Inspection on 24/10/05 for Crescent House

This inspection was carried out on 24th October 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 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 24th October 2005 10:00 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 Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 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 DS0000012755.V260124.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is based upon the outcomes for residents, and upon their views of the service provided. The primary method of inspection used is case tracking which on this occasion involved selecting three residents and tracking the care they receive through observing practice, reviewing care plans, discussion with the service users, were possible and staff. The registered manager was not available within the home on the day of inspection. Prior to the inspection taking place, the inspector spent forty five minutes planning the areas to focus on at this inspection, based upon information gained from reviewing the homes service history and the previous inspection reports. The inspection took place in the morning over a period of five hours. What the service does well: What has improved since the last inspection? Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 the following standard(s): 5 Pre assessment processes are satisfactory, to enable the home to identify the needs and expectations of prospective residents. EVIDENCE: There were records within the care plans, which identified the residents care needs prior to moving into the home. Residents said that they had the opportunity to visit the home prior to moving into the home, one resident said that they used to visit a friend who lived at the home and chose to apply for a place at the home when their health began to decline. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 & 10 There are shortfalls within the care planning and risk assessment processes on recording how residents healthcare needs are to be met. These shortfalls have the potential of placing the residents and the staff at risk. EVIDENCE: Three care plans were looked at and there was records of the care plans being reviewed, however they all lacked thorough assessments of the residents needs, there were no assessments in place on the moving and handling, nutritional diet and fluid intake, pressure area care, emotional and mental health care needs. The monitoring of residents weight gain and loss and appropriate action taken was not recorded in the care plans, the staff said that the home is planning to purchase scales which would be suitable to weigh residents who are unable to use conventional scales. There was no written evidence by the residents or relatives that they are involved in planning or reviewing their care needs. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 10 Within the daily notes there was references to a resident being displaying aggression towards the staff, there was no specific behavioural care plan or risk assessment in place identifying how the staff were to meet the needs of the resident, to ensure the safety of the resident and the staff. Residents who are at risk of falling had no falls risk assessments in place, the daily care notes had an entry that a resident had fallen, no accident report had been completed to record the fall, any injury sustained or treatment required. The current health and physical care needs of the residents were not reflected within the care plans. This was particularly evident for one resident who was being treated by the district nurse for pressure wounds; there was no reference within the care plan of the district nurses input. However there was a district nurse care plan available within the resident’s bedroom, which outlined the plan of care for the resident in relation to the treatment of their pressure wounds. Discussion with the staff indicated this information and information on the general physical, emotional and spiritual needs of residents are communicated verbally, during staff handovers. In general records of visits from health care professionals such as the doctor, optician and chiropodist visits are recorded within the residents daily notes. This method of recording presents difficulty in tracking the frequency of visits. There was some minor record keeping errors, for example records not containing the resident’s name. The staff administer residents medication, the storage and administration records looked at and were in order, however there was not a copy of the homes policy on the storage and administration of medication available to view, within the medication file. 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 DS0000012755.V260124.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14 & 15 The daily pattern of life and activities within the home in general meets the needs of the residents. EVIDENCE: The residents activity records seen indicated mainly watching television, reading or taking communion as the activities they were involved in. Many of the residents choose to spend time within their rooms. Personal and social relationships are encouraged with residents spending time in the company of others within their rooms, visiting times are flexible one resident said that they enjoy keeping the flower beds looking nice. There were notices displayed on the residents notice boards of visiting musicians and entertainment artists There is currently no activity person employed at the home, staff confirmed that there are steps in place to recruit an activity organiser. The small kitchenette provides the opportunity for residents to help themselves to drinks if they wish. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 12 The menus are flexible and the residents have a voice in what is included on the menu on a weekly basis, residents said that the food was good and plentiful and they were given choices to meet their individual needs. Menus were seen and records of individual residents choices are kept Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 the following standard(s): 16 The complaints process is satisfactory. EVIDENCE: Residents said that they were happy with the care provided and that they had no complaints about the service provided by the home, however there was no complaints procedure available to view, and there was no copy on display, readily available for residents or their representative to access, if the need arisen. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,23,24,25 & 25 The residents live in a comfortable home where the décor and furnished are to a high standard. There are some minor shortfalls relating to locks on doors and water temperatures, which could potentially place residents at risk. EVIDENCE: The resident’s rooms seen were well furnished, to a very high standard and personalised with there own belongings. The ensuite facilities seen were spacious, and decorated to an exceptionally high standard, however not all bedrooms have privacy locks to allow residents to lock their doors from the inside, that could be overridden by staff in an emergency. Bathrooms and toilets were clean, and decorated to a good standard, however the water temperature in the wash hand basins was unacceptably hot placing residents at risk of scalding. There were no water thermometers available within the bathrooms to record the resident’s bathwater temperatures. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 15 A portable radio within the hairdressing room did not have the portable appliance testing label on display, and records of the portable appliance testing was not available to view. 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. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 16 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 Residents are cared for by a loyal and committed staff team. EVIDENCE: On the day of inspection there was one senior carer, four care assistants, two domestic assistants and one cook on duty. There was one resident vacancy and two residents in hospital; the actual number of residents within the home was thirty. Staff said that they enjoyed working at the home, and that it really was a ‘home’ for the residents, that they and the residents looked upon each other as friends. Through discussion with staff they were aware of their responsibilities of ensuring that the residents live within a home that is safe. The staff recruitment and supervision records were not available to view, however through discussion with staff it was confirmed that training on moving and handling is available in-house, and that formal supervision takes place approximately every three months, five staff have achieved their National Vocational Qualification level 2. There was a staff notice on display in the kitchen, informing staff of a Health and Safety training session that was planned to take place. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 17 Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 18 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): 33 & 38 The home is run in the best interests of the residents, however there are shortfalls in the standard of the homes care planning, risk assessments and record keeping, which could potentially place residents at risk. EVIDENCE: Residents said that they were very satisfied with the care provided by the home, and observations of staff interacting with residents was very positive, ensuring that the residents rights to be cared for with respect and dignity was maintained at all times. The residents care plans and risk assessments do not accurately reflect their needs. There is a high dependency on information on the changing needs of residents to be communicated verbally. Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X 2 3 Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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 OP7& OP8 Regulation 12(1) a 15(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 (Previous timescale of 01/08/05 not met) There must be documented evidence including the signature of the resident or relative to show they have been involved in the initial care planning process and subsequent reviews. (Previous timescale of 01/08/05 not met) Risk assessments of pressure sores and appropriate interventions and treatment must be recorded in the care plans and reviewed on a regular basis. Risk assessments and appropriate interventions must be in place for residents identified at risk of falling. Records of nutritional assessments, weight gain and loss and appropriate action taken must be in place within care DS0000012755.V260124.R01.S.doc Timescale for action 30/11/05 2 OP7 15.2 (c)(d) 30/11/05 3 OP7 12 (a) 30/11/05 4 OP8 13 (c) 30/11/05 5 OP8 12 (1) (a) 30/11/05 Crescent House Version 5.0 Page 21 6 OP38 13 (5) 7 OP38 13 (7) 8 OP38 17 (1) (a) plans. Risk assessments for the moving and handling of residents and appropriate intervention must be in place. Risk assessments and appropriate interventions must be in place for residents who display aggression and challenging behaviour towards staff and others. All accidents, injuries and incidents must be recorded. In accordance with schedule 3 (j) 30/11/05 30/11/05 30/11/05 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 OP24 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. Consideration should be given to providing therapeutic activities for residents who are unable to participate in group activities, due to their physical and emotional health constraints. Consideration should be given to having a copy of the complaints procedure on display within the home. Water temperatures within the wash hand basins in bathrooms and toilets should be regulated to reduce the risk from hot water scalding. All portable appliances should display the date when it was tested and the date of the next test due. 2 3 OP24 OP12 4 5 6 OP16 OP38 OP 38 Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 Page 22 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 Crescent House DS0000012755.V260124.R01.S.doc Version 5.0 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. 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