Inspection on 21/04/05 for Crescent The (1)

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 The (1) 07/11/06

Crescent The (1) 06/12/05

Crescent The (1) 06/10/04

Crescent The (1) 29/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 1 The Crescent Green Hammerton Nr York North Yorkshire YO26 8BW Lead Inspector Maggie Coxon Unannounced 21 April 2005, 12:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 1 The Crescent Address 1 The Crescent Green Hammerton Nr York North Yorkshire YO26 8BW 01423 331440 01423 331440 N/A St Annes Community Services 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) Mrs Wendy Cosgrove Care Home 5 Category(ies) of Learning disability (5) registration, with number Learning disability over 65 years of age (5) of places 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Registered for 5 service users with learning disailities, who may also have physical disabilities. Date of last inspection 6th October 2004 Brief Description of the Service: 1 The Crescent is a care home registered by St Annes Community Services to provide personal care and accommodation for up to five adults with learning disabilities some of whom may have a physical disability. The home is a detached two-storey property converted from two former semi-detached houses and is located in the village of Green Hammerton, which is accessible from the A59. The home is close to a range of community amenities and facilities including a church, a pub, a social club and a post office/shop. Each of the five bedrooms is for single accommodation, none of which has en-suite facilities. They are all situated on the first floor and the home has a passenger lift. There are well maintained garden areas to the front and the rear of the home and there is level/ramped access to the home. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first to be undertaken between April 2005 and March 2006. It was done at a time when all of the people living in the home would be present. It took place on 21st April 2005 and lasted 5 hours (12.00 noon to 5.00 pm). Discussions were held with the four people currently living in the home, with the care staff on duty and with the registered manager. A number of records including care records, medication administration records and health and safety records were looked at, as were most areas of the home including bedrooms and communal areas. What the service does well: What has improved since the last inspection? More staff have attained recognized qualifications thereby strengthening their knowledge and understanding. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 6 What they could do better: 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. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4 and 5. Well-detailed information about the home is made available to any prospective residents and/or others involved in arranging a placement within the home enabling them to make an informed choice. EVIDENCE: A well-detailed statement of purpose and service user guide have been produced. These provide information concerning services and facilities provided within the home to prospective and current residents and anyone else involved in arranging a placement within the home. The registered manager had undertaken a robust assessment of the needs of a prospective resident having met with this individual and their carers on a number of occasions. A well-structured introductory programme to the home was in operation and staffing levels had been adjusted accordingly. The needs of the people currently living in the home had been assessed prior to them moving in. Following admission, they had each been given a well-detailed contract. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 and 9. People living in the home are fully encouraged to make as many decisions about their personal lives and about the running of the home as possible. They are also encouraged and supported to be as independent as possible taking into account any risks that have to be considered. EVIDENCE: Residents said that they were aware of what was written in their individual personal plans and agreed with this information. They said that they met quite often with their key-worker to discuss any changes to these documents. These reviews were well recorded. Appropriate risk assessments were also in place. Residents gave several examples of the choices that they were encouraged to make on a day-to-day basis and said that staff were very supportive in this way. They said that they were actively involved in the running of the home and examples of this were seen during the inspection. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 and 17. Residents have a varied and interesting lifestyle and are fully involved in their local community. Individuals enjoy a wide range of social and educational opportunities and develop and maintain good relationships with family and friends. They enjoy a wide choice of home cooked, good quality food. EVIDENCE: Residents said that they generally enjoy a very relaxed lifestyle and are involved in a wide range of activities within the local community depending on their personal preferences. Each one has a weekly programme of activities arranged through a variety of local community based services. They also talked about activities, trips and outings organized by staff in consultation with them. They had all recently enjoyed a short break to London and said that they had had a most enjoyable time. They also explained that visiting arrangements are such that family members and friends are made welcome in the home at any time. They explained that they are able to meet visitors in private and to prepare refreshments for themselves and their visitors. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 11 Residents said that they were involved in choosing the menus and were offered a choice of food at each meal. The evening meal is generally eaten all together when everyone has got home. One individual who was spending a day at home did some baking with a member of staff, which they said they enjoyed. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. 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. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20. Residents’ personal and health care needs are fully met. EVIDENCE: Each of the people living in the home is registered with a GP through whom specialist health services are accessed as and when required. Whilst none of the residents is able to take their own medication, each one said that they are satisfied with staff administering this to them. There is a monitored dosage system in operation, which is securely stored. Medication administration records are well maintained. The registered manager explained that appropriate medication training had yet to be arranged for all staff by St Anne’s Community Services although this was being planned. Residents explained that there are locks on their bedroom doors which they can use if they want to and said that staff always knock and request permission to enter before coming into their room. Bathroom doors are also fitted with locks. Staff study the respecting of individuals’ rights to privacy and dignity during their induction and NVQ training. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22. Residents’ concerns are appropriately dealt with and their interests safeguarded. EVIDENCE: There is a comprehensive complaints procedure in operation available in a number of formats. This is made widely available to any interested parties. Residents said that they are quite happy to talk to staff and the manager if they have any concerns. They said that they are always very helpful and supportive. No complaints have been made either to the home or to the C.S.C.I. within the last twelve months. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,27,29 and 30. The standard of the environment of the home is good and provides residents with a comfortable, clean and homely place in which to live. EVIDENCE: The home is well-maintained and recent adaptations including the addition of a passenger lift and the widening of some bedroom and bathroom doors have improved access to potential residents who might have some difficulties with mobility. One of the people currently living in the home said that they can now access their own bedroom more easily than before the adaptations were made. All five bedrooms are for single accommodation and are of a suitable size. None of them has en-suite facilities but each is in close proximity to one of the communal bathrooms. Each resident said that they like their bedroom and all communal areas and have a choice about the decoration and furnishment of the home. Good standards of cleanliness are maintained throughout. Appropriate aids and adaptations are fitted throughout the home. There is ramped access to one of the external doors and level access around the perimeter. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33 and 35. The residents receive a good standard of care from a well-trained and highly motivated staff team. EVIDENCE: Several of the care staff have worked very hard towards achieving an NVQ to level 3. Three of the six have completed their award and a fourth is nearing completion. The other two carers have no plans to undertake the award but, since the last inspection, the home has succeeded in reaching the target of having 50 of care staff trained to NVQ level 2 or above by 2005. The registered manager and the six care workers have between them a wide range of knowledge and experience which makes them a highly efficient staff team with the skills required to support those living in the home very effectively. Staffing rosters for the week including the inspection show that staff were employed in sufficient numbers and were deployed in such a way as to ensure that the needs of people living in the home could be effectively met at all times. Staffing levels had recently been reviewed and increased as required to accommodate the needs of all concerned during those periods when a prospective resident was visiting the home. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. 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 home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, and 42. The residents benefit from a well managed home in which their needs and wishes are put first. EVIDENCE: The registered manager is highly experienced in the management of care services and is appropriately qualified. The residents said that she is very kind, friendly and easy to talk to. They said that weekly resident meetings were held and that she and the staff are always keen to hear their views. They also said that they are able to influence changes within the home. St Anne’s Community services has a quality assurance and monitoring system that includes regular unannounced inspections of the service by a service manager. The reports from these inspections are fed back into the overall quality assurance system. It has previously been recommended that this system be further developed to include ascertaining the views of individuals in the community who have contact with home. The registered manager explained that whilst this had not yet been done, the organization had made some progress in developing a system to do so. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 17 Appropriate procedures and systems to ensure the safety and protection of the residents and the staff are in operation. Fire systems and equipment are regularly tested and staff are given ongoing fire safety training. Other equipment within the home is routinely tested and serviced. A recent Environmental Health report identifies no concerns about the home and a new gas safety certificate was issued to the home in June 2004. Whilst, since the last inspection, the organization had undertaken a check of the hot water storage system in respect of the prevention of Legionella, documentation identified that hot water stored in the home was done so at less than the required 60 degrees Celsius. The registered manager explained that the organization was aware of this and that the matter was being dealt with. 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 x 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 The Crescent Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 19 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 Regulation None 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. Refer to Standard 20 39 Good Practice Recommendations All staff involved in the administration of medication should be appropriately trained. The views of health and social care professionals and other stakeholders within the commmunity, as to the quality of services provided by the home, should be ascertained and incorporated into the quality assurance system currently in operation. Hot water should be stored at a temperature which safeguards against Legionella (at a minimum of 60 degrees Celcius). 3. 42 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 1 The Crescent J53_JO4 S7900 The Crescent V221270 210405 Stage 4.doc Version 1.20 Page 21 - 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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