Inspection on 19/07/05 for Crelake House

This inspection was carried out on 19th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Crelake House 16/01/07

Crelake House 22/02/06

Crelake House 15/03/05

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Crelake House 4 Whitchurch Road Tavistock Devon PL19 9BB Lead Inspector Helen Tworkowski Announced 19 July 2005 @ 9 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. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Crelake House Address 4 Whitchurch Road Tavistock Devon PL19 9BB 01278 447430 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) Crelake Care Ltd Mrs Patricia Jean Hall Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19), PD(E)The Registered Manager is in full of places time day to day control of Crelake House Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The Registered Manager is in full time day to day control of Crelake House. The Registered Manager must have completed an NVQ 4 in Care and Management by 1/2/06 Date of last inspection 15/3/05 Brief Description of the Service: Crelake House is registered to provide a service to people who are elderly and who may have additional physically disabilities. The home is situated on the edge of Tavistock but still within easy reach of the town and it’s facilities. Mr Waft and Mrs Hall, the proprietors live on the site. The home provides the following facilities for service users: two lounges, a sun lounge and a dining room. On the ground floor there are 10 bedrooms (8 single, 2 double), 3 of which have en-suite toilets. There is a bathroom and 2 separate toilets on the bedroom corridor. There is a stair-lift to the first floor. On the first floor there are 6 bedrooms (5 single, 1 double). There is also a bathroom and a separate toilet. There are 3 well-kept garden and seating area. The home has bath hoists and can offer care and support to people who have some levels physical disabilities. The home is staffed 24 hours a day, and there are waking night staff. There are cleaners and a cook. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection took place over a day and a half, and included a tour of the building and grounds, and discussions with staff, the registered providers and service users. Records and Service Users files were also checked. What the service does well: What has improved since the last inspection? What they could do better: The registered providers, Mr Waft and Mrs Hall, are planning to improve the laundry area, and are to continue with the work of risk assessing the environment to remove or manage unnecessary risk. The registered providers have also been required to ensure that they not only have verbal references for new staff but have written references. This is to help ensure that only the right people work at Crelake House. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 6 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. Crelake House D54-D07 63094 Crelake House V224720 190705 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 Crelake House D54-D07 63094 Crelake House V224720 190705 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) 1 and 3 There are systems to ensue that Service Users needs are known prior to moving to the home. This means that Service Users can be confident that these needs will be met. EVIDENCE: A Statement of Purpose and Service User’s Guide have both been developed but are in need of minor amendments. These documents provide prospective Service User’s and their representatives with information about the home and what is provided. Service Users who have been admitted to the home have all been assessed prior to the move. This assessment ensures that the home knows about the help the individual needs. Mrs Hall, the Registered Manager, said that they were hoping to develop the assessment further so that they know more about each individuals background, so that needs could be better met. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10. Service Users are well cared for, and their privacy and dignity is respected. There is a good system for managing medication, which ensures Service Users get the right medication when they need it. EVIDENCE: Service Users have Plans that identify how their needs are to be met and the detailed action staff are to take. These plans help ensure that peoples needs are met consistently by staff. Service User’s said that they felt well cared for and staff were responsive to needs. A key worker system has been set up, such systems help ensure better continuity of care and aid communication. There are risk assessments, which help identify how Service User can be protected from unnecessary risk. A “blister pack” system for managing medication is used. Records show that medication is given when it should be, and an observation of staff giving medication confirmed that staff are competent in administering medication. There was information ready to hand to tell staff the purpose of each medication. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 10 Service Users spoken with during this inspection felt that they were respected by staff and treated with consideration. Staff knock on doors before entering rooms, service users can lock their bedroom doors. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 Service Users are provided with a wholesome diet and are consulted with about the menu. Service Users are offered choices about how they spend time and have control over their lives in the home. EVIDENCE: Service Users said they were able to get up and go to bed when they wished, and that there were no rules about such matters. There is a plan of activities in the home that includes including bingo. Service Users said that they had recently attended the Tavistock Carnival and thoroughly enjoyed the experience. Mr Waft and Mrs Hall confirmed that they this an area of service they wish to focus on in the near future. A number of Service User’s had visitors during this inspection. A new system has been set up so that Service User’s it is not assumed that Service Users wish to receive visitor’s but they are asked. There have been changes to the menu over the last few months, with the introduction of more fresh fruit and vegetables. A meeting has been held with Service Users and the menu amended to better reflect needs and preferences. Service Users thought that the food was generally very good and particularly enjoyed the roast meals. