Inspection on 13/12/07 for Crescent Nursing Home

This inspection was carried out on 13th December 2007.

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 Nursing Home 13/11/06

Crescent Nursing Home 03/11/05

Crescent Nursing Home 22/06/05

Crescent Nursing Home 22/02/05

Crescent Nursing Home 13/05/04

Similar services:

Claremont House

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Crescent Nursing Home 12 The Crescent Bedford Bedfordshire MK40 2RU Lead Inspector Sally Snelson Unannounced Inspection 13th December 2007 12:20 Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 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 Nursing Home DS0000017671.V355492.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 and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crescent Nursing Home Address 12 The Crescent Bedford Bedfordshire MK40 2RU 01234 266933 01234 342557 admin@apexcare.co.uk 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) Apex Care Homes Limited Mr Remigius Mukasa Wamala Care Home 28 Category(ies) of Dementia (5), Learning disability (6), Mental registration, with number disorder, excluding learning disability or of places dementia (28) Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users admitted to the home must be between the ages of 35 and 64. A maximum number of 10 beds may be used to accommodate existing service users in the category of MD (E) or DE (E). 13th November 2006 Date of last inspection Brief Description of the Service: The Crescent nursing home is within two Victorian houses, which have been converted and extended to accommodate up to 28 people with mental health problems. The residents currently assessed to enter the home are under 65 years of age. There are 26 single bedrooms and one double bedroom, with four rooms that have en-suite facilities. The home has various lounges, dining areas and dedicated smoking areas to meet the needs of the residents. Attached to the home via a covered walkway is a day centre for the homes residents. There are attractive gardens to the rear of the building alongside parking areas. The gardens are made secure by locked gates. The fees for this home vary from £650.00 per week, to £750.00 per week, depending on the funding source and assessed need of the resident. Additional charges are made for hairdressing, personal clothes, toiletteries holidays and outings. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out in accordance with the Commission for Social Care Inspection’s (CSCI) policy and methodologies, which require review of the key standards for the provision of a care home for younger adults that takes account of service users’ views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment (AQAA) has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. The inspection of The Crescent was a key inspection, was unannounced and took place from 12.20pm on 13th December 2007. The manager, Mr Remigius Mukasa Wamala, was present throughout. Feedback was given throughout the inspection, and at the end to the manager and Mr Yogendra the operations and training officer. During the inspection the care of three people who used the service was case tracked. This involved reading their records and comparing what was documented to what was provided. In addition to sampling files, people who lived at the home, staff and visitors were spoken to and their opinions sought. Any comments received from staff or service users about their views of the home plus all the information gathered on the day was used to form a judgement about the service. Prior to the inspection two service user comment cards had been received. The inspector would like to thank all those involved in the inspection for their input and support. What the service does well: The home provides care for people but also supports them to work towards independence. This is achieved because the staff team continually assess those living at the Crescent and work with them to met their personal goals and aspirations. The home benefits from an attached day centre, which provides the residents with a variety of activities and opportunities for craft pursuits throughout Monday to Friday. Although the centre plans to be open Monday to Friday Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 6 some evening events take place and the staff working at the centre also arrange day trips and holidays with individual residents. The home has a very open atmosphere and encourages those living there to take part in the running of the home. One of the residents chairs residents meeting and when thanked for his help with the inspection, he said, “ I speak on behalf of all those who live here, particularly those that can not communicate easily”. The home is comfortably furnished and residents are encouraged to personalise their own bedrooms and also make suggestions as to how communal areas are used and decorated. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA 1,2,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of pre admission assessment was such that the management had sufficient information to be certain that the staff team could meet the needs of the residents. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 9 EVIDENCE: All of the residents had received a copy of the Statement of Purpose and Service Users Guide for their own use. A copy was also held on file with copies of contracts. The documents were comprehensive and had been compiled in words and pictures to ensure they were suitable for all of the residents. Files included a needs assessment which when completed acted as a tool for the manager to ascertain that the home had a staff team with sufficient skills and experience to care for the needs of the prospective residents. The care plans in place were directly linked to the assessment of needs. Of the 12 residents who completed the pre-inspection questionnaires almost 50 reported that they had not had a say in their placement. One explained that the admission was as the result of an emergency situation and another that the placing social worker simply said it was time to move. However that resident was clear that the move was on the condition that the people at the home were nice and a subsequent move could be arranged if necessary. The management confirmed that it was planned that all residents would have the opportunity to visit the home before making any decisions and that the initial period of the stay was a trial period, but sometimes, because of the situations the prospective residents were in, a placement was made on behalf of a resident rather than with a resident. The manager was aware that spending time with new residents at the point of admission and not hurrying the process lead to a smooth transition when it came to the time to move in The management had plans to introduce a new residents induction package to ensure that all new residents, and their families, had all the information they considered necessary. