Inspection on 20/05/05 for Crescent House

This inspection was carried out on 20th May 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

Crescent House 12/12/07

Crescent House 19/06/06

Crescent House 24/10/05

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 NN1 4SB Lead Inspector Linda Lilley Unannounced Friday, 20th May at 10:00am 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. CRESCENT HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service Cresent House Address 3 The Crescent Phippsville Northampton NN1 4SB 01604 710222 01604 716951 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) Crescent Homes Limited Mrs Ann Ogbourne CRH 33 Category(ies) of 33 OP - Old Age registration, with number of places CRESCENT HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 20th January 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. CRESCENT HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours in the morning and early afternoon. A partial tour of the home took place and staff, and residents were spoken to. Some resident’s records and documents regarding the management of the home were looked at and observations of the interaction between staff and residents and care practices were observed. What the service does well: What has improved since the last inspection? What they could do better: CRESCENT HOUSE Version 1.10 Page 6 Residents care plans should be kept up to date and reflect the current needs of the resident, to enable appropriate care to be delivered. There should be documented evidence including the signature of the resident or relative to show that they have been involved in the initial care planning process and subsequent reviews. There should be monitoring of residents weight, and weights recorded as part of the manual handling assessment and ongoing residents assessment. All bedrooms should have locks that can be overridden in an emergency. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. CRESCENT HOUSE Version 1.10 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 CRESCENT HOUSE Version 1.10 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) Outcomes for standards 1-6 were not reviewed at his inspection. They were met in full at the previous inspection EVIDENCE: . CRESCENT HOUSE Version 1.10 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, 10 and 11 There are minor shortfalls on ensuring residents healthcare needs are met. These shortfalls have the potential of placing the residents and the staff at risk. EVIDENCE: Individual plans of care are available for each resident. Three sets of plans were reviewed. In general they provided good guidance for the staff providing care. However they did not always reflect the current health care needs of the resident. This was particularly evident for one resident who is being treated by a District Nurse for a wound infection, there was no reference on the residents plan of care to the District Nurses care plan which is kept in the residents room, or any specific infection control measures to be taken. Discussion with the staff indicated this information is communicated verbally. In another residents daily record there was information regarding the outcome of a Doctors visit, which was to apply a medication cream. This was not reflected in the care plan. There were some minor record keeping errors, records not containing the resident’s name, a loose sheet of A4 used which was not secure in the records and correction fluid used to cover an error in recording. CRESCENT HOUSE Version 1.10 Page 10 Within the records examined there was evidence that the personal care given to residents, for example bathing and hair washing was up to date. Information in some of the resident’s files clearly identified that their wishes and their family’s wishes at the time of the resident’s death had been explored. Currently there is no written evidence by the residents or relatives that they are involved in planning or reviewing their care needs, although residents spoken to indicated they had been asked, what time did they want get up, go to bed, and what they liked or didn’t like to eat. There is no monitoring of residents weight, nor are weights recorded as part of the manual handling assessment. Discussion with staff indicated that a review of suitable weighing devices was being undertaken. A number of residents were spoken to and everyone who commented on the staff said they felt the staff treated them with respect and respected their privacy. Staff were seen knocking on doors prior to entering and addressing residents by their preferred title. CRESCENT HOUSE Version 1.10 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, 14 and 15 The daily pattern of life and activities within the home meets the needs of the residents. EVIDENCE: Residents receive a well-balanced, well-presented choice of meals and have choice of attending the dining room or having their meals in their rooms. The residents activity schedules seen indicated mainly watching television, reading or taking communion as the activities they were involved in. The July 2004 quality assurance questionnaire to residents, families and relatives indicated they would like more organised activities. There is one activities officer within the home, but they have been off sick for sometime. Discussion with the staff indicated some measures have been taken to recruit a second person. The notice board contained information regarding various singers who visit the home. 2 residents did describe a recent birthday party. A recent addition to the home has been a small Terrier dog, which the residents said