to maintain appropriate sugar levels. The resident was able to confirm that she does receive this. Staff are trained and competent in health care matters. The home arranges training on health care topics that relate to the health care needs of the residents. The manager is also in the process of arranging oral care training for residents to assist to maintain good oral hygiene for themselves. Although the home is not registered as a service for people with dementia some of the residents do have problems with their short-term memories and DS0000067402.V337170.R01.S.doc Version 5.2 Page 12 are at times confused. To assist the staff team to appropriately support these individual they have received some introductory dementia care training. In addition a specialist in this field has visited to talk about dementia mapping and has carried out an audit of the building and service. The manager was waiting for the report of that visit and will then work towards meeting any recommendations that are made. In June the nutritionist is visiting to talk to team leaders about the nutritional needs of older people. Any information from this will then be included in individuals care plans. Overall the evidence above confirms that residents receive excellent personal and healthcare that not only meets their needs but also encourages and maintains their independence, privacy and dignity. This exceeds minimum standards. None of the residents can self medicate and medication is administered by staff that have received medication administration training. There are policies and procedures for the handling and recording of medication. A random sample of Medication Administration Record (MAR) charts were examined and these were appropriately completed. The medication records include a photograph of the resident, a medical history and details of any allergies. There is also information about the medication and what it is for. This is good practice. Medication is appropriately and safely stored in locked cabinets and liquid medicines have the opening dates recorded on them. There are regular times for administering medication but times are tailored to meet individual needs. For example one resident suffers from anxiety and likes to have her medication early before she does anything else. Another resident has Parkinson’s disease and feels that it is better for him to have the medication early. Therefore medication is safely and appropriately administered in a way that meets residents’ individual needs and preferences. All of the staff have received training about death & bereavement and details of residents’ wishes in the event of their death are recorded in care plans. Religious needs and wishes are also recorded. There is an out of hours priest service based at King Georges Hospital and the home contact this if a priest is needed during the night. Residents who are at the end of their life are supported in the home, as far as is possible, with input from the district nurse or palliative care team. In June the manager is due to attend a training course on end of life care and new care plans are being introduced in the near future. These contain a section on end of life care and this aspect of care will be developed further. DS0000067402.V337170.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Residents have the opportunity to join in a range of activities and outings and this exceeds minimum standards. Visiting times are flexible and visitors are welcomed in the home and residents can keep in contact with friends and relatives and this also exceeds minimum standards. Residents’ views and opinions are important and are used in planning and developing the service and this exceeds minimum standards. The meals in the home are good and residents have a choice of what to eat. DS0000067402.V337170.R01.S.doc Version 5.2 Page 14 EVIDENCE: Activities are provided each day. These include art & craft, bingo, knitting and reminiscence. They have purchased a bingo machine and one of the residents likes to assist to run this. The home has access to a minibus and this is used for outings and short trips. Residents spoken to say that they enjoy the activities. A couple of residents go out by themselves and one of these is able to use the key code for the front door. She said that she likes to go to the local shop. Another resident likes to go to the shop to buy sweets and some lager and staff escort him. A group of residents went on holiday last year with staff to support them. Residents spoken to said that they had a really good time and were looking forward to going away again this year. There were photographs of the holiday showing what residents did and this included using the swimming pool and going on the beach. Residents also spoke about their day trips to France and also to the London Palladium to see the “Rat Pack”. Celebrations are held for birthdays and festivals. This includes going to the local pub for a meal. The home have purchased a portable ramp so that residents are able to access places more easily. There was a Christmas bazaar and local girl guides entertained the residents by singing carols. Once a month a different entertainer visits and this has included singers and pearly kings and queens. The home has strong links with the local church and the church hall is made available free of charge for the home to organise fund raining events. At the weekend after the visit there was a 60s night and some residents already had their tickets and were looking