Inspection on 17/01/06 for Crawford Care Home

This inspection was carried out on 17th January 2006.

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

Crawford Care Home 25/09/06

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

CARE HOME ADULTS 18-65 Crawford Care Home Crawford Care Home 3 Alexandra Terrace Clarence Road Bognor Regis PO21 1LA Lead Inspector Ms B Tye Unannounced Inspection 17th January 2006 10:00 Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 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 Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 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 Adults 18-65. 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. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crawford Care Home Address Crawford Care Home 3 Alexandra Terrace Clarence Road Bognor Regis PO21 1LA 01243 865353 01243 867662 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) Crawford Homes Limited Mrs Deborah Guy Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (1) of places Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Crawford is a private care home registered to accommodate up to eleven service users in the category (LD) Learning Disabilities. One service user is accommodated in the category LD (E). The premise is a three - storey middle of terrace property located in the town of Bognor Regis. Its communal rooms consist of a non-smoking lounge, dining area and small lounge at the rear of the premises. The property has a small patio garden, which is regularly used in the summer months. Crawford is near to the main shopping area, library, health centre, front and beach and is adjacent to the town hall. There are bus routes to Chichester, Worthing and Brighton and the mainline Station is within walking distance. Crawford Homes Ltd privately owns the service. The responsible individual is Mr Gajaruban Ragunathan and the registered manager is Mrs Deborah Guy. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. On the day of the unannounced Inspection, the premises were very clean and tidy. Some residents were dressed and socialising with staff in the dining room, others were out, or still in bed. The Inspector noted a relaxed atmosphere at the home. Service users laughed and joked with the staff and were happy to engage with the Inspection process. The Manager assisted the Inspector by providing information and relevant files as requested. The Inspector examined residents files, Policies and Procedures, Risk assessments, Training files, Staff files, Medication records and all Health and Safety Checks. In addition she toured the premises, spoke to residents and viewed their rooms. Overall quality of care was found to be good and administration systems were comprehensive, well ordered and up to date. What the service does well: What has improved since the last inspection? Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 6 Crawford Care Home took over the existing company in August 2005. Evidence collated from the inspection showed this occurred with minimal disruption to staff and residents. The previous deputy manager is now the registered manager for the home and the majority of original staff remain in post. Staff and residents who were spoken to during the inspection stated the transition of ownership had little impact on them and overall the experience had been positive. Residents and staff confirmed they were consulted about all aspects of change within the home before they occurred. All said they felt ‘involved’ through the changes. Since the last inspection, maintenance in the home has been on going. The hallway and dining room have been decorated and both bathrooms have new flooring. The owners have purchased a new 7-seater vehicle to transport residents as required. A new computer (with Broadband) has been installed in the staff office and residents use it regularly to access the Internet. All risk assessments for individuals and their environment have been updated and are very detailed in content. This recognises the limitations of individuals and promotes their independence where possible. Menus, Training, Policies and Procedures are all under review by the management and changes will be implemented throughout 2006. The Statement of Purpose is currently being updated to reflect changes in staffing. 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. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 4 Prospective residents are provided with all the information needed to make an informed decision, prior to admission of the home. Where possible a transition period to the home is agreed between involved parties. Each potential resident is given the opportunity to visit and have a trial stay if required. EVIDENCE: Prospective residents and their carers are provided with all relevant information to make an informed decision about the home. Residents have the opportunity to discuss their expectations and these are recorded as part of the assessment process. The inspector viewed an up to date Service Users Guide and Statement of Purpose. This is available in symbol and picture format to assist residents in understanding what the home has to offer. Each resident is given the opportunity to visit the home prior to admission, as many times as they feel necessary. This gives them the opportunity to meet other residents and staff, therefore contributing to a smooth transition process. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Individuals, their families or representatives are involved in producing detailed care plans. These reflect their changing needs and personal goals. Residents confirmed they were supported to make choices about their lives. Detailed risk assessments have been completed for each individual and their environment. EVIDENCE: The inspector examined four of the residents care plans. Each plan is generated from pre-admission assessments and information from involved professionals. Plans seen covered all aspects of the individuals health, personal and social needs. All plans are signed by the residents to reflect their involvement in the care planning process. In addition to this, the manger has devised an overview of each residents care needs, (which is duplicated from individual files). These cover behaviour, routines, personal care and appropriate responses from staff. More detailed information has been collated for night staff to ensure the residents needs are met fully at times when staffing levels are reduced. Each set of guidelines is held in a separate file in the staff office so it is easily accessible. