Inspection on 03/05/06 for Crest House Care Home

This inspection was carried out on 3rd May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Crest House Care Home 22/06/07

Crest House Care Home 01/12/05

Crest House Care Home 19/07/05

Crest House Care Home 23/01/05

Crest House Care Home 18/11/04

Crest House Care Home 02/03/04

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Crest House Care Home 6-8 St Matthews Road St Leonards on Sea East Sussex TN38 0TN Lead Inspector Liz Daniels Unannounced Inspection 3rd May 2006 10:30 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 Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 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. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crest House Care Home Address 6-8 St Matthews Road St Leonards on Sea East Sussex TN38 0TN 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) 01424 436229 01424 436229 cresthouse@tiscali.co.uk Mrs Josephine Crawford Mrs Josephine Crawford Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-five (25) Service users must be older people aged sixty-five (65) years or over on admission 1st December 2005 Date of last inspection Brief Description of the Service: Crest House is a care home registered to accommodate a maximum of 25 older people. The premises are a detached property set in its own grounds in a quiet residential area of St. Leonards on Sea. Local shops are nearby and bus routes run close to the Home. The nearest railway station is approximately half a mile away. The Home provides seventeen single bedrooms and four double rooms, currently used as singles. Twenty of the rooms have en-suite facilities. The Home has steps up to the front entrance but there is also a sloped pathway and level access throughout the building, enabling wheelchair access. There is a passenger lift to all floors. Two conservatories, and a sitting room provide communal space. There is also a garden to the front of the Home and a paved area with raised flowerbeds, accessible from the conservatories. The Home welcomes prospective residents or their representatives to view the premises and discuss their needs with the Manager. Weekly fees, as at 3/05/06, range from £350 - £475. The fees do not include hairdressing, chiropody, resident’s telephone calls and any sundries: these are charged as extras. Information about the service, including the Commission’s inspection report, is available from the Manager on request. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced. It included a visit to the Home by an Inspector, which began at 10.30am and lasted for a period of eight hours. The Owner/Manager facilitated the visit and it provided the opportunity to talk with her and four of the care staff before spending time with the residents as they relaxed in the lounge and meeting with four of them within the privacy of their own room. No visitors were available to meet with the Inspector during the site visit. The Inspector also toured the premises and examined records that included resident’s files, medication records, menus, staff files, the accident log and complaints record. Evidence contributing to this inspection has also been gathered from previous inspections and from surveys circulated to residents and their relatives, four of which had been returned to the Inspector. The preinspection questionnaire sent to the Home had not been completed and could not therefore be used to provide additional information. All of the key standards, together with those where concerns had been raised at the last inspection, were inspected. There are currently 13 residents at Crest House. What the service does well: What has improved since the last inspection? Crest House has made good progress in formalising the pre-admission assessment process and in the development of Care Plans, although this needs to be introduced for all residents. The Home is being nicely re-furbished and this is being sensitively managed to reduce any inconvenience for residents. Whilst some Requirements from the last inspection have been partially met, one has been met in full whereby there are now formal processes in place, enabling residents and their relatives to give anonymous feedback about the service being provided at Crest House. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 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. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 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 Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 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): 1, 3, 4 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The information available for residents does not reflect the service available at Crest House but a thorough assessment process is in place for prospective residents whereby they know that the home can meet their care needs. EVIDENCE: At the last inspection a loose-leaf Resident’s Guide was available but the Manager was planning to update it before circulating it to current residents. It did not detail information about the service provision for respite care, the services it does not offer, or resident’s comments regarding the service. This has not yet been amended. Previous inspections have found that, following an enquiry to Crest House, it is usual practise for prospective residents to be invited to visit and where at all possible to share a meal with the current residents and spend time meeting them and staff. They can also view available rooms and discuss the Home’s suitability. If they then wish to pursue an admission, the Manager of the Home undertakes an assessment: a pro-forma to record that assessment has now been introduced and at the last inspection a letter to confirm the outcome of Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 9 that assessment was also being developed. Residents then move in for a fourweek trial period to ensure the Home’s suitability for them. Four residents files were reviewed. Two had a documented assessment preadmission and all had a full assessment either on the day of or day after arrival. Two also had hospital discharge information. The Manager explained that she still does not always complete the pro-forma but makes notes and that information is then used as part of the full assessment undertaken on arrival. No evidence was found that the Home then confirms the outcome of the pre-admission assessment, in writing. Discussion with the same four residents demonstrated that although they could not all remember an assessment process prior to coming into the Home, they had met with the Manager and recalled talking about whether the Home was suitable. Crest House does not offer intermediate care although residents can be admitted for respite care. