Inspection on 10/01/08 for Croft Avenue Residential Home

This inspection was carried out on 10th January 2008.

CSCI found this care home to be providing an Good service.

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

Croft Avenue Residential Home 13/10/06

Croft Avenue Residential Home 09/12/05

Croft Avenue Residential Home 02/09/05

Croft Avenue Residential Home 24/01/05

Croft Avenue Residential Home 10/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Croft Avenue Residential Home Wordsworth Street Penrith Cumbria CA11 7RJ Lead Inspector Jenny Donnelly Unannounced Inspection 10th January 2008 10:15 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 Croft Avenue Residential Home DS0000022547.V354056.R02.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 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 Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Croft Avenue Residential Home Address Wordsworth Street Penrith Cumbria CA11 7RJ 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) 01768 867155 01768 210759 www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd Ms Denise Shearer Care Home 40 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (40) of places Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include: up to 40 service users in the category of OP (Older people) up to 4 service users in the category of DE(E) (Dementia over 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 13th October 2006 2. Date of last inspection Brief Description of the Service: Croft Avenue is a care home registered to provide care for forty older adults. The home is owned and run by BUPA Care Homes. The home is located in a quiet residential area of Penrith and is approximately half a mile from the town centre and local facilities and amenities. Accommodation is offered on the ground and first floors, there are three sitting rooms, two dining rooms, a treatment room, general offices, kitchen and laundry on site. The home has a passenger lift. A call bell system is operational throughout the home. There is a well-attended garden and car parking is available to the front of the home. The weekly fees at the time of this visit ranged from £373.00 to £579.00. Copies of the latest inspection reports and information for prospective residents about Croft Avenue, was available in the home. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was the main or ‘key’ inspection of the service. Jenny Donnelly inspector, made an unannounced visit to the service on 10th January 2008. During the visit we (the commission) toured the building, spoke with residents, staff and the management. We looked at care, medication, staffing and management records. We saw how people were spending their day, and observed lunch and the afternoon’s activities. Prior to this inspection the manager had completed and returned an Annual Quality Assessment Audit (AQAA) that we had requested. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We sent surveys out to half of the people who live in the home and their relatives. The findings of the surveys are included in this report. Since the last key inspection in October 2006 we made a brief ‘random’ visit to the service in February 2007, to monitor the homes’ progress. The report from the random visit is not available on our web site, but can be requested from the CSCI helpline. At the time of this inspection, the registered provider had applied to the commission to register croft Avenue to provide 12 nursing beds. This application is currently being assessed. What the service does well: Croft Avenue provides good information for people interested in using their service, and has a detailed admission process to help people settle in well. The planning and delivery of care is individual to each person and based around their particular needs and wishes. People are enabled to make choices, feel listened to and are treated with respect. The variety, choice and quality of the meals served is very good. The home is warm and comfortable and standards of cleanliness and hygiene are high. The staff team is well motivated. Staff undertake a wide range of good quality training, and are fully supervised and supported by senior management. There are sound quality assurance checks in place, which include the views and opinions of those people using the service and their relatives. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 6 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. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 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 Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good information to people interested in using their service and operates sound admission procedures. EVIDENCE: The home had produced a statement of purpose and an informative information pack for prospective residents and their families. People were issued with a contract of residency either directly with themselves or through their funding agent. The manager had carried out pre-admission assessments of prospective residents, to assess their health, personal and social care needs. This helped the manager judge whether Croft Avenue would be suitable for each person’s individual needs. The process also allows prospective residents and their families to ask more about the service. People told us they were given enough information about the care home to be able to make a decision about living there. The home does not provide an intermediate care facility. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were receiving good quality health and personal care that enhanced their quality of life. EVIDENCE: Since the last inspection a new care planning system had been fully set up in the home, and was working very well. We looked at the care records of three people with different levels of need, and found the records were well organised and up to date. Individual plans of care were very personalised and built around people’s choices and wishes. Plans specified whether people preferred a bath or shower, what time they liked to get up and where they liked to keep important items such as their reading glasses. Risk assessments for people’s moving and handling, skin care and nutritional needs were clearly set out, along with the action needed by staff to reduce any risk. For example, one person was underweight and staff knew to provide additional calories in his/her meals and to offer snacks if the person was awake during the night. There was evidence that people had been consulted about their care plan and Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 10 been involved in care reviews. Records showed that people had good access to their doctor and to the community nurse, as well as other health professionals including the chiropodist, dietician and optician. People told us that staff treated them well, and said they felt well cared for. The surveys told us that people received the care and medical support they needed and that staff listened and acted on what they said. We inspected the management of medicines in the home and found this to be satisfactory. There were clear records of all medicines received, administered and returned. No mistakes were found in the medicine records and the stock balances checked were correct. Staff were knowledgeable about peoples individual medicines and understood those given in variable doses or at odd intervals. Short courses of medication such as antibiotics were well managed and medicines with a short shelf life had been marked with opening dates. There were safe systems in place to assist people to manage their own medicines if they wished and had been assessed as able to do so. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 11 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. 