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 10 Changes to care plans occur as needs of the resident change or following a formal review. This demonstrates the care provided at the home is in line with the residents changing needs. Crawford has a Health and Safety Manager who has devised detailed risk assessments for each resident and their environment. The inspector found these were very detailed and in good order. The inspector examined recording sheets for each resident. These detailed any significant event, which needed to be handed over to other staff. Residents personal information is held on files in a locked staff office, ensuring confidentiality of personal information, within the home. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 & 17 The outcome for the residents in terms of personal development and activities provided was good. Residents spoken to were enthusiastic about the activities they took part in. Relationships outside the home are encouraged and supported by staff. The menu at Crawford offers a range of healthy balanced meals. EVIDENCE: An activities programme for residents is devised a month in advance and displayed in the dining room. Residents go on weekly outings as a group and daily as individuals. Activities include visits to the library, local shops walks to the beach, local markets and community events. One resident attends a day centre, another supported workshops and two of the residents go to college twice a week. All activities are recorded in the staff diary on a daily basis. The home has a 7- seater vehicle to transport residents as needed. The home has organised activities in house on a regular basis, including a hairdresser and chiropodist every six weeks and a healing group fortnightly. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 12 On the day of inspection a local musician attended the home and the inspector observed the residents singing along with him and enjoying themselves. Residents spoken to by the inspector all confirmed the staff support them to pursue a range of activities. The inspector noted there was a good balance achieved between supporting residents to participate in activities and encouraging independence where possible. Residents and information seen on care plans confirmed family contact is promoted. Some residents have home visits on a regular basis. Visitors are welcome to the home and a policy is in place to support this. The inspector examined menus for the home. Residents confirmed they liked the food and were consulted on about what they liked to eat. A staff member stated if residents changed their minds on the day an alternative could be offered. Packed lunches are prepared for residents who attend college or day centres. Those who remain at the home are offered a choice for lunch on the day. Hot and cold drinks facilities are available for residents to make their own drinks when they choose. Residents have the opportunity to assist staff in cooking regularly in the home and will shop and prepare the ingredients to promote independent living skills. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, & 20 Residents receive personal care and support as detailed in their care plans. All the care plans examined showed detailed information and action plans relating to physical and emotional needs of each resident. Observations and feedback from residents showed these needs were being met by the home. Medication is stored and labelled appropriately. The inspector found that all MAR sheets and information relating to medication was in good order and signed by staff. EVIDENCE: Care plans seen by the inspector held information relating to all aspects of healthcare and medication for individuals. The records were up to date and in place, which ensures good staff practice is upheld. Personal care and support is provided in line with care planning and residents preferences are identified to ensure appropriate action by staff. Some staff tasks are gender specific according to the needs and wishes of the residents. Residents are registered with the local GP and have access to all NHS entitlements. Records of all dental and GP appointments are held on file. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 14 Individual files show residents have access to community health specialists to ensure all aspects of their health needs are met both by the home and wider community. A key worker system is in place to enable residents to talk through day to day issues and any aspect of their care on a weekly basis. Staff support individuals to access community agencies when needed and will accompany residents to appointments as required. Policies and procedures relating to all aspects of healthcare and medication administration are in place and up to date. Records show staff have undertaken relevant training to dispense medication safely. Medication is stored appropriately at the home and medication charts examined were up to date and in good order. A local chemist is responsible for regular audits of all medication within the home. Medication is suitably stored in locked cabinets in the office and the home has an agreement in place with a local pharmacy who will offer advice and assistance as required. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a complaints log in place which is supported by an up to date complaints policy and procedure. A complaints procedure is available to residents and their families in the Statement of Purpose and Service Users Guide. All residents spoken to felt listened to and able to vocalise any issues of concern. All staff receive training in respect of working with vulnerable adults as part of the LDAF training and induction programme. EVIDENCE: The home has a detailed procedure for complaints, which is included in the Service Users Guide and Statement of Purpose, providing residents with clear information about how to complain. All complaints information is printed in a format suitable for residents to ensure they are clear about their rights within the home. The complaints log was seen, there have been no official complaints at the home for over a year. Residents have regular informal meetings, which provide them with a forum to talk about issues of concern. In addition to this, the key worker system gives residents with the opportunity to talk on a one to one basis. Staff have completed the Learning Disability Assessment Framework training in relation to Protection of Vulnerable Adults. This reduces risk within the home Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 16 and ensure staff were clear about reporting procedures should suspicion of abuse arise. A recommendation was made for Adult Protection policies and procedures at the home to be updated, to include the new management framework. Staff will use this alongside County Procedures and guidelines, which are available in the staff office. This will be monitored at the next inspection. