Inspection on 19/06/06 for Crescent House

This inspection was carried out on 19th June 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

Crescent House 12/12/07

Crescent House 24/10/05

Crescent House 20/05/05

Crescent House 09/08/04

Crescent House 27/05/04

Crescent House 05/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Crescent House 3 The Crescent Phippsville Northampton Northants NN1 4SB Lead Inspector Irene Miller Unannounced Inspection 19th June 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000012755.V300193.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000012755.V300193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crescent House Address 3 The Crescent Phippsville Northampton Northants NN1 4SB 01604 710222 01604 716951 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) Crescent Homes Limited Mrs Ann Ogbourne Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places DS0000012755.V300193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home will limit its services to the following service user categories: No person falling within the category Older Persons (OP) can be admitted where there are already 33 persons of category OP in the Home. The total number of service users in the Home must not exceed 33. 2. Date of last inspection 24th October 2005 Brief Description of the Service: Crescent House is situated in a pleasant residential area of Northampton close to local shops and accessible by public transport. The premises offer mostly single bedroom accommodation. There are three shared bedrooms, which offer very spacious en-suite bed-sit style accommodation for couples or people who positively choose to share. There are five different communal areas, which include attractive dining rooms and lounges. The rooms have views over the well-kept landscaped gardens, one of which includes a fishpond. The Home is furnished to a very high standard.Fees range from £350.00 to £500.00 per week. DS0000012755.V300193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The primary method of inspection used was ‘case tracking’ which involved tracking the care of three residents, through a review of their records and discussion with them where possible. Observation of care practices, discussion with the manager, residents and staff and also included a limited tour of the building. Prior to the inspection taking place The Commission for Social Care Inspection sent out to the provider a pre inspection questionnaire to gain feedback on the establishments policies and procedures, staffing, and input from other professionals who provide a service to the home. The provider completed the pre inspection questionnaire and it was returned back to the Commission for Social Care Inspection within the specified timescale. Also comment cards were sent out to residents and visitors, prior to the inspection-taking place no comment cards were returned to the Commission for Social Care Inspection. The inspection took place over a period of approximately five and a half hours following two hours preparation, which included reviewing previous inspection reports, and other documentation in relation to the home. What the service does well: Information about the home is made available to all residents, copies of the homes Statement of Purpose (that outlines the qualifications and experience of the registered provider and manager, and the range of care that the home is registered to provide) are made available to all prospective residents and all residents are provided with a copy of the Service User Guide (that outlines the range of services available within the home, and daily routines) Staff were observed treating residents in a respectful and courteous manner. Residents were addressed by their preferred name; residents said that they were very happy with the care they received at the home, that the staff are very kind and helpful. The home is furnished, to a very high standard, the bedrooms are personalised with resident’s own belongings and en-suite facilities are spacious, and decorated to an exceptionally high standard. DS0000012755.V300193.R01.S.doc Version 5.2 Page 6 There is specialist beds, baths, chairs, hoists and moving and handling equipment available to ensure that the residents changing needs can continue to be met What has improved since the last inspection? What they could do better: The storage, administration and recording of residents medication was well managed, however one of the prescribed medications listed on the medication administration record (mar sheet) for one of the residents case tracked, had not been signed by staff, over a five day period On further investigation it was identified that the residents had received their medication, the importance of staff signing the mar sheet was stressed to the registered manager, who said that this error would be fully addressed with the staff concerned. Accidents reports should be constructed and maintained in accordance with the Data Protection Act 1998. Advice on the temperature probing of cooked foods and food safety standard guidelines should be sought from the environmental health department. Please contact the provider for advice of actions taken in response to this DS0000012755.V300193.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000012755.V300193.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000012755.V300193.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 3 standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process enables prospective residents to make a fully informed choice as to whether the home will meet their needs and expectations. EVIDENCE: The statement of purpose, service user guide and copies of inspection reports are available to all prospective and existing residents. Full pre assessments are conducted for each prospective resident and they are encouraged to visit the home prior to moving in to ensure that the home can fully meet their needs. DS0000012755.V300193.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information contained within the care plans, ensures that resident’s immediate needs can be met. However there is concern in relation to the medication administration records and accident record keeping system. EVIDENCE: The care plans viewed, demonstrated that much work has taken place on ensuring that the information contained within them was current to residents health and personal care needs. Within the care plans the input from other professionals such as the district nurse and general practitioner was recorded, and the treatment and action taken to address any health care needs was recorded. DS0000012755.V300193.R01.S.doc Version 5.2 Page 11 The storage, administration and recording of residents medication was well managed, however one of the prescribed medications listed on the medication administration record (mar sheet) for one of the residents case tracked, had not been signed by staff, over a five day period On further investigation it was identified that the residents had received their medication, the importance of staff signing the mar sheet was stressed to the registered manager, who said that this error would be fully addressed with the staff concerned. Staff were observed treating residents in a respectful and courteous manner. Residents were addressed by their preferred name; residents said that they were very happy with the care they received at the home, that the staff Are very kind and helpful. Within the daily notes of one resident case tracked there was reference to the resident having been found on the floor and of receiving a minor head injury. First aid had been administered and appropriate action taken, however on further examination the accident record book was looked at, and no formal accident record had been made. It was also noted that within the accident book, entries containing the details of residents accidents were consecutively made, with several residents accidents listed on the same page, the need for accidents to be recorded on separate pages was discussed with the registered manager to comply with the Data Protection Act 1998. A falls prevention monitoring process has been introduced, to identify the possible physiological, psychological and environmental factors that culminate in a resident falling, such as physical health, frailty, effects of medication, confusion and disorientation, and identified the high risk times and staff intervention required to prevent and protect the residents identified at risk of falls. DS0000012755.V300193.