forward to going. Quiz nights are held and some residents like to go, these nights are well supported by staff from the local doctors surgery. Therefore the home is very much part of the local community. Visitors are welcome at any reasonable time and relatives’ meetings are held. One resident said that she had a large family and that they sometimes had meals with her or they all had a takeaway in her room. She was very pleased that the family were welcomed to visit her. A relative said “ we visit regularly and you can come when you want to. The family feel very comfortable to visit and this includes bringing the children” Residents are encouraged to be as independent as possible and to be involved in choices about the home and about their lives. One resident organises his own transport for social events and meetings that he wishes to attend. Regular residents’ meetings are held and are now chaired by one of the residents. Residents said that they talk about what they like, any complaints and what they want. They put forward ideas and staff see what the can do. Residents’ opinions are sought and acted upon. DS0000067402.V337170.R01.S.doc Version 5.2 Page 15 During the course of the inspection a vicar was visiting one of the residents. Monthly Church of England services are held and the catholic priest visits two weekly. None of the current Jewish residents wish the Rabbi to visit. Residents said that some people go to church. Therefore residents spiritual needs are met. One of the resident’s is Portuguese and has limited English. There is a list of key words and how to pronounce them and also the home has tapped into “Language line” and can access an interpreter 24 hours a day. Therefore they are able to find out what this resident wants and he is able to express his views. Residents are offered a choice of meals. Special diets can also be catered for and also different types of meals. For example kosher food. The new chef said that he had met with the daughter of one of the Jewish residents to get a list of the sort of kosher food that she likes. Meals are served in the dining area and tables are nicely laid. Drinks and snacks are available and a resident said that the night staff make her a cup of tea during the night. There are also a couple of water coolers around the home and therefore residents can access a cool drink when they wish. One resident said that she has got a coffeemaker in her room and makes herself a coffee whenever she wants to. The take-away service still operates periodically. Residents can pay and order via the staff. This has included fish & chips, Chinese and pie and mash. Residents said that they enjoy this. Drinks and snacks are available. Nighttime care plans include details of the drink that residents would like in their rooms in the morning. One of the residents likes to be involved and she helps to lay the tables and to serve breakfast. Picture menus have been developed to assist residents to make choices. Residents said “if you don’t like it you can choose something else like jacket potato or scrambled eggs.” DS0000067402.V337170.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. There is a user-friendly complaints procedure that is followed in the event of any complaints being made. Staff have received adult protection training to ensure that they are clear about what constitutes abuse and what to do if abuse is seen or suspected. This gives residents a greater protection from abuse. Residents’ finances are appropriately managed and monitored and this lessens the risk of financial abuse. EVIDENCE: There is a complaints procedure and this is displayed in the home. Complaints are recorded and dealt with by the manager and the staff team. Complaints are checked by the service manager and by the local authority. Residents and relatives are encouraged to voice any problems so that they can be sorted out as soon as possible. The manager actively seeks feedback from residents and relatives. Staff are reminded to record any complaints so that they can be appropriately dealt with and evidence of this was seen in the complaints book. Staff also record comments and feedback after each mealtime so that the quality of meals and also residents’ preferences can be monitored. Residents DS0000067402.V337170.R01.S.doc Version 5.2 Page 17 spoken to said that they can talk to staff if they are not happy about anything or they can talk to the manager. They also confirmed that their opinions and views are sought and are taken into account. Also that if they are not happy with anything the manager will do her best to sort it out. The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. Staff spoken to were aware of the issues of abuse and aware of their responsibility to residents. The home has an open culture and staff, residents and relatives feel able to raise any concerns that they might have. Staff understand what restraint is and the use of any equipment that may be used to restrain individuals such as bed rails and wheelchair belts is decided within a risk assessment framework. Residents said “the staff are kind and always around when you need them.” “The staff have treated me wonderfully”. Some of the more vulnerable residents have ‘alarm mats’ so that night staff are alerted when they get up and are therefore able to give them the support that they need to safeguard them. Some of the residents keep their own money and the home holds cash for others. The cash held is used for items such as hairdressing, chiropody and newspapers. The organisations policy is that no more than £100 can be held for any resident. One resident is unable to manage his own finances and as he has no relatives his finances are managed corporately by the organisation. Records are kept of financial transactions. Regular checks are made by the manager to ensure that these are correct. The cash held for four of the residents was checked at the time of the inspection and were found to be correct. Appropriate receipts were on file. The organisation carries out unannounced annual financial audits. Therefore systems are in place to ensure that residents are protected from financial abuse and that residents’ finances are appropriately managed and monitored. DS0000067402.V337170.