CARE HOMES FOR OLDER PEOPLE
Croft House Croft House Carlyle Crescent Shotton Colliery Durham DH6 2PB Lead Inspector
Bridgit Stockton Unannounced Inspection 24th October 2005 11:00 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 House DS0000007462.V260868.R01.S.doc Version 5.0 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 House DS0000007462.V260868.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Croft House Address Croft House Carlyle Crescent Shotton Colliery Durham DH6 2PB 0191 5261132 0191 5208821 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) Croft House (Care) Limited Mrs Jacqueline Addison Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st February 2005 Brief Description of the Service: Croft House provides personal care for up to 21 people in the category of older persons. The home is owned by Croft House (Care) Ltd and is located in the centre of Shotton village The home benefits from a passenger lift to both floors and has a large garden to the rear. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 4 hours on the 24th October 2005. The home did not know the inspection was going to take place. The plan for the inspection was to check whether the home had implemented the recommendations made at the previous inspection; to talk with the residents about living in the home; to meet with care staff and the home’s management team; and to look at records. What the service does well: What has improved since the last inspection?
A new system for recording in care plans has been introduced and is working well. All members of staff have a personnel file and this system of recording has also been up dated. The redecoration of some rooms has taken place and some service users bedrooms have been re carpeted. The lounge dedicated to service users who smoke now benefits from an air conditioning unit. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 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. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 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 House DS0000007462.V260868.R01.S.doc Version 5.0 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): 3 Prospective service users cannot be confident the home is able to meet their needs before they move into the home. EVIDENCE: The manger said that the people who are admitted to the home are not normally assessed prior to them moving in. This is not good practice. A bed enquiry form is completed which collects some personal information. This form is not related to any care needs the service users may require. Some care plans did contain reviews from a social worker but this was following admission. The manager said that most of the residents admitted to the home have either stayed at the home for respite care, or else are known to the home via the homes domiciliary care agency. All service users should only be admitted following a full and documented assessment. Following this assessment the manger is then required to write to the prospective service user to confirm that there identified needs can be met at the home.
Croft House DS0000007462.V260868.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, &10 Good systems are in place to ensure that care needs of the residents are met. EVIDENCE: Service users care plans are comprehensive. The plans indicate that the care service users received is reviewed regularly. This is good practice. Service users have their health care needs met and the residents care plans details all clinical visits by health care professionals. The plans are of a good standard and staff clearly work hard to maintain this. The residents spoken to said that the staff “were wonderful” and that their particular needs and requests were addressed in a kind and professional manner. Residents said that staff did respect their privacy, and that all staff knocked on bedroom doors before entering. Any assistance given to residents during the inspection was done discreetly. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 10 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, &15 Flexible visiting arrangements allow the residents to maintain regular contact with family and friends. Residents living at the home are supported to have choice and control over how they choose to live. EVIDENCE: Residents confirmed that they could have as many visitors as they like and at any time they chose. Residents follow their own hobbies and participate in activities according to their wishes .One resident had just had a birthday, the cards were displayed and a birthday cake had been provided. She said she had really enjoyed her day. Residents said that the food was good and “very nice”. Observation of the lunchtime meal provided evidence that residents were able to make choices about meals. Some residents had chosen to take lunch in their bedrooms while others preferred the communal dining area. The cook and staff were knowledgeable about service users requirements. One service user who had not been up for very long said he preferred a light lunch and a cooked tea and staff always accommodated his request.
Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 11 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&18 There are well-established systems for safeguarding service users, which helps in their protection from abuse. Service users can be assured that all complaints are dealt with. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints. The complaint file was examined. There had only been one complaint that had been investigated by the home manager. This was documented and the outcome recorded. Residents said that if they had a complaint they would speak to the manager, they were confident that “any grumbles would be dealt with immediately” The home had in place policies and procedures for the protection of vulnerable adults from abuse. This provides a good reference point for staff to report any concerns accurately and promptly. The manager was able to give a clear account of what action she would take should any alleged abuse was reported to her. There were procedures in place regarding the recruitment of staff and there was evidence that adequate vetting of prospective staff takes place. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 12 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 Service users safety is compromised due to fire doors being wedged open EVIDENCE: A new fire alarm system has just been fitted at the home. However the magnetic openers on the fire doors are not compatible to the new system. These fire doors as well as most of the resident’s bedroom doors and corridor doors were wedged open. The recording of the fire alarm test was not up to date. From the documentation available the system had not been checked for several weeks. This is not acceptable. The fire alarm must be in proper working order and the door wedges must be removed. A notice was left at the home instructing the manager to remove all of the door wedges and to make sure that the fire alarm was working properly. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 13 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): 28,29, &30 The recruitment and training of staff is good which contributes to the ongoing protection of service users. EVIDENCE: The training offered at the home was good. Staff received regular training and updating in caring for people. Links have been established with local collages, and staff are also given in house training from the manager on subjects such as nutrition, infection control and protection of vulnerable adults. The home had staff files in place that provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 14 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): 38 The health and safety of service users and staff was potentially compromised. EVIDENCE: There was no electrical wiring certificate available for inspection, this helps ensure the wiring in the home is safe and forms part of the documentation required to validate the homes insurances. As mention previously in this report fire doors were wedged open and the system used to hold the fire doors open was not functioning properly. Four bedrooms on the ground floor did not have any hot water. One service user who occupied one of these rooms said that this was unusual. The water in another service users bedroom was very hot and potentially a risk to the occupant. The manager said she would contact a plumber to look into this. There was no current
Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 15 documentation available to verify that the hot water outlets were tested on a regular basis. Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 16 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 X X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 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 3 17 X 18 3 1 X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 1 Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 17 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. 1 Standard OP3 Regulation 14(1) Requirement All prospective service users must be assessed before admission to ensure their needs can be met at the home. Doors should not be held open be inappropriate means. All door wedges must be removed. The magnetic closures on the fire doors must function correctly and be compatible with the fire alarm system An up to date electrical wiring certificate must be obtained and any necessary works completed The registered provider must ensure that hot water temperatures in areas where service users have access does not exceed 43 degrees centigrade Timescale for action 24/10/05 2 3 OP19 OP19 23(4) 23(4) 24/10/05 24/10/05 4 OP38 23(4) 27/11/05 5 OP38 13(4) 24/10/05 Croft House DS0000007462.V260868.R01.S.doc Version 5.0 Page 18 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 House DS0000007462.V260868.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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