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 this service. People were free to choose how to spend their time, there was a variety of activities and entertainment available, and the provision of meals was very good. EVIDENCE: People told us that there was no activity organiser in the home at present and this was causing some concern. The manager told us this post was vacant and was being advertised. In the meantime one of the senior carers was working 12 hours a week on activities, and had been able to continue with the usual programme of events. During the run up to Christmas there had been various musical events, baking and craft sessions taking place. The home booked regular visiting entertainers and an accordion player was performing on the afternoon of our visit. The hairdresser was also in the home that day, and staff were seen supporting individuals to make their own choices and go out for walks. The home kept rabbits and guinea pigs, which were used in pet therapy sessions. Care plans included good information on people’s wishes in relation to activities, and there was evidence of individual work going on with Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 12 some people. Sometimes people used the homes minibus to attend joint events at another BUPA care home in the town. People gave very good feedback on the meals provided saying, • “The meals are excellent” • “We always have a choice, and even then you can have something different” • “At dinner time if I don’t fancy the alternatives they make me a salad – my favorite”. We saw lunch being served and saw that both the main menu options and some alternatives were provided, according to what people had asked for. The menus were on display showing two options for each mealtime, along with a list of other available items. BUPA operates a “Night Bite” menu system when the kitchen is closed, and there was a colour poster and colour flip chart for people to see pictures of the items available, which include soup, sandwiches, beans on toast, fruit and yoghurts. People who needed help with eating were assisted in a quiet and sensitive way and the mealtime was relaxed and unhurried. Tables were nicely set with cloths, napkins and flowers, and people were able to remain at the table to chat if they wished to. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People felt safe and protected in the home and felt that any concerns would be listened to and acted on. EVIDENCE: The home had a complaints procedure that was on display and there were complaint forms available on the reception desk for anyone who wishes to make a formal complaint to BUPA. People told us they knew how to complain and would speak to the manager or contact their social worker if needed. Since the last inspection the home had received one complaint about lost belongings. The correspondence relating to this was all on file and showed that the manager had responded in a timely way and gone to some effort to find and then compensate for the loss. No complaints have been made directly to the inspector since the last inspection. Staff had received training on safeguarding vulnerable adults and abuse, this comprised of a DVD film and workbook package. There were policies and procedures available to guide staff in what to do in the event of an allegation of abuse being made. People told us they felt safe living in the home, and thought staff listened to them. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Croft Avenue provides a very comfortable standard of accommodation, which is kept clean and fresh. EVIDENCE: Croft Avenue is located in a quiet residential area of Penrith and is approximately half a mile from the town centre and local facilities and amenities. Accommodation is offered on the ground and first floors, there are three sitting rooms, two dining rooms, a treatment room, general offices, kitchen and laundry on site. The home has a passenger lift. A call bell system is operational throughout the home. There is a well-attended garden with seating areas and car parking is available to the front of the home. The communal rooms and outside space were nicely presented and comfortable for residents. Bedrooms varied in size and shape throughout the building; there were 24 single and 7 shared bedrooms, some with an ensuite Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 15 toilet. The majority of bedrooms had been nicely personalised and made homely. Since the last inspection a lot of improvements had been made to the home. New beds and mattresses had been provided in every bedroom, 14 bedrooms had new furniture, new windows had been installed at the front of the building, there were new lounge carpets, new dining furniture, and a new tumble drier and freezer. The home had five bathrooms, consisting of four standard baths and a shower room. A new assisted bath had been ordered for one bathroom, and consideration was being given to upgrading a second bathroom to allow easier access for people with mobility problems. The home was clean, tidy, warm and fresh smelling throughout. The laundry arrangements were satisfactory and people said their clothes were nicely laundered. A new senior housekeeper had been appointed since the last inspection, and the standard of hygiene had improved. All staff had completed training in infection control. A smoking room, which complies with the new legislation, was being created for peoples use. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent, caring and suitably trained team of staff cares for the people living in this home. EVIDENCE: At the time of our visit there were 25 people living in the care home and staffing for the day consisted of the manager, one senior carer and three care staff, plus the housekeeping and administrative staff. Rotas showed this to be typical for daytime, with two staff on duty at night. These arrangements were satisfactory to meet the needs of the people currently living in the home. People spoke well of the staff saying, • “The staff are very kind” • “All the staff are very good” • “All the carers seem to be very compassionate and kind to my mother”. Staff were seen to work positively with people, they were not rushing, responded to requests quickly and were able to spend some time chatting with people. The home supported staff to access suitable training and 80 of the care staff had achieved or were working towards a National Vocational Qualification level 2 in care, which is very good. All staff received regular mandatory training in fire safety, health and safety and moving and handling. In addition to this staff completed workbooks on a range of subjects including Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 17 abuse, the new mental capacity act, dementia care, and nutrition and food hygiene. Inspection of staff files showed that the manager had adhered to good recruitment practices and ensured all checks were in place before people started work. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the people who live there. EVIDENCE: The registered manager, Denise Shearer, has been in post for a number of years, and has completed the Registered Managers Award. A local general manager and a regional operations manager support her in her role. Staff and people living in the home knew the manager well, saying she was easy to talk to and helpful. Residents meetings were held periodically, the last one being in November, and we saw the minutes of this. There were quality surveys done throughout the year by the BUPA quality department, and the results of these were displayed on the notice board. A survey on catering had just Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 19 commenced. There were management audits in place to monitor the quality of care planning, medicines management and the kitchen. These checks were clearly having a positive impact on the quality of service delivered. Any residents spending money managed by the home, was safely handled, kept in personal banking accounts, and all spending (such as hairdressing and newspapers) invoiced monthly. There was an annual business plan and budget for the home that included all major spending and refurbishment and contingency plans. Staff received regular supervision sessions, which were recorded in detail and addressed issues of care practice and training needs. The written information supplied to us by the home indicated that all service records were up to date for the building and the equipment. The home had received satisfactory visits from the fire officer and environmental health officer during 2007, and a satisfactory health and safety inspection this month. Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 20 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 X 3 Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. Extracts may not be used or reproduced without the express permission of CSCI Croft Avenue Residential Home DS0000022547.V354056.R02.S.doc Version 5.2 Page 23 - 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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