Inspection on 17/07/06 for Crawshaw Hall Medical Centre

This inspection was carried out on 17th July 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Crawshaw Hall Medical Centre 19/06/07

Crawshaw Hall Medical Centre 19/12/05

Crawshaw Hall Medical Centre 10/05/05

Crawshaw Hall Medical Centre 15/09/04

Crawshaw Hall Medical Centre 20/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Crawshaw Hall Medical Centre Burnley Road Crawshawbooth Rossendale Lancashire BB4 8LZ Lead Inspector Mrs Susan Hargreaves Key Unannounced Inspection 17th July 2006 10:00 Crawshaw Hall Medical Centre DS0000022511.V289129.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 Crawshaw Hall Medical Centre DS0000022511.V289129.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 Older People and 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. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crawshaw Hall Medical Centre Address Burnley Road Crawshawbooth Rossendale Lancashire BB4 8LZ 01706 228695 01706 215670 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) Mrs Eileen Karoo Mr Adrian Mark Andrew Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Physical disability (21) of places Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing for service users requiring nursing care will be in accordance with the Notice issued dated 7 December 2001 The registered provider shall at all times, employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as manager of Crawshaw Hall Medical Centre Within the overall total of 21 a maximum of 10 service users requiring personal care who fall into the category of PD. A maximum of 21 service users requiring nursing care who fall into the category of either OP or PD. Within the overall total of 21 a maximum of 1 service user requiring personal care who falls within the category of OP. The total number of service users within these categories must not exceed 21 (twenty one). 19th December 2005 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Crawshaw Hall Medical Centre is registered to provide either nursing or personal care for up to 21 residents. Older and younger adults may be admitted to the home. Accommodation is provided in single rooms on the ground and first floors. A large communal lounge with dining area is located on the ground floor. There is a smaller lounge on the first floor where smoking is permitted. A passenger lift facilitates access to all areas of the home. The home is a grade 2 listed building with extensive grounds. Crawshaw Hall is situated on the outskirts of Crawshawbooth with shops and a public house. There is a reasonable bus service to the area. The current fees charged at Crawshaw Hall Medical Centre are £565.50 - £750 per week. Additional charges are payable for chiropody, hairdressing, newspapers, toiletries, clothes, transport & holidays. A copy of the statement of purpose and service user guide was available to prospective residents and their relatives on request. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over eight hours. One complaint has been made to the Commission since the last inspection. The provider was asked to investigate this complaint. At the time of this inspection 20 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the proprietor regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Prospective residents should be given as much information as possible about a care home. This must include confirmation in writing their care needs can be met at the home. It is important that keeping in relation to wound care is improved. Records about the care of wounds must give detailed information about their treatment and condition. It is essential that these records are kept up to date. Urgent action must be taken to promote safety and prevent medication error a record of the receipt of all medication into the home must be kept. Accurate records of the administration of all medication must be kept. Medication must be given in the dose prescribed by the doctor. Procedures must be in place to ensure repeat prescriptions are ordered in time to prevent medication being Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 6 out of stock at the home. Members of staff should check that any residents who are self-medicating are managing their medication correctly and taking prescribed medication as directed by the doctor. Hand written instructions on the medicines administration records should be signed and witnessed. Written instructions should be in place for individual residents stating when medication prescribed when required should be given. It is important that a nutritional risk assessment is in place for all residents in order to ensure their healthcare needs are fully met. In order to provide effective care for all residents 50 of care assistants must have an NVQ level 2 in care. Recruitment procedures must be thorough to ensure residents are protected from abuse. Two written references must be obtained for all new staff before they start working at the home. It is important that all members of staff receive appropriate training. Induction training should be further developed in order to meet the ‘Skills for Care’ standard. To promote the health and safety of residents and staff all members of staff must receive training in fire prevention. 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. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 (adults 18-65) and 3 (older people) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures were thorough. EVIDENCE: The individual records of three residents were inspected. Two of these contained a detailed pre-admission assessment. The other resident was admitted in an emergency and an assessment was completed on admission. However, there was no evidence to suggest that residents received written confirmation that their care needs could be met at the home. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) 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 and 8 (adults 18-65) 7 and 14 (older people) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans were not in place for all residents. There was a failure to regularly review all care plans and up date them when the needs of the resident changed. Residents were encouraged and enabled to make decisions about their lifestyle. EVIDENCE: The individual care plans of four residents were inspected. Three of these plans clearly identified the personal care needs of the resident and explained how these needs were met. Appropriate risk assessments had been carried out. Information about how identified risks were dealt with was also included in the care plans. One of these care plans was reviewed monthly. A care plan Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 10 for a resident in receipt of regular respite care was not reviewed on each occasion this resident was admitted to the home. One care plan relating to wound care was not updated when the condition of the wound changed. A care plan was not in place for the other resident. Residents and their relatives were invited to be involved in reviewing care plans. Residents were encouraged to make decisions about their lifestyle and activities. These were recorded in their individual care plans. Advocacy services were used by one of the residents. Information about how to contact these services was displayed in the home. Residents were encouraged and supported to manage their own finances. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) 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, 16 and 17 (adults 18-65) and 10, 12, 13 and 15 (older people) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 12 Residents were encouraged to make decisions about their lifestyle. The daily routine was flexible in order to meet the needs and preferences of the residents. The meals were wholesome and menus offered variety and choice. EVIDENCE: Residents were encouraged to pursue their own interests and educational activities. Visits to the local library and pub were arranged. A variety of activities were organised. These were advertised in the home and included, dominoes, monopoly, scrabble, puzzles, manicures and skittles. Trips out to Blackpool and a drive out and pub lunch were also organised. A holiday to Skegness had been arranged for four of the residents. Independence was promoted and residents were encouraged to help with household tasks e.g. setting the tables. Discussion with residents and staff confirmed that the daily routine was flexible in order to meet the needs and preferences of the residents. Postal votes were arranged for residents who wished to be politically active. Visitors were welcomed into the home at anytime. One visitor said, “The staff are always polite.” A local priest regularly visited the home. The meal served at lunchtime looked wholesome and appetising. Members of staff offered assistance to residents in a sensitive and patient manner. Lunch was unhurried allowing residents time to chat and enjoy their meal. All the residents asked except one said they had enjoyed their lunch. However, the care records inspected for one resident did not include a nutritional assessment. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) 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 and 20 (adults 18-65) and 8, 9 and 10 (older people) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Privacy and dignity was promoted for all residents. Care plans did not identify and address all aspects of healthcare. Some procedures relating to medication were not managed correctly. EVIDENCE: The individual records of four residents were inspected. Three of these contained appropriate risk assessments including, moving and handling, falls, pressure sores and nutrition. Only one risk assessment about self-medicating was in place for the other resident. Records relating to the care of a wound for one resident did not include an up to date detailed description of the wound. Information about the condition of this wound was not recorded at each dressing change. In fact the last recorded dressing change was more than four Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 14 weeks before this inspection. The care plan had not been updated when the condition of the wound and the type of dressing used changed. Records of the visits of other healthcare professionals e.g. GP, chiropodist, etc. were included in the care plans. At the time of the inspection two residents were self-medicating with risks assessments were in place. However, a medication administration record had not been completed for one of these residents. Records of the amount of medication this resident had brought into the home were not available. There was no evidence to suggest that members of staff had checked this resident was managing their medication correctly and taking prescribed medication as directed by the doctor. One resident was prescribed medication to be taken ‘when required’. Although two of the tablets had been taken from the packet records showed the time of administration for only one of these. The proprietor was advised to provide clearly written instructions stating when medication prescribed ‘when required’ should be given to individual residents. One resident was prescribed different doses of the same medication in the morning and evening. The higher dose tablet was out of stock. However, an audit of this medication suggested that the resident had possibly been given two of the lower dose tablets on a number of occasions. Hand written instructions on the medication administration records were not signed and witnessed. Medication was stored correctly in a locked trolley, cupboards and fridge inside a locked utility room. The temperature of the fridge and utility room were checked and recorded daily. Controlled drugs were stored correctly and a stock check was satisfactory. Personal care was carried out in private. Members of staff were observed attending to residents in caring and professional manner. Two members of staff explained in detail how they promoted dignity for the residents. One resident said about the staff, “Nothing’s too much trouble for them.” Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) 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 (adults 18-65) and 17 and 18 (older people) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were taken seriously and investigated. Members of staff had a clear understanding of adult protection issues, which protects residents from abuse. EVIDENCE: A copy of the complaints procedure was displayed in the home. Three complaints have been made to the home since the last inspection. Records of the complaints and the investigation were seen. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with three members of staff. They were aware of the procedure and said they would report any concerns immediately. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) 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 and 30 (adults 18-65) and 19 and 26 (older people) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and well maintained for the comfort of residents. Laundry facilities were appropriate for the size of the home. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 17 EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. This provided a safe and comfortable environment for the residents. A plan for the routine maintenance and redecoration of the premises was in place. Communal rooms were suitable for a variety of social and cultural activities. The grounds were accessible to all residents. One visitor commented on the cleanliness of the home. Laundry facilities were suitable for the size of the home. An infection control police was available. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) 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, 33, 34, and 35 (adults 18-65) and 27, 28, 29 and 30 (older people) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Less than 50 of care assistants had achieved NVQ qualifications. Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were not thorough potentially putting residents at risk. Induction training needed further development to ensure consistency in the delivery of care. EVIDENCE: It was evident from discussion with four members of staff and the proprietor that training opportunities were available. However, only two care assistants (18 ) had achieved NVQ level 2. Examination of the duty rota confirmed that Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 19 a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. The files of four members of staff appointed since the last inspection were examined. Three of these files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. Although two verbal references had been obtained for the other employee there was no evidence to suggest that written references had been obtained. Induction training for new employees took place but this did not meet the ‘Skills for Care’ standard. The proprietor was advised to compile an organisational training plan. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) 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 and 42 (adults 18-64) and 31, 33, 35 and 38 (older people) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced and competent manager. A system for obtaining the views of residents was in place. Health and safety procedures were in place but staff were not trained in fire prevention. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 21 EVIDENCE: The registered manager is an experienced nurse and has completed the NVQ Registered Manager’s Award. The home had achieved the nationally accredited Investors in People award. Resident’s were encouraged to express their opinions about the quality of care and facilities at resident’s meetings and informally at anytime. Minutes of the last resident’s meeting indicated that meals, laundry and the cleaning of wheelchairs were discussed. Anonymous satisfaction questionnaires had been distributed to the residents. A business plan for 2006/7 was available. This plan stated how outcomes for residents might be improved. Transactions involving resident’s money were seen to be well maintained and up to date. Policies and procedures relating to safe working practices were available. Members of staff had received training in moving and handling. A member of staff qualified to administer first aid was on duty for all shifts. Fire alarms were tested weekly and emergency lighting monthly. Fire drills took place monthly and staff attendance records were kept. However, not all members of staff had received training in fire prevention. Records of the routine servicing of equipment were seen including an electrical installation certificate dated 29/11/05 and gas safety certificate dated 21/09/05. The testing of small electrical appliances took place on 19/05/06. Safety notices were displayed in the home. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 X 2 2 3 X 4 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 2 43 X 2 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crawshaw Hall Medical Centre Score 3 2 1 X DS0000022511.V289129.R01.S.doc Version 5.1 Page 23 YES 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 YA2 Regulation 14(1)(d) Requirement Timescale for action 17/07/06 2. YA6 15(1) 3. YA6 15(2)(b) 4. YA6 15(2)(C) The registered person shall not provide accommodation to a service user unless, so far as it shall have been practicable to do so (d) the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. Unless it is impracticable to carry 17/07/06 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. All residents must have a care plan. The registered person shall – (b) 04/08/06 keep the service user’s plan under review. The care plan of any resident in receipt of regular respite care must be reviewed on each occasion that resident is admitted. The registered person shall (c) 04/08/06 DS0000022511.V289129.R01.S.doc Version 5.1 Crawshaw Hall Medical Centre Page 24 (d) 5 YA17 12(1)(a) 6. YA18 17(1)(a) 7. YA20 13(2) 8. 9. 10. YA20 YA20 YA20 13(2) 13(2) 13(2) where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service user’s plan and (d) notify the service user of any such revision. Care plans must be updated when the needs of the resident change. The registered person shall ensure that the care home is conducted so as – (a) to promote and make proper provision for the health and welfare of service users. All residents must have a nutritional risk assessment. The registered person shall- (a) maintain in respect of each service user a record which includes the information, documents and other records specified in Schedule 3 relating to the service user. (k) a record of any nursing provided to the service user, including a record of his condition and any treatment or surgical intervention. Records relating to wound care must be detailed and up to date. The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. A record of all medication received into the home must be kept. Accurate records of the administration of all medication must be kept. Medication must be administered as prescribed. Procedures must be in place to DS0000022511.V289129.R01.S.doc 04/08/06 04/08/06 17/07/06 17/07/06 17/07/06 17/07/06 Page 25 Crawshaw Hall Medical Centre Version 5.1 11. YA32 18(1)(c) (i)(ii) 12. YA34 19(1)(b) Schedule 2 13. YA35 18(1)(c) (i) 14. YA42 23(4)(d) ensure repeat prescriptions are ordered in time to prevent medication being out of stock at the home. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users - (c) ensure that the persons employed by the registered person to work at the care home receive - (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. 50 of care assistants must have an NVQ level 2 or be working towards this by the date given. Timescale of 31/03/06 not met The registered person shall not employ a person to work at the care home unless (b) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 7 of schedule 2 Two written references must be obtained prior to appointment. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (c) ensure that the persons employed by the registered person to work at the care home receive (i) training appropriate to the work they are to perform. Induction training for new employees must meet ‘Skills for Care’ specification. The registered person shall after consultation with the fire DS0000022511.V289129.R01.S.doc 29/09/06 17/07/06 29/09/06 29/09/06 Crawshaw Hall Medical Centre Version 5.1 Page 26 authority- (d) make arrangements for persons working at the care home to receive suitable training in fire prevention. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard YA20 YA20 YA20 YA24 YA35 YA39 Good Practice Recommendations Hand written instructions on the medicines administration records should be signed and witnessed. Members of staff should ensure residents who are selfmedicating are managing their medication correctly and taking prescribed medication as directed by the doctor. Written instructions should be in place for individual residents stating when medication prescribed when required should be given. A plan for the routine maintenance and renewal of the fabric and redecoration of the premises should be produced. An organisational training plan should be developed. An annual development plan should be produced. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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. Crawshaw Hall Medical Centre DS0000022511.V289129.R01.S.doc Version 5.1 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!