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The residents live in a clean and comfortable home that has suitable aids and adaptations for their needs. The staff team continue to work to improve the environment and to make it as homely as possible. DS0000067402.V337170.R01.S.doc Version 5.2 Page 19 EVIDENCE: The home is in Barkingside and is near to the local shops, bus routes and train station. The home is accessible to wheelchair users. On the ground floor there are three lounges and a dining area plus a small visitors/smoking room. There is a small lounge upstairs and bedrooms are on both floors. There is a lift to the first floor. Adapted bathing and toilet facilities are available and there are enough baths, showers and toilets to meet the residents’ needs. Hoists and slings are available for residents that need these. A hearing loop system has been fitted in one of the lounges. This assists those with hearing difficulties to participate in activities and meetings. Therefore the equipment needed to meet the residents’ specialist needs is available in the home. Since the last inspection the hallways and the lounges have been redecorated. The home is appropriately decorated and furnished throughout. Residents are encouraged to bring some of their own furniture and personal possessions with them and one resident was pleased that some of her furniture had been used in the upstairs lounge. Some of the residents showed the inspector their rooms and these were all very different, as they had been individually personalised. The kitchen is appropriately equipped and is clean. Food was appropriately labelled and stored. The cook carries out the necessary checks to ensure that the environment meets the necessary standards of hygiene and that residents’ food is prepared in line with good food hygiene practice. There is a separate laundry and this has appropriate equipment. There is a nice garden at the rear of the home and this has a patio area and tables and chairs. The manager said that there are plans to extend the patio area to make it easier for residents to access the garden. The garden also had tubs and hanging baskets and as previously stated one of the residents helps to look after these. Another resident has “taken responsibility” for an area of garden outside her bedroom window and with the help of friends she is going to add more plants and make changes to this area. This resident also has bird feeders attached to her window so that she can continue to enjoy feeding and watching the garden birds. New fencing has been fitted at the front of the building and CCTV will be fitted to the exterior of the building to safeguard staff, residents, relatives and the building. At the time of the inspection the home was clean and free from offensive odours. There is an infection control policy and advice is sought from external specialists if the need arises. In addition the manager is an infection control trainer and therefore can ensure that staff are appropriately trained in this area. DS0000067402.V337170.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Residents are supported and protected by the organisations recruitment practice. Staffing levels are sufficient, and staff receive the necessary training, supervision and support, in order to meet residents’ current needs and provide a good service for them. Residents are supported by a staff team that know them well and who are committed to providing a good quality service. EVIDENCE: At the time of the visit there were 34 residents living at the home. and this included one respite resident. The usual staffing is 1 team leader and 4 carers on the morning shift and 1 team leader and 3 carers on the late shift. At night there are 2 waking night carers and 1 sleep in team leader on call. Domestics, kitchen staff, laundry staff, a handyman and an administrative assistant support the care staff. There has been a stable staff team for some time and there have not been any new staff for over a year. Agency staff have not been used for more than two years. Therefore residents get continuity in their care. The home is fully staffed and any additional shifts are usually DS0000067402.V337170.R01.S.doc Version 5.2 Page 21 covered by the staff team. Therefore residents receive a consistent service from a staff group that are aware of their needs and how to meet them. The staffing arrangements are sufficient to meet the residents’ needs and the views of residents who contributed to the inspection was that the staff were available to attend to them and meet their needs. One resident said “staff are always around of you need them”. Another said “if you press the buzzer they come and help you and they check you every hour at night”. In addition to short courses