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The changes in the standard of care planning at this home provided staff with clearer guidance on how they should support the residents to meet their individual needs and ensure all their care needs were met. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 11 EVIDENCE: Since the last inspection care had been taken that all care plans were written in more detail, were reviewed at least 3 monthly and more often if required. In the files sampled there were plans in place for all the activities of daily living that had been appropriately reviewed and updated. There was also evidence that residents had been involved in planning and reviewing their care. The introduction of a resident s quality package named “Your say”, encouraged and enabled residents to participate in the running of the home and to suggest changes. It was apparent that residents were aware of how the home ran and were kept informed, and indeed expected to be informed, of any changes. Some residents had been part of staff recruitment processes and one resident chaired resident meeting’s and then met with the manager to discuss the running of the home from the resident’s point of view. . Throughout the care plans it was apparent that staff gave consideration to risk and assessed the risk. Observation of the physical and emotional support offered to one resident during the inspection, so that the risk to that resident was reduced, was carried out appropriately. This support had been described in the resident’s records and the staff member providing the one-to-one support was changed every two hours. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 13 YA 12,13,15,16,17 Quality in this outcome are is excellent This judgement has been made using available evidence including a visit to this service. Activities inside and outside the home were encouraged and staff supported the residents to have contact with friends, family and the local community. EVIDENCE: There was information in the care files for all of the residents who were tracked about activities that they had enjoyed in the past and anything that they would wish to pursue. The home benefited from an attached day centre. The day centre had a planned programme of activities for residents to participate in if they so wished. It was noted that activities available were advertised so that residents could choose when they wished to use the facility. Information provided by the home showed that activities provided include, baking, watching films, shopping, 10-pin bowling, singing and arts and crafts. A number of the residents were keen to show us the Christmas decorations and displays that they had recently made. A room in the home was being turned into a cinema room. It had a large TV and it was planned that films would be available at anytime. Residents’ support plans gave clear information about how they should be supported to develop and maintain skills, including hopes and aspirations. Most of the residents were engaged in a range of activities in and out of the home, giving them opportunities to have new experiences and develop skills. For example a resident who wished to use a computer was being supported to find the right course via the local library. One of the residents, whose care was tracked during this inspection, choose not to socialise but to stay in his room other than at mealtimes. Staff had recently begun supporting him to attend a local church, which was helping him socialise, and supporting his interest. Documents submitted by the home to the Commission for Social Care Inspection showed that residents were also helped to keep in contact with their families. Staff had recently supported a resident to meet up with family many miles away. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 14 During inspection it was observed that many resident had the opportunity to be independent in their use of communication, social and living skills. The home worked to a four week planned menu, which was planned taking account of resident’s likes and dislikes. Residents were offered two choices at each meal but staff confirmed that there were some residents who did not like a lot of variety and separate meals were often prepared for them. On the day of the inspection residents were offered chicken curry and rice or egg and bacon pie for lunch and pasty, sausage roll, baked beans or sandwiches for tea. Residents were then offered a sandwich supper and could have milk drink and biscuits at bedtime if they wished. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA 18,19.20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff supported residents in accessing healthcare so that they benefited from a range of specialist professionals to reach a good level of well being in their individual health. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 16 EVIDENCE: Examination of resident’s care records and discussion with the manager indicated that people had their say in how they wished any personal care to be provided and when they choose to have this. People were dressed in individual styles that suited their personalities and age and encouraged to choose and buy their own clothes and in some cases look after them. Discussion with staff and observation of people indicated that people’s mental health usually improved during their stay and they presented with few negatively presenting behaviours (such as banging of the head and a high level of withdrawal from social contact). We noted that staff were responsive to a person’s restlessness and provided activity therapy, to reduce the person’s restlessness, with very good effect. Examination of three resident’s care records and discussion with the manager indicated that residents had access to a range of health care professionals including dieticians, specialist nurses, speech and language therapists, local hospitals and GPs. The AQAA told us that, “trained nurses monitor and observe service users throughout the dayand night and any physical or mental health problems are spotted and necessary action taken immediately”. During the tour of the premises we noted that people were receiving personal care in private, behind closed doors. Medication stocks were examined. Medication administration records had been signed and gave clear information on the medication to be given and the times that this should be done. The Deputy Manager has overall responsibility for ordering the supplies of medicines for the residents at the home. Medication was seen to be stored in a locked cupboard. Training records submitted by the home showed that all staff designated to administer medication had received training in this area. The home was strongly advised to consider requesting ‘bulk prescribing’ and to ensure that when auditing medication supplies care was taken that the correct balance was recorded. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust complaints procedures and policies to protect vulnerable adults ensured that residents and staff were kept safe. EVIDENCE: As at previous inspections it was noted that within the individual care records a copy of how the resident could complain was seen. The homes complaints procedure was comprehensive and included to whom the resident could speak and how to take a complaint further and how long the resident would expect to wait for a response. Resident’s feedback, through the comment cards sent to the Commission for Social Care Inspection detailed that they were aware of how to complain. We had received no complaints about the home and, according to the manager; no complaints had been made to the home. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 18 The homes protection of vulnerable adults policy alongside local guidance was in place, this as previously assessed, gave sufficient guidance. The home had made appropriate POVA referrals since the last inspection. On interviewing a staff member, they were able to demonstrate that they knew how to report a suspicion of abuse and confirmed that they had been trained in this area. The general manager, also the Responsible Individual, was the Chairperson of the providers Subgroup of the Adult Safeguarding Board in Luton and also attended the policy subgroup. As a result the home had good relationships with the various parties that made up the board. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA 24,25,26,27,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The crescent provided people with a homely place in which to live and bedrooms that they could customise to their own taste. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home worked to a continual environmental improvement plan that ensured all areas of the home were updated and improved as necessary. Since the last inspection five beds had been replaced with new fully electric beds, considered more suitable for some of the residents. There had also been replacement of chairs and flooring in some of the communal areas. A tour of the home identified that some bath and shower rooms were cluttered, and that although they had obscure glass at the windows there were no curtains or blinds which could mean when back lit people in the room might be seen. The home was clean and tidy throughout and resident’s rooms contained personal items, which reflected their individual personalities. Residents had unrestricted access to communal areas within the home and to a paved and grassed area outside the home. Many of the residents had been assessed as able to leave the home independently. One room was designated as a smoking room. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA 32,34,35,36, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People received appropriate and safe care from staff who were well recruited and trained to care for people with mental health problems. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 22 EVIDENCE: On the day of the inspection, in additon to the manager, on duty there were two nurses and five carers. The AQAA informed us that 11of the 14 care staff had an NVQ level 2 or above in care. Senior staff were supported to gain maximun experience and were supported to get management qualifications. All of the staff told us that either they had an NVQ or had been accepted on a level 2 training course. In addition to national qualifications and manadatory training staff were offered a range of specialist training to help them meet the needs of the residents. The manager had a comprehensive list of what training staff had undertaken over the last year but there was no easy way to ascertain when a training needed to be updated. A check of three staff files was undertaken to look at recruitment practices. It was noted that the files contained proof of identity, references and that Criminal Records Bureau clearance had been obtained prior to commencement of employment. Examination of staff supervision records and discussion with staff indicated that staff have regular 1:1 supervision and records of these supervision sessions were maintained. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 24 YA 37,39,42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home was well organised and robust quality assurance systems ensured that the residents views were considered at all times. EVIDENCE: Prior to the inspection the manager had completed and returned a very comprehensive AQAA that detailed accurately the way the home was run and the planned improvements for the next year. The manager of the home held the Registered Managers Award. The home, as previously reported, continued to be well run by the manager and deputy manager who were very committed to ensuring that residents received the care they need and were helped to lead as independent lives as possible. All residents and staff spoken with spoke very highly of the manager and his approach and commitment to the home. The home seeks the views of residents at meetings and via questionnaires and encourages the involvement of advocates. Quality assurance questionnaires were very in-depth and feedback was given to those who completed the questionnaires. Staff and training records showed that staff had undertaken training relating to health and safety matters, including fire safety and food hygiene. Fire safety checks were regularly undertaken alongside food temperature and water temperature checks. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 4 40 X 41 X 42 3 43 x 3 3 3 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crescent Nursing Home Score 3 3 3 x DS0000017671.V355492.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 Refer to Standard YA20 YA27 YA35 Good Practice Recommendations Staff should ensure care is taken when adding up and taking away as part of any medication audit. Consideration should be given to having blinds or curtains in all bathrooms. There should be a system to easily identify the training needs of staff, particular the need to refresh training. Crescent Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Nursing Home DS0000017671.V355492.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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