Inspection on 01/07/05 for Croft Acres

This inspection was carried out on 1st July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Croft Acres 01/10/08

Croft Acres 10/10/06

Croft Acres 08/03/06

Croft Acres 01/02/05

Croft Acres 04/05/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Croft Acres 15 Hibberd Road Malin Bridge Sheffield S6 4RE Lead Inspector Carol Makin Unannounced 1 July 2005 09:00am 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 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. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Croft Acres Address 15 Hibberd Road Malin Bridge Sheffield S6 4RE 0114 2340016 0114 2316729 None Croft Acres Limited 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) Karen Walker (not registered) PC Care Home Only 24 Category(ies) of OP Old age - 24 registration, with number of places Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1 February 2005 Brief Description of the Service: Croft Acres is a care home providing personal care. Accommodation is provided for 24 residents. The home is privately owned by Mrs Pamela Bradshaw and is situated in a residential area not far from Hillsborough centre. There is good access to public transport and services/shops and amenities are close by. The home is purpose built with accommodation provided on two floors, which are accessed by a lift. Residents accommodation is provided in 24 single rooms. There is a lounge on each floor and two dining rooms on the ground floor. The home is served by a central kitchen and laundry. Sufficient bathing facilities are provided. There is a car park at the front of the home surrounded by raised flowerbeds. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home has a new manager who has been at the home for 5 weeks. At the time of the inspection she had not undergone the registration process with the CSCI. Time was spent with the manager to give guidance and discuss what action needed to be taken for improvements. This was an unannounced inspection that took place over 5 hours. A brief tour of the building was carried out, a selection of records was checked and five residents were spoken to. What the service does well: What has improved since the last inspection? What they could do better: Better systems must be put in place so that residents health needs are met by ensuring that residents medications are administered as prescribed. The safe storage of medications must be improved for the safety of all the residents living in the home. The manager must not be routinely used to cover care staff shortages, which would give her sufficient time to implement strategies that would improve the day-to-day management of the home. Mandatory staff training must be arranged as a priority to safeguard the residents and develop the staff team. Staff must not be employed without undergoing the required checks for the protection of the residents. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 6 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. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 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 standard(s) 1, 3, 4, 5, Residents are not given sufficient information to enable them to make an informed decision if the home can meet their needs and that they would like to move into the home. One resident’s file checked who had recently been admitted contained a full written assessment and a follow up review carried out by the placement authority had taken place to confirm the placement was appropriate for their identified needs. Some residents are not receiving the level of care they need due to changes in their physical, psychological and medical conditions. Higher dependency levels and needs of some residents have not been re assessed since moving into the home. This has led to some residents feeling that the home has not come up to their expectations and needs are not being met. Consultations and re assessments had not taken place to determine if the home is best meeting the needs of some residents who needs have deteriorated since they were first admitted to the home. Prospective residents are able to visit and look around prior to admission. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 9 EVIDENCE: One resident’s file checked had a thorough assessment and review of their needs on transferring from a home, which was closing, to Croft Acres. One resident when asked said that they were not given any information about the home before they moved there. Some resident’s needs appeared to have changed, one resident said that a lot of the resident were confused and there were not many other residents that they were able to hold a conversation with. Two resident’s said that they had a look around the home before they made the decision to move there to live. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10. Residents care plans do not contain sufficient information to ensure that resident’s needs are identified and the appropriate care is given. Health needs were not being met; sufficient stocks of medication are not being maintained that would ensure that resident’s health needs are met. The safety of residents is not assured due to poor systems for the safe storage of prescribed medications. Staff treat residents with respect and maintain the privacy of resident’s by knocking before entering their rooms. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 11 EVIDENCE: One care plan was checked; the information for all aspects of the health, welfare and daily living of the resident was not recorded. The plan did record the information of the residents GP but no other health care professionals involved in their care was recorded. The majority of the sections within the care plan had not been completed. Two residents medication records checked had evidence that they had not received important prescribed medications. The code recorded on the medication-recording sheet indicated that the medication stock had run out and had not been replenished. One resident affected by this and said one of their medications had run out three weeks before and told the inspector that this had caused them distressed. They also said they had not been given three of their prescribed medication that day and had been informed that the home had run out. The manager was informed that immediate action must be taken to obtain the medication required that day. The manager later said when she contacted the chemist they said a supply of the medication would be delivered that day. Prescribed medication was left insecurely stored in the office and a resident’s bedroom. The resident had recently moved into the home and three weeks medication was found in the room, which was not locked. The manager was informed immediately to secure all medications. Residents spoken to said that staff treated them with respect and that their privacy was maintained. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 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 standard(s) 13, 14, 15 There has been a high turnover of staff, which has had an unsettling affect on the residents and the home. Resident are able to maintain contact with families and friend’s and visitors to the home are made welcome. Residents are given a varied diet and are offered a choice that is acceptable to them. EVIDENCE: Residents spoken to said that there had been a large turnover of staff and this had been very unsettling for the residents. Two residents said that they liked living at the home. Residents said that they were able to keep contact with family and friends and one had their own telephone installed in their room. The residents said their visitors were always made welcome when they visited. All residents spoken to said that the food was good and they were offered a choice if they did not like what was on the menu. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 13 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 standard(s) 16, 18. Staff are kind to the residents, they are treated with respect and their privacy is maintained. Residents know whom to contact if they have a complaint and were confident that they thought any issues they may have would be sorted out. Staff had not received training on adult protection to ensure that residents are protected from abuse. EVIDENCE: Resident’s spoken to said that they felt safe at the home and that the staff treat them well. All felt that they were well cared for and the staff was kind. They knew whom to contact if they had a complaint and felt that they would be listened to. One resident said that the only complaint they had was that they were not receiving the medication they were prescribed. This is commented on in another section of this report. There was no concise record of training that staff had undertaken therefore it was not clear which staff had received training in adult protection. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 22, 24, 26. The home is furnished and decorated well to ensure the residents live in a safe and comfortable environment. Residents asked said that they were comfortable and liked their rooms. A hoist in a bathroom was not maintained to a good standard for residents to use. The home is kept clean and odour free to ensure the residents comfort is maintained and they live in pleasant surroundings. EVIDENCE: The home is well maintained, furnished and decorated to a good standard. One bathroom contained a hoist that was rusty in parts due to the paint, which had peeled off. Residents spoken to said they like their rooms, they are comfortable and contain what they need. All had their own personal possessions to make them feel homely. The home is clean and tidy with no unpleasant odours. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30. The managers working time is routinely used to make up for the shortage of care staffing numbers to provide direct care to the residents. This has been detrimental to the management of the home and issues reported in other sections of this report reflect this. There were no clear records available to say how many staff have obtained their NVQ qualification to ensure that residents are in safe hands. Residents are not supported or protected by the recruitment practices at the home. The required checks are not carried out before new staff commences working at the home. Staff do not receive sufficient training that would ensure that they had the knowledge and skills to fulfil the aims and objectives of the home and meet the changing needs of the residents. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 16 EVIDENCE: Agreed staffing levels were not being maintained. The care staffing rota’s checked included the manager on most days to make up the shortfall of care staff to care for the residents. The new manager did not have the information available of how many staff had NVQ qualifications and no concise records were available which recorded what training staff had undertaken. Some new staff recruited had not undergone the required checks before they had commenced working at the home. Criminal Records Bureau (CRB) checks had not been carried out, no proof of identity had been checked and no written references obtained. The manager was informed that immediate action must be taken to rectify these omissions. Sufficient records of staff training were not kept to enable the inspector to check that staff had received all statutory training. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36, 37, 38. There were no clear lines of accountability at the home due to the manager working as a care assistant to cover staff shortages for the majority of her working week. This has resulted in the aims and objectives as stated in the homes Statement of Purpose and Service User Guide not being met. The home does not have a quality assurance system in place that would ensure that the residents, relatives and professionals involved in the home could give feedback to ensure that the service provided by the home is acceptable. The provider does not carry out monthly unannounced visits and produce a report to continually self-monitor the service and provided them with information relating to the shortfalls in the management of the home which are detailed throughout this report. Records kept are not sufficient to ensure that the home meets their legal responsibilities and ensure that the service provided is adequate. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 18 Staff do not receive adequate training and supervision to support them to fulfil their duties. The CSCI received written notice that the staff fire training had been updated and the managers had received instructions on the fire system operation before this report was published. EVIDENCE: The manager had been in post for five weeks at the time of the inspection. She has previously held the post of a registered manager in a different care setting. It was evident that she has not been able to fulfil her managerial responsibilities due to working as a care staff for the majority of her working week. The manager said she is in the process and had nearly completed her management qualification. Residents had not been asked for their opinions on the home and the home does not have a quality assurance system in place. There is no continuous selfmonitoring that would assist in the setting of an annual development plan for the home. One resident commented that they were not receiving the service they expected from the home. Staff do not receive supervision at the required frequency to discuss all aspects of care, philosophy of the home and their own career development. Staff mandatory training and records of this were not up to date. Staff fire training was not up to date; the manager was informed during the inspection that this must be immediately rectified as each staff who had not been trained next came on duty. The manager had not received instruction of how to operate the homes fire alarm system. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 2 x 3 x 3 STAFFING Standard No Score 27 1 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x 2 1 x x 1 1 1 Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 20 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 1 Regulation 5, 17, 43, Schedule 4. Requirement The homes Service User Guide must contain views of the residents of the home. The previous timescale of 1 May 2005 for action to be taken was not met. Prospective residents must be given sufficient information on the home for them to make an informed choice before deciding to live there. The homes assessment tool must contain all of the information as outlined in standard 3 of the National Minimum Standards. The previous timescale given for action to be taken of 1 May 2005 was not met. Consultation must take place with the residents, their representative, staff, care management and other relevant professionals to determine whether the home is best meeting the needs of identified service users with increasing dependency.Records of this consultation, and outcomes, must be recorded.The previous timescale given for action to be Timescale for action 1 Sept 2005 2. 1 4, 5, 43. 1 Sept 2005 3. 3, 37. 14, 17, 43. 1 Sept 2005 4. 4, 37. 12, 17, 43. 1 Sept 2005 Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 21 5. 7, 37. 15, 17, 43, Schedule 3. 6. 9, 37 12, 13, 15, 17, 43, Schedule 3 7. 9, 8 12, 13, 43. taken of 1 May 2005 was not met. Care plans must be completed in full and be maintained up to date.Individual care plans must contain specific information on the staff action required to ensure identified needs are met.Care plans must be signed by the resident or their representative.The previous timescale given for action to be taken of 1 May 2005 was not met. The homes risk assessment tool for self-administration of medication must be fully utilised to ensure service users are offered choice, where able.The previous timescale given for action to be taken of 1 May 2005 was not met. Residents prescribed medication must be administered as their GP has stated therefore sufficient stock must be available at all times. Medications must be stored securely, where residents administer their own medication systems must be in place to monitor and record that their medications are stored safely. All staff that administers medications must undertake training in medication administration, a record must be kept of this training. The rusting bathroom hoist must be repaired The manager must not be routinely used to cover the shortfall of care staff. Recruited staff must not commence employment at the 1 Sept 2005 1 Sept 2005 8. 9, 37. 13, 17, 43. 9. 9, 37. 13, 18, 43. The manager was informed of this immediatel y. The manager was informed of this immediatel y. 1 Sept 2005 10. 11. 12. 22 27, 32. 29 16, 23, 43. 18, 43. 18, 43, Schedule 1 Sept 2005 1 Sept 05 The timescale Page 22 Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 2 13. 29 18, 43, Schedule 2. 14. 30 18, 43. 15. 33 24, 43. 16. 33 26, 43. 17. 36 18, 43. 18. 38 18, 43. home until an enhanced CRB check has been obtained. Staff already working at the home without a CRB check must not work unsupervised with residents. The provider was informed that immediately action must be taken at the last inspection of 1 Feb 2005, this had not been actioned. Staff files must contain all the information as required in Schedule 2, including evidence that references have been obtained. The previous timescale of 1 May 2005 for action to be taken had not been met. All staff must undertake training on Adult Protection procedures. The previous timescale of 1 May 2005 for action to be taken had not been met. The home must produce a quality assurance system and development plan that meets all areas listed in this standard and includes the reviewing of the policies and procedures. The previous timescale of 1 May 2005 for action to be taken had not been met. The provider must carry out an unannounced visit to the home each month and produce a report which includes all areas as stated in Regulation 26 of the Care Home Regulations 2002. Care staff must receive supervision at least 5 times a year. This must cover all aspects of care, philosophy of the home and career development needs of the staff. The previous timescale given of 1 May 2005 for action to be taken had not been met. An audit of staff mandatory training must be carried out. given on 1.2.05 was immediate. A second immediate timescale was issued on this inspection. 1 Sept 2005 1 Oct 2005 1 Oct 2005 1 Sept 2005 1 Sept 2005 1 Oct 2005 Page 23 Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 19. 38 18, 43, Schedule 4. 18, 43 20. 38, 37. Staff must be provided with training as identified within the audit. Identified staff must undertake refresher training in moving and handling, heallth and safety and food hygiene. The previous timescale of 1 May 2005 given for action to be taken had not been met. Staff fire practice drills must take place at the required frequency. The previous timescale of 1 May 2005 for action to be taken had not been met. Staff training records must be maintained and up to date. The previous timescale of 1 May 2005 for action to be taken had not been met. 1 Sept 2005 1 Sept 2005 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 28 31 Good Practice Recommendations Plans should be put in place to ensure that 50 of care staff are quaslified to NVQ level 2 by 2005. The manager should obtain her NVQ level 4 qualification in management and care by 2005. Croft Acres J55 S2951 Croft Acres V230008 01.07.05 UI Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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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