Inspection on 20/07/05 for Cranwood

This inspection was carried out on 20th July 2005.

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

The inspector 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

Cranwood 11/12/06

Cranwood 14/02/06

Cranwood 01/09/04

Cranwood 07/04/04

Cranwood 16/12/03

Cranwood 24/11/03

Cranwood 06/08/03

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

CARE HOMES FOR OLDER PEOPLE Cranwood 100 Woodside Avenue Muswell Hill London N10 3JA Lead Inspector Peter Allcock Unannounced 20 July 2005 @ 09.00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cranwood Address 100 Woodside Avenue, Muswell Hill, London N10 3JA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8883 0563 020 8442 0075 Mary Hennigan of London Borough of Haringey Ms Donna Hamilton LA Care Home 34 Category(ies) of OP registration, with number of places Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide accommodation and personal care for up to 38 persons of either gender who are over 65 years of age (OP). 2. The provider must undertake a programme of measures that will achieve compliance with National Minimum Standards for Older People Standards 19 to 26 - Environment, or those equivalent standards that may be published at the time, as required by Regulation 23(1)(a); 23(2)(a-p); 23(4)(c); and Regulation 16 (2)(c)(g)(j)(k) - by 1st April 2005. 3. In order to promote the health and safety needs of service users living in Cranwood, the provider must ensure that the home complies with all requirements contained in relevant Health and Safety Legislation and further must undertake a programme of measures that will achieve full compliance with National Minimum Standards, or those equivalent standards that may be published at the time, as required by Regulation 23(1)(a); 23(2)(a-p); 23(4)(c); and regulation 16 (2)(c)(g)(j)(k) - by April 1st 2004. 4. To provide intermediate care to a maximum of 9 of the 34 service users of either gender, seven of whom must be 65 years of age or older. Two of these nine service users may be aged between 60 and 65 years of age. Accommodation for this service is restricted to the dedicated unit on the lower ground floor. The unit must have a team of staff specifically dedicated to it. Any individual serice user`s stay within the unit should not be any longer than 6 weeks. Date of last inspection 1 September 2004 Brief Description of the Service: Cranwood is a residential home registered to provide care and support to up to 38 older people. Owned and operated by the London Borough of Haringey, and located in a residential area of Muswell Hill in North London, the home is close to local shopping and transport facilities. The main aim of the home as set out in the statement of purpose is “To work with older people and their relatives in order to give advice, care and support” The objectives of the home are to: 1. Provide a comfortable/enjoyable residential care home for all service users 2. Create an environment, which enables service users to retain their individuality, independence, dignity and privacy, as set out in the Charter of Rights for service users. 3. Encourage service users to maintain their previous friendships, skills, hobbies and interests. 4. Allocate to each service user a key worker, who will have designated responsibility for helping with his/her personal requirements. 5. Provide activities and a lifestyle for all service users which will operate within a risk assessment system. 6. Offer a service of the highest quality, in a non discriminatory, equal opportunities environment. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on an unannounced basis between 11am and 4.00pm. The inspector read the pre-inspection information sent by the home, completed questionnaires from two placement officers, six health care professionals, seven general practitioners, one service user and eight relatives. The health care professionals and GP’s were positive about the care given in the home with one exception. Six relatives were positive about the home and two who raised particular issues with the inspector were advised as to how to resolve them with the home. The one service user reply spoke positively about the home, and the two placement officers were again positive about the care offered in the home. During the inspection, the inspector spoke to the manager, two senior staff and a number of care staff. The inspector also spoke to eight service users, toured the building and examined records and eight care plans. What the service does well: What has improved since the last inspection? What they could do better: It is important that the registered provider work with those responsible to reduce the delays in the provision of adaptations to the homes of service users from the intermediate treatment unit. The inspector understands that this is not totally within the control of the home, but its importance to individual service users at a vulnerable time cannot be underestimated. The use of daily logs would benefit from revision with a focus on the extent to which targets in Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 6 service users plans are being met. Staff would benefit from training and support in this area of practice. To further the range of activities available to service users, staff would benefit from training and support to develop their role in this area of practice. 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. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 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 standard(s) 3, 6 Service users are assured that their assessed needs will be met by the home. The ability to live independently on leaving the intermediate care unit is compromised for service users who are required to return home before the appropriate adaptations to their home have been completed. EVIDENCE: All service users have their needs assessed prior to admission, and copies of these assessments were seen on the six service user files examined during this inspection. The care plans reflected service users needs in general, though there is no link between the goals set out in the care plans and the daily logs which record work done to meet these needs. It is recommended that such a link be established and that the format of the daily logs is reviewed as they allow little space to record comments, although the new manager has attempted to remedy this by including space for additional recording on the rear of the form. The inspector noted that the daily records included a number of general comments such as a service user “was fine” It is recommended that staff receive training in recording and that this focus on a record of the extent to which targets identified in service users plans have been met. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 9 The intermediate care unit currently has two service users, as it will close to provide accommodation for long stay service users during the refurbishment of the home. This unit has enabled a number of people to return home and is becoming a valuable community resource. The inspector spoke to two staff in the unit who expressed frustration at the not infrequent delays in the provision of adaptations to service users homes prior to their return home. The effect on service users is that a number have returned home without the required adaptations to their homes, which impacts adversely on their ability to maximise their independence. The registered provider must work with the equipment suppliers to resolve these difficulties as a matter of importance. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 Service users benefit from care plans, which set out their individual health, personal and social care needs, and are protected by the homes policies and procedures for the administration of medication. Personal care is provided in a manner that respects service users and values their privacy. EVIDENCE: Service user plans seen during this inspection contained information on individual health, personal and social care needs, and there are targets set in order to meet these needs. There are records that indicate service users have access to health care services as required, and three service users confirmed to the inspector that the doctor had come to see them when they were feeling unwell. The home has clear policies and procedures for the receipt, storage, administration and disposal of medicines in the home. Records seen during this inspection demonstrated that these procedures were being followed by staff. Only staff who have received the appropriate training administer medication to service users. Controlled drugs were appropriately stored in the home and the record of administration was as required including a running total of medication in the home and the signature of two staff when medication is Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 11 administered. Service users resident in the four long stay units have their medication administered by staff, and those service users spoken to during this inspection were happy with this arrangement. In the intermediate care unit, service users are encouraged and supported to administer their own medication as part of their rehabilitation prior to returning home. Observation of practice in the home showed that personal care was undertaken by staff with a respect for the privacy and dignity of service users. The inspector discussed these issues with a number of service users who all felt that their privacy and dignity was upheld, though two commented that when staff are busy things are sometimes done “in a bit of a hurry” Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12, 13, 14, 15 Service users recreational interests are supported but would be further enhanced by supporting care staff to undertake this role when the activity coordinators are not working. Contact with family and friends is encouraged by the home and enables service users to receive visits at a time convenient for them. Service users know that they can make choices and have some control over their lives, and benefit from food, which is wholesome and appealing. EVIDENCE: The home employs two part time activities co-ordinators to provide activities in the home four days a week (Monday, Tuesday, Thursday, Saturday). There is a programme of activities provided in one morning session and one afternoon session on these days. Whilst service users are offered every encouragement to participate, the choice of whether to do so is entirely theirs. The inspector observed a group of service users enjoying a morning exercise session. It is recommended that staff are trained and supported to provide activity sessions on the days when an activity co-ordinator is not available. The home has an open door policy for family and friends, with the only stipulation that visitors do not disturb or intrude on the privacy of other service users. All nine of the relatives questionnaires returned to the inspector stated that they were able to visit relatives in private. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 13 The inspector observed lunch in one of the ground floor units. There was a choice of two main courses and in addition one service user had chosen a sandwich for lunch, which was provided. Another service user who changed her mind when the food was being served was quickly accommodated. The food seen by the inspector was attractively presented, hot and tasty. Observation of staff/service user interaction during this inspection showed that service users were given appropriate encouragement to eat and were given individual support in a way that maintained their independence. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16, 18 There are systems in place to enable service users to complain and to protect them from abuse. EVIDENCE: The registered provider has a clearly drafted procedure for making complaints. The complaints book was seen to contain the details of four complaints made in the home since the last inspection. The nature of complaint was clearly recorded along with a record of the investigation and the outcome of the complaint. The complaints were dealt with by the previous manager within the timescales set out in the complaints procedure. The registered provider has a dedicated complaints unit, which monitors how complaints are managed. Two service users told the inspector that they would complain to the manager if they were unhappy about anything. The registered provider has systems in place to protect service users from abuse. There have been no allegations of adult abuse since the last inspection. Three service users told the inspector that they felt safe living in the home. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 26 The home is clean and hygienic and service users will benefit from the soon to start refurbishment of the home. EVIDENCE: The residential units in the home look tired and in comparison to the newly refurbished intermediate care unit are old fashioned. The registered provider is about to commence a significant programme of updating, which will see the residential units refurbished over the summer and autumn of this year. Whilst this is clearly welcome the conditions of registration required this work to be completed by April 2004. The registered provider must therefore inform the Commission for Social Care Inspection in writing upon completion of the refurbishment of the home. The building was clean and tidy on the day of this inspection. The manager must replace the loose tiles in the intermediate care unit bathroom. When these were pointed out to the manager, she immediately locked the bathroom and told the inspector that it would remain locked until the repair was undertaken. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 Service users benefit from sufficient staff on duty and are protected by the homes recruitment policies and procedures. EVIDENCE: The home has recently been using a significant number of agency staff. The manager told the inspector that vacant posts had now been recruited to, and that some posts had been filled by staff redeployed from another of the registered providers homes, which has just closed. One service user who had come from the closed home told the inspector that settling into a new home had been made easier by having some familiar staff around. Some of the vacant posts have been filled by employing staff previously supplied on an agency basis, which maintains a continuity of care for service users. The home recruits and selects staff in accordance with the London Borough of Haringey policies and procedures. These procedures based on principles of equal opportunity ensure that nobody begins work without appropriate references and the satisfactory completion of the appropriate checks. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 There are systems in place to protect the health, safety and welfare of service users. EVIDENCE: Records seen in the home demonstrate the regular servicing of equipment with the exception of an up to date Landlord’s Gas Safety Certificate. The registered Provider must supply such a certificate as part of their response to this report. It is also recommended that the manager replace the medical waste bin with one that can be locked. The record of fire drills was seen to be up to date. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 2 Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 12(1)(a) Requirement The registered provider must work with the equipment suppliers to resolve delays in the provision of adaptations to the homes of service users from the intermediate care unit. The registered provider must inform the Commission for Social Care Inspection in writing upon completion of the refurbishment of the home The manager must ensure that the loose tiles in the intermediate care unit bathroom are replaced The registered Provider must supply a current Landlords Gas Safety Certificate as part of their response to this report. Timescale for action 30th September 2005 2. 19 23(2)(d) 30th December 2005 30th August 2005 30th August 2005 3. 19 23(2)(b) 4. 38 13(4)[c] 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 3 Good Practice Recommendations It is recommended that the manager review the recording of the daily logs so that they evidence a link between G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 20 Cranwood 2. 3. 4. 3 12 38 targets on service users care plans and the work done with service users. It is recommended that staff receive training in recording and that this focus on a record of the extent to which service users care plans have been met. It is recommended that staff are trained and supported to provide activity sessions on the days when an activity coordinator is not available. It is recommended that the manager replace the medical waste bin with one that can be locked. Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London, N14 6HA 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 Cranwood G59 S33341 Cranwood V239724 20.07.05 Stage 4.doc Version 1.40 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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