Inspection on 07/11/06 for Crescent The (1)

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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) 06/12/05

Crescent The (1) 21/04/05

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 Crescent The (1) 1 The Crescent Green Hammerton Nr York North Yorkshire YO26 8BW Lead Inspector Mrs Maggie Coxon Unannounced Inspection 7th November 2006 09:30 Crescent The (1) DS0000007900.V318454.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 The (1) DS0000007900.V318454.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 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 The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crescent The (1) Address 1 The Crescent Green Hammerton Nr York North Yorkshire YO26 8BW 01423 331440 F/P01423 331440 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) St Anne`s Community Services Mrs Wendy Cosgrove Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 5 service users with learning disabilities, who may also have physical disabilities. 6th December 2005 Date of last inspection 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 who may be aged over 65 years old and some of who 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. Current information about services provided at 1 The Crescent in the form of a statement of purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. Information provided by the registered manager on 6th October 2006 indicated that the current weekly fee for the home ranges from £322.00 to £358.00. Additional costs include toiletries, hairdressing and a contribution to the funding of transport. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report: • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called a preinspection questionnaire. A visit to the home that they didn’t know was going to happen. This lasted for five hours and included talking to three residents and care staff about how the home is run. All areas of the home were also seen and records that the home has to keep were checked. Residents’ medication was also checked to make sure that it was being properly looked after for them. People living in the home have expressed a preference to be known as residents. What the service does well: Residents and staff get to know each other very well and staff are kind and friendly so residents can be confident that they will get good help. Residents can have lots of contact with friends and family and see them at any time. Staff also spend a lot of time talking to the residents. This means that they can have company whenever they like. Residents meet with the manager to talk about the help they need and to find out about the home before they move in. They can also visit the home to see if they like it. This means that residents can decide whether or not they move into the home. The home is very well run and staffed so residents are well looked after. They have plenty of activities both inside and outside of the home and spend lots of time out and about in the village and visiting places further away. Residents are helped to be as independent as possible and to make as many choices as they want to regardless of their age, gender or needs, they are all treated equally, they are also all treated respectfully by the staff. Residents are asked to say what care they need and how they would like this to be given, this gives them the chance to have a say in planning services for themselves in the future. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 6 Residents see their GP, dentist, optician and chiropodist whenever they need to and are by staff are helping them exercise often. This helps them stay in good health. Residents have a good choice of food and drinks so they can enjoy their meals. Residents and their relatives and friends are asked what they think about the home so that the staff team can make changes to make things better for residents. 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 The (1) DS0000007900.V318454.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 4. Quality in this outcome area is excellent. Residents are fully informed and have their needs fully assessed so that they can exercise choice about living in the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has a detailed statement of purpose and service user guide both of which have been produced in easy read and pictorial formats. Residents have been given a copy of the service user guide. The most recently admitted resident had met with the manager and had helped her to complete a full assessment before and whilst visiting the home. This individual had made many visits to the home before moving in on a trial basis so that all parties could decide whether or not the placement should be made permanent. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9. Quality in this outcome area is excellent. Residents make as many decisions and everyday choices as possible and have an active say about the running of the home. They can also be confident that their needs will be met by the staff team who provide individually tailored services. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Case tracking confirmed that residents’ individual personal plans that set out the needs of the person and how these can best be met, are very detailed and well organized and are being regularly reviewed. These all promote the individual’s independence wherever possible. Person centred meetings have been held for resident in which they have had a say in planning any changes to services. Individuals’ wishes and agreed outcomes have been recorded and are being actioned. This has resulted in an Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 10 increase in the number and variety of activities provided for individuals including one of them renewing old contacts. Daily records and observations at the visit show that residents are able to make many choices and decisions in their daily lives and can take reasonable risks subject to a personal risk assessment the details of which are fully recorded. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Quality in this outcome area is excellent. The range of activities enjoyed by residents is varied and individually tailored to increase their community presence and provide stimulation and personal development. Residents are supported to develop and maintain personal relationships. Meals are nutritious and varied and residents have a healthy diet. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Residents have a wide variety of activities that they participate in; several residents attended activities out in the community during the visit. The registered manager and staff have planned activities so that residents have an increased presence in their local community this included residents recently Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 12 making a picture board presentation about the home to members of their local community and contributing to the village competition. They were also actively involved in tending their garden and won the St Anne’s best-kept garden award for the present year. The staff team have arranged individual holidays for each resident. Residents are allowed personal space when they want it and staff have undertaken communication training and are using these techniques to improve their communication with one of the residents in particular. Residents are well supported to develop and maintain personal relationships and friendships of their choosing. Residents have a choice at mealtimes; this was observed during the visit. Lunchtime was very relaxed and informal and support given to individuals was done so in an unobtrusive manner. Liquid refreshments were also offered on a regular basis. Staff explained that the residents choose the menus and records of meals provided identify that meals are varied and nutritious with a healthy diet being encouraged. Residents and staff are also planning to organize a fitness group to complement this. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. The healthcare needs of residents are identified and arrangements are in place to ensure that their diverse care needs are met. Residents are supported to take medication as prescribed by their GP. Personal care needs are well met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A carer described the way that personal care is provided. This indicates that the residents’ privacy and dignity are respected and observations made during the visit confirmed this. Residents have their own bedroom keys. Case tracking identified that each resident is registered with a GP. They attend regular appointments with chiropodists, dentists, opticians, psychologists and GPs. Staff help residents to manage their own medical issues with support and residents are setting up a fitness group with support from staff. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 14 One resident partly self medicates but they all have some or all of their medication administered by staff. This is well recorded and all medication is securely stored. All staff except the most recently employed have undertaken appropriate medication training, which will be arranged for these individuals once they have completed their induction, and foundation training. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Systems are in place for dealing with concerns or complaints and for ensuring the protection of residents. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A comprehensive complaints procedure is followed and is made available to residents in easy read and pictorial form. Residents have regular meetings in which staff explain the procedure to them and encourage them to express any dissatisfaction they might have. Staff have all undertaken adult protection training as part of their induction training and the carer talked to was fully aware of the procedure he would follow should he witness or suspect the abuse of a resident. Daily checks of residents’ finances are undertaken and the carer explained that there is a policy of no physical restraint in the home. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,29 and 30. Quality in this outcome area is good. The standard of the environment is good and provides residents with a clean, comfortable and safe home in which to live. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Shared areas including the kitchen, the two lounges and the two bathrooms are well maintained, decorated, furnished and equipped. Every resident’s bedroom was seen all of which have been decorated and furnished to the resident’s personal taste. The last resident to move in said that she had chosen the décor for her bedroom before she moved in. Residents have easy access to both bathrooms both of which have lockable doors. The home has appropriate aids and adaptations to meet the needs of all of the residents including a stair lift and a full passenger lift both of which were in good working order. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 17 The home was clean, warm and tidy throughout. There is a separate laundry facility that is well equipped. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. Quality in this outcome area is good. The home is adequately staffed by individuals who are well trained. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Sufficient staff were on duty at the time of the visit and staff rosters show that the home is well staffed at all times. Staff confirmed this to be the case. Whilst personnel records were unavailable for checking because the registered manager was not present it has previously been evidenced that robust recruitment procedures are followed including appropriate personnel checks. The carer spoken to said that he was aware that the appropriate checks had been undertaken for the new employees prior to them starting work. A newly employed carer said that he was in the process of undertaking the learning disability award framework induction and foundation training as well as basic training on adult protection and infection control. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 19 The home had previously exceeded the target of NVQ qualified staff although that number had dropped following recent changes to the staff team. The carer explained however that NVQ training is currently ongoing with staff members either having completed the award or being in the process of doing so. All staff are undertaking varied training relevant to their roles including schizophrenia awareness, empowering individuals, makaton communication and diabetes training. Staff said that they have regular supervision from the registered manager who also holds regular staff meetings. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41 and 42 Quality in this outcome area is excellent. The home is extremely well managed with the quality of services being continuously monitored and improved for residents on an individual as well as group basis. Comprehensive health and safety systems and procedures are in operation with necessary improvements being addressed. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The registered manager is fully qualified and very experienced in the management of care services. She has been the registered manager of 1 The Crescent for a number of years. Staff describe her as an efficient manager who provides good leadership, guidance and support in an open and inclusive Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 21 style. They also said that she encourages them to contribute fully to team meetings. Monthly quality audits being undertaken by the service manager. Residents’ views are heard in regular residents’ meetings in which they are helped by staff and through individual person centred planning meetings. Relatives’ and healthcare professionals’ views are also surveyed. Information from all sources has been fed into a team plan that assesses the current quality of services for individual residents and identifies how this can be continued and further improved. Residents, staff and the registered manager are also involved in ‘making it happen’ and ‘taking part’ meetings where their views are discussed at an organizational level. Current records pertaining to residents are well maintained and safely stored. Monthly health and safety checks of the building are undertaken and fire safety is well maintained including regular fire safety training for all staff. Other health and safety systems and records are well maintained including fridge and freezer temperatures that are recorded twice daily and hot water temperatures that are tested weekly. Records also showed that an external auditor has undertaken a risk assessment of the hot water storage system and staff explained that a new temperature gauge has been fitted to the hot water tank. Records showed that this is read and recorded on a monthly basis and that the hot water is being stored at the right temperature. Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 22 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. 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 4 5 X 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 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 4 X 3 3 X Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Crescent The (1) DS0000007900.V318454.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. 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