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 12 Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 13 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 There is a good system for dealing with complaints, and for dealing with issues before they become complaints. EVIDENCE: The Registered Provider and the Commission have received no complaints since the last inspection. There is a complaints procedure and a system for managing complaints should any be received. Mr Waft and Mrs Hall have also set up a system for managing concerns or issues before they might become complaints; a record of these issues and actions taken is kept. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 14 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, 25 and 26 Service Users have a safe and comfortable environment in which to live. EVIDENCE: A tour of the building confirmed that the building is clean, tidy and in good decorative order. Service Users are able to bring their own items of furniture to the home and many have chosen to do this. The communal areas are well decorated and domestic in character. Since Mr Waft and Mrs Hall took over Crelake House earlier this year environmental risk assessments have been developed or are in the process of being reviewed. Such assessments help ensure that the home is safe for staff and service users. The existing laundry area has been re-organised so that it provides a better work environment for staff. This area needs upgrading and Mr Waft and Mrs Hall have plans to carry out improvements later this year. Service Users confirmed that the laundry service in the home is good. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 29 Service Users needs are met by considerate and caring staff who have sufficient time. EVIDENCE: Changes have been made to the staffing of the home in recent months with the appointment of two further senior care staff. This means that there is now a senior care staff on duty at all times, with responsibility for carrying out specific roles such as administering medication. There are three care staff on during the morning and two on through out the rest of the day. Mr Waft and Mrs Hall said they were also available much of the time to provide additional support. At night there is one waking staff and there is on call “sleep in cover” provided by Mr Waft and Mrs Hall who live on the premises. Staff confirmed that this is generally sufficient staff; Service Users said that the staff always find the time to stop and chat, which they particularly valued. One theme that cropped up in every discussion with a Service User was the how considerate and caring the staff at Crelake are. The recruitment of new staff involves them completing and application form and being interviewed. Two references are taken and a criminal records bureau check started. The records show that whilst verbal references are taken written references have not been received when staff started. Two written references must be received before a new member of staff can start. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 16 New members of staff undergo a period of induction training and Mr Waft and Mrs Hall is in the process of reviewing staff training to ensure that all staff have the skills and competence to do their work. Crelake House D54-D07 63094 Crelake House V224720 190705 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) 32, 35 and 38 There are good management systems in the home and staff appear well motivated and well led. Safety issues and concerns are being consistently addressed through a process of risk assessment. EVIDENCE: Discussions with staff indicated that they felt well supported and that there was a sense of direction and purpose in the care home. If they had ideas about things they wanted to do then they felt happy to raise them with managers. Senior care staff have recently started to meet together as a group, and this was felt to be of great value. A system for communicating with staff has also been set up using memos- which all staff are required to read and sign. This is aimed at ensuring all staff know what is happening in the home so that Service Users get a better service. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 18 No money is held on behalf of Service Users. Information about where to get advice is available to Service Users on the notice board. Meetings have been held with Service Users to discuss changes to be madefor example with regard to the menu. Mr Waft and Mrs Hall indicated that there were plans to further develop discussions with Service Users and their relatives in the coming months. Mr Waft and Mrs Hall have started to review the risks posed in the premises and have put in place a number of improved procedures – particularly in relation to fire. Many of the radiators have been covered however a few still remain to be covered, this is so that Service Users are protected from burns if they should fall and lie against a hot radiator. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 19 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 3 x 3 x x N/A 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 3 x x x x x 2 2 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 x x 3 x x 3 x x 2 Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 20 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 OP25 Regulation 13 Requirement Timescale for action 1/10/05 2. OP26 23,13 3. OP25,OP38 23,13 4. OP29 19 The Registered Providers must continue the process of covering radiators/ hot pipes based on a risk assessment. (This requirement was made at the last inspection with a timescale of 1/10/05). The Registered Providers are 1/10/05 required to draw up plans to provide appropriate laundry facilities for the home.(This requirement was made at the last inspection with a timescale of 1/10/05). The Registered Provider must 1/11/05 risk assess all aspects of the home, including in relation to legionella and asbestos, and take action within appropriate time scales.(This requirement was made at the last inspection with a timescale of 1/11/05, and the majority of this requirement has been met). The Registered Provider must 1/9/05 ensure that ensure that two written references are received before a member of staff is employed at the care home. Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 21 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 Good Practice Recommendations Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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 Crelake House D54-D07 63094 Crelake House V224720 190705 Stage 4.doc Version 1.40 Page 23 - 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!