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle in the home meets the resident’s needs and expectations. EVIDENCE: On the residents notice board there was information on forthcoming events and visiting entertainment. On the day of inspection there was afternoon entertainment, facilitated by a small group if singer from St Mathews Church. Staff were observed inviting all residents to the planned activity, and residents who did choose to attend were supported by the staff team. Residents said that they enjoyed the entertainment provided by church and said that they had been visiting the home for a number of years. Residents were observed moving around the home independently as they wished, chatting with staff, choosing were to spend their time. Residents said that they could receive visitors at any time of the day, and that the staff would make them welcome. DS0000012755.V300193.R01.S.doc Version 5.2 Page 13 Records within care plans contained information on resident’s individual and social preferences in relation to activities, and records were retained within care plans of the activities undertaken by the residents. Provision is available for residents who wish to worship according to their faith. The care plans demonstrated flexibility in accommodating the individual routines of residents Resident’s weights are closely monitored and dietary preferences recorded within the care plans. The meal on the day of inspection was mince, with mashed potatoes, Brussels sprouts, or cooked meat salad followed by rice pudding. There was fresh fruit available. Residents said that they were happy with the meals and they could choose an alternative to the meal on any given day if they so wished. The kitchen was clean and tidy, records of fridge and freezer temperatures were retained and in order, however no records of food temperatures or hot holding temperatures were retained, on speaking with the registered manager and staff this is not a practice that was thought to be required, advice was given to contact the environmental health department to seek further clarification on this matter. The food store was looked at and contained a variety of tinned, dry and frozen foods that were stored appropriately. The dining room was clean and very pleasant; tables were set with flowers and matching tablecloths and napkins with decorative napkin rings. DS0000012755.V300193.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives can be assured that any concerns they may have about the service will be taken seriously and acted upon. EVIDENCE: There is a complaints procedure available within the home, which is outlined within the homes statement of purpose and service user guide. The Commission for Social Care Inspection has not received any concerns or complaints about the service since prior to the inspection-taking place. The provider dealt with one complaint that had been raised by a relative satisfactorily. Training on the protection of vulnerable adults takes place during induction training and refresher training. Staff said that they would know how to report any suspected or actual abuse should there be a need to. DS0000012755.V300193.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at the home are provided with a pleasant, homely and comfortable environment. EVIDENCE: The communal areas and resident’s rooms seen were furnished, to a very high standard, the bedrooms were personalised with residents own belongings. The en-suite facilities seen were spacious, and decorated to an exceptionally high standard. Bathrooms and toilets were clean, and decorated to a good standard. DS0000012755.V300193.R01.S.doc Version 5.2 Page 16 There is specialist beds, baths, chairs, hoists and moving and handling equipment available to ensure that the residents changing needs can continue to be met Residents have access to a pleasant landscaped garden, to include fishponds and outdoor seating. The dining rooms were pleasantly decorated and furnished to a high standard, the dining tables were decorated to include good quality table linen and napkins with decorative holders. The home was clean and tidy and free from offensive odours. DS0000012755.V300193.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a loyal and committed staff team that ensures that the residents receive a quality service. EVIDENCE: On the day of inspection there was the deputy manager, one senior carer, four care assistants, one domestic assistant and one cook on duty. There were two resident vacancies, the number of residents within the home was thirty one. Staff said that they enjoyed working at the home, and that it was homely for the residents, that they found satisfaction in providing the care for the residents living at the home. Staff were aware of their responsibilities of ensuring that the residents live within a home that is safe. The staff recruitment and supervision records looked at demonstrated that the staff recruitment systems in place are robust. Training on moving and handling is available in-house, and formal supervision takes place. DS0000012755.V300193.R01.S.doc Version 5.2 Page 18 There was a staff notice on display in the kitchen, informing staff of training sessions that were planned to take place. DS0000012755.V300193.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is well managed and promotes the residents rights to choice, privacy and dignity and respect. EVIDENCE: The registered manager has in-depth knowledge of the needs of the residents living at the home and is well respected by residents and staff. The deputy manager has responsibility for ensuring that the residents care plans, health care assessments, risk assessments and other day to day operational tasks are completed, it was evident through discussion and review DS0000012755.V300193.R01.S.doc Version 5.2 Page 20 of documentation that she is very skilled, experienced and competent to undertake these responsibilities. The pre inspection questionnaire was returned back to The Commission for Social Care Inspection prior to the inspection taking place and provided the information to demonstrate that the health, safety and welfare of residents and staff is promoted and protected. Resident’s confidential records are stored securely. DS0000012755.V300193.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000012755.V300193.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement Medication that is administered to residents must be signed for on the resident’s medication administration record. Timescale for action 20/06/06 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 Refer to Standard OP37 OP38 Good Practice Recommendations Accidents reports should be constructed and maintained in accordance with the Data Protection Act 1998. The provider should seek advice on the temperature probing of cooked foods and food safety standards guidelines, from the environmental health department. DS0000012755.V300193.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 DS0000012755.V300193.R01.S.doc Version 5.2 Page 24 - 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. 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