Inspection on 05/07/05 for Crest Lodge

This inspection was carried out on 5th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Crest Lodge 15/01/09

Crest Lodge 16/01/07

Crest Lodge 25/11/05

Crest Lodge 17/01/05

Crest Lodge 11/08/04

Crest Lodge 16/02/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

Prinsted

49 Glendale

The Springs Community

Crossways Community

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

CARE HOME ADULTS 18-65 Crest Lodge Churt Road Hindhead Surrey GU26 6PS Lead Inspector Miss Marianne Barham Announced Inspection 05 July 2005 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. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Crest Lodge Address Churt Road, Hindhead, Surrey. GU26 6PS 01428 685327 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) Mr L Hasham Mr Thomas Feury CRH (N) 27 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia (MD) 27. of places Past or present alcohol dependence (A) 6. Past or present drug dependence (D) 4. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) Residents are to be aged between 30 and 65 years. Up to 6 may be in the category (A) and up to 4 may be in the category (D). 2) Out of the total 27, one resident may be admitted from the age of 25 years. This person will be within the category (MD) mental disorder. Date of last inspection 17 January 2005 Brief Description of the Service: Crest Lodge is a large detached property located in Hindhead, close to the amenities of Beacon Hill. The home is owned by Care Homes of Distinction and provides accommodation and specialist nursing care to up to 27 adults with enduring mental health needs. The accommodation is arranged over two floors with the first floor being accessed by stairs or passenger lift. All bedrooms are single occupancy and all have en-suite facilities. There is a bathroom and separate shower room on the ground floor and a bathroom on the first floor. Communal facilities include a lounge, two dining rooms and a designated smoking room. The home has its own mini-bus to access the local and wider community and there is parking for several cars to the front of the property. A public bus stop is close by. There are gardens to the front and rear of the property, however they are not at present accessible to service users as neither are enclosed and they lead onto a busy main road. The home has strong links with the local community and the service users regularly take part in local events and activities. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out at 10.20am by Marianne Barham, lead inspector for the service. The inspection was undertaken over a period of five hours and ten minutes and was the first inspection in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. The registered manager Mr Tom Feury and nurse in charge Mrs Virginia Tamba were present and, a total of twelve service users and six members of staff were spoken with during this inspection. A number of comment cards from service users relatives and involved healthcare professionals were received prior to this inspection, all of which were complimentary about the service provided by the home. What the service does well: What has improved since the last inspection? The home has recently introduced a new pre-admission assessment devised by the manager. The assessment covers all aspects of the service users life, including past social, work and medical/care history. There is also a section for the service users and the carers’ view of the situation. The assessment is clearly written and gives the detailed information required to form an effective care plan. The floor cover in room 27 has been replaced, meeting a requirement made at the last inspection. The home now has its own mini-bus making it easier for service users to access activities in the local and wider community. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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 Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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 Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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 and 4 Service users are able to visit the home and have their individual needs and aspirations assessed prior to moving in to the home. EVIDENCE: The home has introduced a new format for assessing service users prior to admission to the home. This has been devised by the manager and is very detailed and comprehensive, not only covering the person’s current care and social needs but also their previous history. The assessment also takes account of the views of the service user and their carers. Service users and their families are invited to visit the home prior to admission, initially for a look round the home and meet the other service users and then to stay for a meal, leading to an overnight stay. During these visits the home is able to further assess whether it can meet the needs of the service user. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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 and 9 Service users have an individual care plan detailing their needs and they are supported to take risks as part of everyday life. EVIDENCE: Each service user has an individual care plan that is generated from the initial assessment. The care planning system in place is detailed and thorough. Records are kept of personal care, doctor’s visits, key-worker input and social activities. The care plans are clearly written, giving detailed information and guidance to staff on how to meet the needs of the service user and are reviewed monthly. Risk assessments are in place for all service users according to their individual circumstances and needs, again these are clearly written giving specific information on managing identified risks to service users. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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) 15 and 17 Service users are supported to engage in and maintain appropriate relationships. They are offered a healthy, nutritious diet according to their individual needs and preferences. EVIDENCE: Service users are able to receive visitors at any time without an appointment. The home is committed to service users maintaining contact with their friends, families and the local community. Examples of this are of a service user being reunited with their parent after a long separation, service users keeping in contact with their children and friendships being supported and encouraged by the home. The home has recently employed a new chef who has many years experience initially in hotels and then in residential care homes. The kitchen is clean, well equipped and well stocked. All records relating to the handling of foods are maintained and the chef and kitchen assistants hold the food hygiene certificate. Menus are rotated four weekly and offer a balanced and varied diet to service users. There are alternatives for every meal and any special dietary Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 11 requirements are catered for. Service users were observed having their lunch, this looked appetising and those service users spoken with stated that the food was very nice and that they could choose what they had. Staff were observed to support service users with their meals in a dignified manner. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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 and 19 Service users receive personal support according to their preferences and their physical and emotional needs are met by the home. EVIDENCE: Service users preferences regarding personal support are recorded in their care plans. Members of staff were observed supporting service users in a dignified and caring manner. All service users spoken with were complimentary about the staff team, saying that they cared for them well and were kind. Service users emotional and physical needs are assessed and detailed in their care plans. Reviews are held regularly with input from social worker, consultant psychiatrist, GP, and community psychiatric team. The home enjoys a close relationship with the multi-disciplinary team and is able to access support day or night. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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) 23 Service users are protected from abuse by the home. EVIDENCE: All staff members have received training on the prevention of abuse to vulnerable adults and all senior staff members have attended the training organised by Surrey. The home has its own procedures in place that is in line with the Surrey Multi-Agency Procedures, a copy of this is also held at the home. There is also a whistle blowing policy, all members of staff are made aware of this at induction and also have a copy of the General Social Council codes of conduct. Staff members spoken with were aware of their responsibilities to report any concerns and training records examined confirmed their attendance of training on abuse. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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, 26, 27, 28 and 30 Service users bedrooms promote independence and suit their needs and lifestyles and there are sufficient toilets and bathrooms to meet their individual needs. The home is clean, tidy and comfortably furnished with adequate interior communal areas, however the gardens are not safe or suitable for the needs of the service users. EVIDENCE: A tour of the home was undertaken. The home is clean and tidy and in a good state of decoration and general repair. Service users bedrooms are comfortable and all have en-suite facilities. It was pleasing to see that the floor cover in room 27 had been replaced, meeting a requirement made at the last inspection on 17th January 2005. Service users spoken with were pleased with their bedrooms and made remarks such as very nice, lovely, comfortable and private. All bedrooms are able to be locked by the service user and have a pass key entry for emergencies. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 15 The home has gardens to the front and rear of the property, however these are not suitable for all service users’ as they are not enclosed and lead on to the busy main road to the front of the home. At present the rear garden is not accessible owing to there being a lot of old furniture and other rubbish in it, a requirement has been made that is removed. Access to the front garden by service users is possible, only if they are under close supervision by the staff owing to the close proximity to the road and their tendency to wander or deliberately abscond in some cases. This was discussed with the manager and a requirement has been made that a safe and enclosed garden area is provided in order to provide choice, promote independence and give freedom of movement to service users. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 16 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) 31 and 34 Service users are supported and protected by the homes recruitment procedures and they benefit from staff having defined roles and responsibilities. EVIDENCE: Staff personnel records were examined. All members of staff have a job description detailing their duties and responsibilities in the home. Members of staff spoken with were able to explain their role and duties in the home. The home has a recruitment procedure that is followed when employing new staff. All files sampled had records of Criminal Records Bureau (CRB) checks, proof of identity, application forms and references, job description and a contract stating terms and conditions of employment. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 17 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) 38 and 39 The leadership and management of the home benefits service users and their views on the services provided are sought and acted upon. EVIDENCE: The manager has an open style of management and this is reflected in the positive interaction observed between himself and staff members and with service users. Members of staff spoken with reported that the manager is approachable and supportive. Service users said that he is kind and they like to talk to him. The manager has attended training on team leading and supervision of staff and has many years experience of managing people. The home has a system in place for obtaining feedback from service users, their families and involved professionals. Questionnaires are sent out and an annual audit of the service is undertaken, the results are then collated and any areas for improvement highlighted and acted upon. Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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. 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 4 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 1 x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x x 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crest Lodge Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x x x H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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. 2. Standard 28 28 Regulation 23 (2) (o) 23 (2) (o) Requirement The old furniture and other rubbish must be removed from the rear garden. A safe, enclosed and accessible garden area must be provided for the use of the service users in the home. Plans for providing the garden area as described above must be submitted to the inspector. Timescale for action 22/07/05 05/11/05 3. 28 23 (2) (o) 05/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Crest Lodge H58 H09 s17604 Crest Lodge v227860 050705 Stage 4 ann.doc Version 1.30 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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