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 10 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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Crest House has made good progress in developing comprehensive Care Plans but, by each resident not yet having one, there is a risk that their individual needs will not be met. EVIDENCE: The care files for four residents were reviewed. New documentation has been introduced since the last inspection and this is currently being completed for each resident. Each file seen, contained a comprehensive assessment and two care plans had been completed in January and March this year. They have not yet been reviewed. One resident who had been admitted nine days previously, did not have a care plan. The staff explained that they do not complete the care plan until the second week of residence to enable a new resident to settle in. This was discussed and the staff agreed that an initial care plan should be put in place and a more comprehensive plan then developed once the individual’s needs are clearer. A Daily Record sheet is completed for each resident, recording any significant events and any changes in care are passed on verbally between shifts as well as being recorded in the ‘Report Book’. Health professionals are accessed as needed and residents are accompanied if Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 11 they need to attend hospital appointments. The Manager confirmed that where possible residents remain registered with their own GP or register with a GP of their choice. One resident who has recently been admitted was pleased that she could still be seen by her GP as she has ‘been with him for years’. The chiropodist visits the Home every 6 weeks and district nurses or nurse specialists are contacted for any particular concerns. During the inspection, staff were observed to be attentive and courteous to the residents. The Home supports residents in caring for themselves as far as they are able: many of the residents at Crest House need minimal help with their personal care. One resident self-medicates and orders her own medication. The Home keeps a record of the medication she has been prescribed and monitors her condition to ensure she is being well controlled by the medication she is taking. Although the Manager assessed the resident prior to admission, a Risk Assessment was not completed. There is no written evidence that the individual is happy to self-administer, although when she met with the Inspector she explained that she was ‘happy to manage my own drugs and nebuliser’. Past inspections have found that medications for the Home are well managed and the Inspector found on this occasion that the Medication Administration Record (MAR charts) for the residents continue to be correctly completed and that medication is stored safely: the majority of medication is dispensed in blister packs. The Boots pharmacist undertakes a medication audit every 3 months. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 12 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The good selection of pastimes and activities that are available ensure the lifestyle experienced by residents matches their expectations and preferences. They also benefit from varied and nutritious meals. EVIDENCE: A lounge and two conservatories, provide space for residents to meet together, watch television or sit quietly to read or listen to music. The residents are encouraged to meet together for coffee in the morning and to join in with the outings and activities that are organised, if they feel able. Relatives are also welcomed to be involved as much as they wish and to visit anytime. There is an activity programme in place and a video library has also been developed within the Home. A new digital television has been bought for the lounge, providing many channels, some of which regularly show old films and series for the residents to enjoy. One lady who has impaired vision was pleased that she can access both large print books and talking tapes as she wishes. A local vicar visits each month to offer communion and hold a short service and taxis are arranged for any resident who wishes to attend a local church for service on a Sunday. As found at previous inspections, funeral services continue to be held in the Home for those residents who die, if their relatives wish. A visiting library calls in every three months to change the selection of books and the hairdresser visits fortnightly. There is also a small Tuck Shop. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 13 Many of the residents at Crest House do not need high levels of personal care. They have personal possessions in their rooms and they either manage their own financial affairs or a relative or solicitor acts on their behalf. The Home does not act as the appointee for any resident. Previous inspections have found the food provided at Crest House to be varied and enjoyed by the residents. Again at this visit one resident commented that the ‘food is very good with lots of fresh vegetables’ and another said ‘there’s plenty of food and it’s nicely served’. Another said ‘the food is very good – home cooked and fresh. I’m certainly never hungry!’ The cook was off site during the visit and the Manager was therefore preparing the meals. Fresh fruit and vegetables were evident and the menu appeared varied and nutritious. The Manager explained that some adjustments to the menu had been made as a result of feedback from the recent food survey undertaken by the Home. A new hand washbasin has now been fitted in the kitchen as recommended by Environmental Health. Meals can be eaten in the dining room or in resident’s rooms if they prefer. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 14 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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home has a satisfactory complaints procedure and there is good evidence that resident’s views are listened to and acted upon, although the investigation, outcome and any action taken is not recorded in full. Good measures are in place to ensure residents are protected from abuse. EVIDENCE: Previous inspections have found a comprehensive complaints procedure in place, which is readily available for residents and relatives. Residents who met with the Inspector during this site visit said they would raise any concerns they may have with the Manager or the Care Manager. They all said they had confidence that any worries would be listened to and sorted out for them. Similarly the four surveys received by the Inspector, unanimously stated that they always know who to speak with if not happy and always know how to make a complaint. The Commission has not received any complaints about the service since the last inspection. The last entry in the Complaints Log was in November 03. The Manager explained that she does not log every concern as she ‘manages these informally by discussing the issue with the resident or relative and agreeing a satisfactory outcome with them’. There continues to be adult protection policies and procedures in place. All staff have completed training in Adult Protection, through a training package purchased by the Home. The training includes multi choice questionnaires, which are marked in house, and then a final test, which is sent away for external marking before a Certificate is issued. All staff who met with the Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 15 Inspector could explain what action they would take if they had any concerns about the welfare of a resident. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 16 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 and 26 Quality in this outcome area is adequate. This judgement has been made using evidence including a visit to the service. The comfortable furniture and pleasing décor at Crest House provide a homely place for residents to live: however residents are at risk until radiator guards are installed. EVIDENCE: Crest House is a large detached property with steps up to the front entrance but also a sloped pathway, providing level access throughout the building suitable for wheelchairs. On the ground floor, there is a dining room, a lounge area and two conservatories for residents to relax in. There is also a garden to the side of the property and a paved area with raised flowerbeds accessible from the conservatories. The Manager explained that all the hedging and shrubs had been cut back recently to clear the flower beds ready for residents to plant out if they wish. A shaft lift provides access for both the ground and first floor. The Home is comfortably furnished and as with previous inspections it was again found to be clean and free from any odours. Resident’s bedrooms that were seen are furnished to assure comfort and privacy: the residents that met with the Inspector all said they liked their rooms and they had been Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 17 encouraged to bring bits and pieces from their homes to make them feel more homely. There are not locks on the bedroom doors whereby residents can have their own key, and no lockable space within the rooms. As at previous inspections the Manager confirmed that a lock would be put on the door of any resident who wished to have a key to their room and a safe would be provided if a resident wished to have a lockable facility within their room. None of the residents who met with the Inspector wished to have their own key or wished to lock any of their possessions away in their room. One resident commented that she didn’t need to, as ‘it’s very safe here’. A refurbishment programme is underway: five bedrooms have already been redecorated and re-carpeted whilst they have been vacant and the Manager is planning to continue a programme throughout the Home, as rooms are available. The programme therefore appears to have been sensitively managed to reduce any inconvenience for the residents. The carpet in the front entrance that was previously taped and worn has also been replaced and one of the three bathrooms has been retiled and redecorated with a new vanity unit and new bath hoist also being installed. The radiators throughout the home remain unguarded. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 18 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, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. In general there are satisfactory recruitment procedures in place, ensuring that residents are protected. The home is appropriately staffed and residents benefit from the training opportunities available for staff. EVIDENCE: As found at previous inspections three care staff are rostered to work each morning and two in the afternoons. The Manager is also present. At night there is one waking carer and a carer who sleeps in, who can be woken if needed. These numbers appear adequate for the number of residents currently in the home. The Manager assists with the daytime care of the residents if needed: on the day of the site visit the cook was unavailable and the Manager therefore cooked the mid-day meal and organised the evening meal for the residents. Of the thirteen care staff two are currently studying for their NVQ Level 2 and one is undertaking her NVQ Level 4. Three staff files were inspected during the site visit. All had evidence of CRB disclosures and copies of contracts issued. One file had two references but there was only one reference for a member of staff employed last September. As mentioned earlier in this report the Home has purchased a training package with many different modules for staff to study. The Manager confirmed that the member of staff employed last autumn has been undertaking the Induction training, although she has not yet got evidence on file that it has been completed. Three of the staff are now trained as First Aid trainers and three as Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 19 Moving & Handling trainers. The aim is that this training will then be cascaded to other staff. Certificates are held for staff training in individual files. The Care Manager aims to develop a matrix to help with monitoring training. Specialist training is also arranged. Eight care staff have recently been trained in the administration of oxygen. The duty rota is arranged to ensure one of those staff is always on duty to assist a resident in her needs. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 20 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): 31, 33, 35, 36 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Crest House is well managed with the best interests of residents in mind, but formal quality assurance systems are not in place to monitor and protect residents, and poor adherence to fire regulations compromises their safety and welfare. EVIDENCE: The owner of Crest House has been the Registered Manager for many years and has considerable experience in caring for older people. She has attained her Advanced Manager’s Course (AMC) through City & Guilds. This equates to the Registered Manager’s Award. A Care Manager who also has the AMC and is studying for her NVQ Level 4 supports her in leading a team of carers and ancillary staff. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 21 Crest House continues to encourage residents to meet with each other for morning coffee and staff, as at previous inspections, again identified this as a time when they learn of incidental concerns that may be troubling the residents and therefore saw this as an informal opportunity to gain feedback about the service offered. Since the last inspection, the home has developed and circulated a survey to gain feedback about the Christmas activities that had been organised and another to find out if the food provided meets everyone’s wishes and needs. The Inspector was shown questions planned for several other surveys that the Home plans to circulate over the year. An example was given of some feedback from the food survey that had resulted in the menu being reviewed and a particular food included a little more frequently. Feedback from the surveys received by the Inspector was very positive and this was discussed with the Home. The Manager confirmed that she does not have a written maintenance plan but hopes to complete the refurbishment this year. However she explained that if a particular need is identified she is flexible in her plans and adjusts the priority with which things are done, accordingly. As found at the last inspection, there is no formal staff supervision programme in place. The Manager explained that there is a small staff team and a very low staff turnover, whereby she can regularly work alongside the staff and informal staff supervision can therefore occur on a daily basis. Staff were last trained in Fire Safety in August 05 and a further session is booked for the end of May 06. The last two fire drills were in July 05 and January 06. Both had included a mix of night and day staff: the need to ensure night staff have four drills per year was discussed and it was agreed that future drills would be arranged at times when night staff would be able to attend. As discussed earlier in the report not all staff have had their mandatory training in Moving and Handling and in First Aid. Records of maintenance checks were not examined in detail at this site visit and the Home has not returned this information. However previous inspections have found that health and safety checks and maintenance checks have been undertaken as required. The Care Manager is also developing a new folder of policies and procedures. As policies are being updated they and any supporting information or research are put in the folder and each staff member asked to read and then sign that they have done so. The Accident Log was seen and had been completed for minor slips, trips & falls. The Manager reviews all accidents recorded, each month. A new carbonised Log has been introduced from the beginning of May. During the day, doors to some resident’s rooms were propped open; this practice must cease. The Manager and the residents concerned, confirmed that they do not wish to have their door closed whilst in them during the day: alternative arrangements must therefore be put in place that do not compromise fire safety for the residents. Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 22 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 2 X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 1 X 1 Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4 (1)(2) 5(1)(2) Schedule 1 Requirement The Home’s Statement of Purpose and Resident’s Guide must include information regarding its service provision for respite care and also details of the services it does not offer. The Home must also consider including resident’s comments regarding the level of service offered at Crest House. (This is an outstanding Recommendation from the last inspection in September 2005). The Manager must confirm in writing that following the assessment the Home can meet the residents needs in respect of health & welfare. (This is an outstanding Requirement from the last two inspections, in December 05 and July 05) Although progress is being made, all residents, once admitted, must have a Care Plan. (This is an outstanding Requirement from the last two inspections, in December DS0000021080.V289200.R01.S.doc Timescale for action 31/08/06 2. OP4 14(1)(d) 31/05/06 3. OP7 15(1)(2(a -d) 31/05/06 Crest House Care Home Version 5.1 Page 24 4. OP9 12 (4) 16 (2)(1) 5. 6. OP16 OP28 22 Schedule 4(11) 18(1)(ac), Sch2(4) 7. OP33 24 8. OP36 18(2) 9. OP38 18(c)(1) 10. OP38 13 (4)(a)(c) 05 and July 05). There must be a current Risk Assessment and lockable storage, for any resident who wishes to self-medicate. (This is an outstanding Recommendation from the last inspection in December 05) All complaints received must be logged and the investigation and any action taken be recorded. 50 of care staff must be trained to NVQ level 2, or equivalent, or enrolled for the training. (This is an outstanding Requirement from the last two inspections in December 05 and July 05). There must be quality assurance systems in place that involve the views of service users, relatives and stakeholders. These must include an annual internal audit and an annual development plan for the Home that reflects the aims of the service and outcomes for service users. Care staff must receive formal supervision at least six times a year. (This has been an outstanding Requirement from the last six inspections). Although progress is being made, all staff must have their mandatory training in First Aid and Moving & Handling. (This has been an outstanding Requirement of the last three Inspections). Radiators must be guarded, to reduce the risk of residents being burnt if they fall against them. (This is an outstanding Requirement from the last DS0000021080.V289200.R01.S.doc 31/05/06 03/05/06 30/09/06 31/08/06 30/09/06 30/09/06 31/08/06 Crest House Care Home Version 5.1 Page 25 11. OP38 12 (1) 23 (4) inspection in December 05) All fire doors must be closed and the local Fire Authority for Crest House should be consulted about appropriate methods of holding bedroom doors open. 30/06/06 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 Crest House Care Home DS0000021080.V289200.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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