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 & 30 The home’s premises are suitable for its stated purpose. The home was very clean and tidy and furnishings are homely and comfortable. Service users rooms were decorated to their personal specification and all those observed by the Inspector were clean, tidy and of a reasonable standard of décor. EVIDENCE: Some areas of the home have recently been redecorated and overall the premises provides a homely, comfortable environment. There is a comfortable lounge with TV, play station and stereo equipment. The dining room is the most used communal area in which all residents have access to drink making facilities. There is also a small quiet room at the rear of the kitchen where some residents go to listen to music. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 18 Residents rooms were a good size and furnished in their individual styles with personal possessions and pictures. One resident proudly showed his pictures, and view of the sea. Another residents room was sparsely furnished with nothing on the walls. The occupant confirmed this was her preference. All bedrooms have locks on the door to ensure privacy. There are suitable toilets and washing facilities throughout the building. Staff clean the house regularly with support from residents. This encourages a sense of ownership and promotes independent living skills. A laundry room provides a large washing machine and tumble dryer. Residents do their own washing with assistance by staff if required. A fire alarm and emergency lighting system is in place throughout the home. The inspector viewed detailed risk assessments for all aspects of the environment which ensures potential hazards are identified and minimised where possible. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 The staff employed to work at Crawford have all been recruited and trained to meet the assessed needs of the residents. The homes recruitment procedures and policies are upheld and there was evidence to show the residents needs were met appropriately by the staff team. EVIDENCE: The staff spoken to by the inspector were confident in their roles, enjoyed working at the home and said how supported they felt by the manager. Staff confirmed they attend regular meetings which provide support and enables them to participate in decision making processes about care provision at the home. Crawford has an up to date recruitment policy and procedure in place. The inspector examined several staff files and found they contained all the relevant checks and information needed to meet the standards. All staff have CRB checks which reduces risk to vulnerable residents and ensures staff are able to competently fulfil their roles. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 20 All staff have undertaken LDAF training and mandatory training within the home. This includes health and safety, medicine management, good practice, positive communication and understanding abuse. Staff have also completed specialist training in the areas of challenging behaviours and mental health. Over 50 of the staff team have completed or are undertaking NVQ Level 2 & 3. From January 2006 the manager is implementing a new training schedule from Mulberry House, which provides long distance learning modules in all aspects of care provision. The manager of Crawford is currently undertaking the Registered Managers Award. Feedback from residents, staff interviews and observations led the inspector to conclude that the staff functioned effectively as a team to ensure the residents needs are met appropriately. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 43 Good practice in the home was evident. This was supported by efficient administrative systems, which promote the health, safety and welfare of the residents. EVIDENCE: The inspector examined all safety records at the home including, fire records, training, water temperatures, maintenance and the accident book. They were all up to date and in good order promoting the welfare and safety of the residents. Good practice in the home was evident. This was supported by efficient administrative and recording systems. The home has up to date policies and procedures in line with current legislation to safe guard the rights and interests of the staff and residents. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 22 Discussions and observations confirmed staff are given clear direction in their roles and good working practices are promoted through staff support and training. One staff member stated he felt the management were ‘very supportive’. The most recent Quality Assurance report and Inspection report from the Commission is available to residents and parties involved in the home. The Quality Assurance report includes feedback from residents providing them with an opportunity to contribute to the way the home is run. The inspector concluded that the overall conduct and management of the home served the best interests of the residents and the staff who work there. Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 X 3 Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 24 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. 1 Refer to Standard 23 Good Practice Recommendations To update Adult Protection Policy and Procedure to include new management framework Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Crawford Care Home DS0000065030.V279558.R01.S.doc Version 5.1 Page 26 - 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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