the staff team have also shown a commitment to achieving their NVQ. Sixty percent of staff have obtained NVQ qualifications. The training record of one member of staff confirmed that she had received training in fire safety, dementia care, supervision, safeguarding adults, oral care, medication and equality and diversity. Fifteen staff hold current first aid certificates. Staff are receiving the necessary training to provide an appropriate and safe service to meet the needs of the residents and future training needs have been identified. Staff have job descriptions and in discussion were clear as to their individual role in the home. The organisation has a thorough and appropriate recruitment procedure. There are application forms, interviews and the appropriate references and checks are made. A random sample of staff records were checked during the inspection and were found to contain the required information. The last vacancy recruited to was that of the deputy manager and residents participated in the recruitment process. DS0000067402.V337170.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The home is very well managed and provides a safe environment for the residents and this exceeds minimum standards. The manager sets an example of good practice to her team, and is keen to continue to develop the service at Cranvale. She has a strong emphasis on residents’ rights and welfare and encourages residents to be involved in the day-to-day operation of the service. DS0000067402.V337170.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager has worked in the home for several years and has substantial experience of working with older people. She holds the City and Guilds Advanced Management to Care Certificate and has successfully completed NVQ level 4 in management and care. The deputy manager also holds NVQ level 4 in management and care. The atmosphere in the home is relaxed and friendly and there is a stable staff team. The manager communicates a clear sense of direction and staff are aware of the standards that are expected of them. She also promotes equality and diversity issues and is aware of good practice issues. A member of staff said “she will work alongside staff and does whatever is necessary to ensure that the residents are well looked after.” The manager is always looking for ways to improve the service provided and to ensure that residents are involved in this. The quality of the service provided to the residents is monitored by the manager and by the organisation. The service manager carries out monthly monitoring visits to assess how effectively the home is operating to meet its stated aims and objectives, and reports are written. These indicate the action to be taken when deficiencies are identified. Copies of these reports were available in the home and copies are sent to the Commission. In addition to this the organisation carries out a quality audit each year and also a financial audit. Residents are regularly asked for their feedback about the service and this includes those who stay for respite care. Therefore the quality of the service provided to the residents is monitored. Residents’ finances are appropriately managed and monitored and this lessens the risk of financial abuse. Details of this can be found in the section on complaints and protection. The home has a part-time handyperson who carries out health and safety checks and assessments. He is very proactive with regards to health and safety to ensure that any potential risks are minimised as far as possible and this exceeds minimum standards. This includes checking the wooden handrails weekly to ensure that they are not only safely attached but that they do not have any splinters. He also cascades health & safety awareness to staff. The handyman and the manager meet regularly to review health and safety and the maintenance of the building. All of the necessary health and safety checks are carried out and a safe environment is provided for the residents. This is reflected in the fact that there are very few accidents in the home. There is also an emergency plan in place and this is updated regularly. This includes any information that would be required should an emergency arise and the home needed to be evacuated. DS0000067402.V337170.R01.S.doc Version 5.2 Page 24 Staff meetings and staff supervision have been taking place regularly, providing staff with the opportunity to discuss problems and to be involved in the development of the service. Staff meetings have an agenda and are minuted, supervision notes are also taken. The manager said that they are going to be changing the rota so that supervisors and their supervisees are on shift together. This will facilitate them working together and enable supervisors to directly observe the work practice of individual staff that they supervise. Staff spoken to said that there is very good communication and teamwork in the home. Training and development needs are identified as part of supervision and appraisal. DS0000067402.V337170.R01.S.doc Version 5.2 Page 25 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 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 3 X 4 DS0000067402.V337170.R01.S.doc Version 5.2 Page 26 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. 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. Refer to Standard Good Practice Recommendations DS0000067402.V337170.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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