they loved and he was seen being patted by many residents. A number of residents were spoken to during the lunchtime and those who commented on the food said it was good, plentiful and they were given choices to meet their individual needs. Menus were seen and records of individual residents choices are kept. Some residents who were having lunch in their rooms said this was their choice. CRESCENT HOUSE Version 1.10 Page 12 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 and 17. Residents are aware of the complaints process, and arrangements for enabling residents to exercise their legal rights are satisfactory allowing them to exercise judgements and choice in the civic process. EVIDENCE: Residents spoken to indicated they would speak to the Manager about any concerns and they had seen the complaints procedure. There has been one complaint received since the inspection in august 2004. Residents spoke about the recent national election and how they had been able to take part in the postal voting process. Discussion with staff indicated that party leaflets had been given to residents but that active canvassing by candidates in the home had been discouraged, to protect vulnerable residents. CRESCENT HOUSE Version 1.10 Page 13 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) 24 and 25 Overall the quality of the furnishings and décor of the home is excellent, providing a comfortable, clean and pleasant environment both inside and outside. However there are minor shortfalls relating to locks on bedrooms doors, and window restrictors on the ground floor. EVIDENCE: The resident’s rooms seen were well furnished, to a very high standard with some of the resident’s personal possessions and some personal furniture insitu. The ensuite facilities seen were spacious, and decorated to an exceptionally high standard. Not all bedrooms have the kind of locks that could be overridden in an emergency. A replacement programme is underway, driven by residents choice or when residents change. The lower ground floor windows do not have restrictors; therefore residents who wish to, are unable to leave the lower ground floor windows open at night for security reasons. Discussion with staff indicated a planned programme of window replacement is underway, using UPVC windows that have a facility to enable ventilation without increasing the security risk. CRESCENT HOUSE Version 1.10 Page 14 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) 30 Residents are cared for by staff that has undergone specific training to enable them to deliver a good standard of care. . EVIDENCE: Discussion with staff indicated over 90 of staff have NVQ qualifications and that there is a robust programme for in-house training, including topics such as, Administration of medicines, care planning, Manual handling, and food hygiene. Evidence of training is recorded on an attendance list for each session, though discussion with staff indicated a matrix chart is being planned that clearly and quickly indicates each member of staffs training in the current 12 month period. CRESCENT HOUSE Version 1.10 Page 15 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) 33, 37 and 38 There are effective quality assurance systems in place that ensure that the home is run in the best interests of the residents. There are minor shortfalls in the standards of record keeping. Health and Safety procedures ensure the safety of staff and residents. EVIDENCE: The results of a residents and families survey (July 2004) and 5 relatives/visitors comments cared received by the Commission, showed a high level of satisfaction with the provision within the home. The results were seen in a published newsletter for the home. There is minor record keeping errors in resident’s plans of care, (See standards 7-11). A letter from the Manager indicated the Fire Officer was contacted in January 2005 and confirmed the home was carrying out safe practices. Fire alarm testing records were up to date. The home has recently obtained a “Transfer of Waste” contract for the safe disposal of continence products. All taps within the home have regulators in place to ensure regulation of water temperature and reduce the risks from hot water. CRESCENT HOUSE Version 1.10 Page 16 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. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION x x x x 4 3 3 x STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x 3 x x x 2 3 CRESCENT HOUSE Version 1.10 Page 17 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 OP7& OP8 Regulation 12(1)a15( 2) b Requirement Residents documented care plans must be kept up to date and reflect the current needs of the resident, to enable appropriate care to be delivered There must be documented evidence including the signature of the resident or relative to show they have been invovled in the initial care planning process and subsequent reviews. Timescale for action August 1st 2005 2. OP7 15.2c(d) August 1st 2005 3. 4. 5. 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 OP8 Good Practice Recommendations Purchase appropriate scales to enable all residents to be weighed as part of the moving and handling risk assessment, and as part of the residents ongoing assessment All bedrooms should have locks that can be overridden in an emergency. Version 1.10 Page 18 2. OP24 CRESCENT HOUSE 3. CRESCENT HOUSE Version 1.10 Page 19 Commission for Social Care Inspection 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 CRESCENT HOUSE Version 1.10 Page 20 - 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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