Inspection on 04/01/06 for Croft House

This inspection was carried out on 4th January 2006.

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

The inspector 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 House 27/08/08

Croft House 07/12/04

Croft House 26/07/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Croft House North Croft Williton Somerset TA4 4RR Lead Inspector Jane Poole Unannounced Inspection 4th January 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Croft House Address North Croft Williton Somerset TA4 4RR 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) 01984 632536 01984 633983 carolparsons@somersetcare.co.uk Somerset Care Limited Carol Phyllis Margaret Parsons Care Home 41 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. REGISTERED FOR 41 PERSONS IN CATEGORIES OP AND DE (E) One named service user not less that 60 years of age. Date of last inspection Brief Description of the Service: Croft House is registered with the Commission for Social Care Inspection to provide care for up to 41 people over the age of 65. The home is divided into two units, the main part of the home is able to accommodate 27 older people and the Seaton unit is home to 14 people who have a dementia. All rooms in the Seaton unit have been block purchased by Somerset Social Services in accordance with the Specialised Residential Care scheme (SRC). The home was purpose built some years ago and is located in a residential area of Williton. All service user accommodation is set on the ground floor, all bedrooms in the home are used for single occupancy and there is a variety of communal space. The home is owned by Somerset Care, the registered manager is Carol Parsons and responsible individual is Brenda Clare. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors, Jane Poole and Kathy McCluskey over a 4 hour period. The inspectors were given unrestricted access to all parts of the home and all records requested were made available. The inspectors were able to spend time talking with service users and observing care practices in the home. Some service users were unable to fully express their opinions but all appeared extremely relaxed and comfortable in their environment. Not all standards have been inspected on this occasion and therefore this report should be read in conjunction with the report dated 8th June 2005. What the service does well: What has improved since the last inspection? There have been no major changes in the home since the last inspection. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. All service users have a contract with Somerset Care or a financial agreement with the relevant social services department. A welcome pack is given to all new service users. EVIDENCE: There have been no changes to the statement of purpose since the last inspection. Each new service user receives a welcome pack when they move in,which gives details of the facilities at the home. Service users who are funding their stay privately receive a statement of terms and conditions from Somerset Care. Those who are being assisted with their fees by the local authority have a financial agreement with the relevant Social Services department. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 9 Service users spoken to stated that they, or their representative had been able to visit the home prior to moving in on a permanent basis. In addition to full residential care the home also offers day care and respite care which is an opportunity for prospective service users to spend time at Croft House before making a decision to make it their home. Thirty of the forty-one rooms at the home are ‘block contracted’ by Somerset Social Services and the Somerset Partnership NHS and Social Care Trust. Therefore all service users are fully assessed by relevant professionals before being offered a place at the home. The inspectors viewed 4 service user personal files and saw no evidence of these pre admission assessments or any assessments carried out by the home. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 & 11. Care plans seen were not fully reflective of the needs of the service users or the assistance given by staff. EVIDENCE: The inspectors viewed the personal files of four service users. None contained copies of the pre admission assessment carried out by the home but all contained an assessment of need completed upon admission. Care plans viewed were not fully reflective of the needs of service users or the level of support that staff were giving. For example in one file there had been a sleep chart partly completed but there was no mention in the care plan of any sleep difficulties. Another plan of care for a person who was registered blind gave no information about this aspect of their life or any difficulties that this may lead to. There was very limited information in personal files in respect of social or emotional history. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 11 Running records are written daily about each service users. Records viewed were comprehensive and informative but the valuable information contained in these had not always been incorporated into the care plan. All service users are registered with local GPs and other relevant healthcare professionals. The home is clear about the level of need that they are able to meet and on the day of the inspection one person, whose needs had increased, was moving into nursing care. The inspectors discussed with the manager about how they care for someone who is dying. It was stated that the local GPs and district nursing team offer advice and support where required. Friends and family are able to stay with the person as long as they wish to and additional staff can be made available to service users who have no close friends or family. The home uses the Boots Monitored Dosage System for medication. There are adequate storage facilities for all medication and service users have lockable spaces in their personal rooms where they are able to store creams and any medication that they self administer. Medication is only administered by senior staff who have received appropriate training. The inspectors viewed the Medication Administration Records and noted that the quantity of variable dosages administered was not always recorded. For example when a prescription stated; take one or two tablets there was no record of the amount given. Controlled drugs were viewed and records kept correlated with stocks held. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13. Friends and family are able to visit the home at any time. Routines in the home are flexible to suit the needs and wishes of the service users. EVIDENCE: There are no set routines in the home with people being free to choose what time they get up, when they go to bed and how they spend their day. There are two activity workers who work through the week, Monday to Friday, in both units. Service users stated that there are a variety of organised activities such as skittles, bingo, quizzes, and trips out. There are regular visits from ‘pat’ dogs and members of the local church visit some service users. Some service users talked of the activities that had occurred over the Christmas period, these included a party, meal out and a pantomime performed by the staff at the home. Each unit in the home has a communal space where people are able to watch TV and alternative quiet lounges. Many service users have TVs and radios in their personal rooms if they choose not to socialise with other people. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 13 The inspectors observed that staff interacted with service users in a relaxed and respectful manner. Many of the service users who live in the Seaton unit are unable to occupy themselves and staff in this unit provide ongoing social stimulation. All service users in the Seaton unit appeared extremely relaxed and content in their environment. All service users asked stated that they were able to have visitors at any time. One visitor was spoken to during the inspection, they stated that they were always made welcome and able to drop in at any time. Some service users are able to access the local community without staff support and risk assessments are in place where appropriate. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18. There are systems in place to minimise the risk of abuse to service users. EVIDENCE: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Since the last inspection three complaints have been made. Records viewed by the inspector showed that all had been addressed by the manager to the satisfaction of all parties. Service users spoken to during the inspection all stated that they would be comfortable to approach a member of staff or the manager with any worries or concerns. The Seaton unit is locked by an electronic keypad. All service users who live in this unit have been assessed by the home and outside professionals as requiring this level of security. The inspectors observed that people living in the unit has unrestricted movement around their home and into the gardens. Service users living in the main part of the home are able come and go as they please and risk assessments are in place for people who regularly go out without staff support. All service users are on the electoral role and use postal votes if they wish to vote. No service users are currently accessing an independent advocate but the home is aware of how to contact advocates and has done so in the past. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 15 Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25 & 26. Croft House provides a comfortable, homely environment for service users. Further hand washing facilities need to be made available in personal rooms to minimise the risk of infection. EVIDENCE: The home is designed around an inner courtyard with all service user accommodation on the ground floor. All areas are accessible to service users with all levels of mobility and various aids and adaptations have been put in place to encourage people to move independently around the home and gardens. The Seaton unit is separated from the main part of the home by an electronic keypad. The inspectors were given unrestricted access to all areas of the home. All communal areas were seen and a sample of personal rooms were viewed. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 17 There are three assisted bathrooms in the home, one in the Seaton unit and two in the main part of the home. Some rooms have en suite facilities and all have wash hand basins. The majority of bedrooms in the home are small, approximately 9 square meters, but those seen by the inspectors had been personalised to reflect the needs and tastes of the service users and provided comfortable accommodation. Environmental risk assessments have been carried out and appropriate action taken to minimise risks to service users. Aids and adaptations, including clear signage, have been put in place around the home to assist service users to maintain their independence. A fire detection and call bell system is fitted throughout the home. All areas seen on the day of the inspection were clean and fresh. The inspectors noted that there were no appropriate hand-washing facilities for staff in bedrooms where staff assist with personal care. Some staff spoken to did not appear to appreciate the importance of good infection control measures. Both areas of the home have access to safe, attractive outside space. As previously mentioned there is an inner courtyard, there is also a sensory garden and summer-house attached to the Seaton unit. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 29. Staff appeared confident and well motivated. There is good interaction between staff and service users. EVIDENCE: The service users spoken to were very complimentary about the staff who work at the home. People described the staff as extremely kind and always ready to listen to any concerns or worries. Staff observed during the inspection appeared happy and confident in their roles. In the morning there are a minimum of 5 care staff and a supervisor on duty, in the afternoon there are 4 carers and a supervisor. Overnight (9.30pm7.30am) there are just 2 staff on duty covering both units. The management and ancillary staff hours are in addition to this. The manager stated that there is some flexibility in the staffing levels to deal with unforeseen situations. There is a strong commitment to staff training and records of induction and on going training were seen in staff files. Only three members of the care staff team have not yet attained a National Vocational Qualification in care at level 2 or above. These three people are currently working towards the award. The inspectors viewed the recruitment file of the most recently appointed member of staff. The file contained all information required by this standard, however the inspector noted that the employment history on the application Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 19 form appeared incomplete and there was no evidence that this had been discussed with the staff member. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The management style in the home is extremely open and approachable meaning staff and service users are comfortable to discuss issues and raise concerns. Reasonable steps have been taken to ensure the health, safety and welfare of service users. EVIDENCE: The registered manager of the home is Carol Parsons. She demonstrates an excellent knowledge of staff and service users at the home. Carol monitors the quality of the care at the home by observation and informal supervision of staff. Service users and staff describe her as extremely open and approachable. There are regular meetings in the home, which is an Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 21 opportunity to pass on information, discuss issues and make suggestions on the running of the home. All staff and service users asked stated that the management of the home was extremely approachable and that they would be comfortable to discuss any issues that they might have. Since the last inspection a new deputy has been appointed who has a good knowledge of the home and has NVQ level 4 in care and management. There is always a senior member of staff on duty who offers informal support and guidance to less experienced staff. In addition to this all staff have regular group and individual formal supervision. Records of supervision seen showed that this is an opportunity for staff to discuss a variety of issues including training and career development needs. The home does not act as a financial appointee for any service user but does hold small amounts of money in respect of 31 of the 40 people currently living at the home. The inspector viewed the records of these monies. A running total for each person is maintained and all transactions are accompanied by two signatures and receipts. The administrator stated that senior staff on duty have access to service users monies and records of accounts at all times which allows people unrestricted access to their monies. The manager takes appropriate action to ensure the health, safety and welfare of service users. The inspectors viewed the homes fire log, which showed that alarms are tested weekly by the home and the system is serviced regularly by outside contractors. There was no record that emergency lighting is regularly tested but the manager gave assurances that this is tested weekly with alarms. Staff received training in fire safety in August 2005. All accidents are recorded and audited by the deputy manager. It was noted that the time of accidents is not audited and the inspectors suggested that this should be done in future to ascertain any patterns in accidents that may have implications for staffing levels in the home. All senior staff are qualified first aiders meaning that there is a qualified first aider on duty at all times. Appropriate environmental risk assessments have been carried out and action taken to minimise risks to service users. Hot water outlets on communal baths are fitted with thermostatic controls and these temperatures are regularly tested. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 X 3 3 2 STAFFING Standard No Score 27 3 28 4 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 X X 3 3 X 3 Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 23 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 2 3 Standard OP7 OP9 OP26 Regulation 15(1) (2)[b] 13(2) 13(3) Requirement The manager must ensure that care plans are fully reflective of service users needs and wishes. The manager must ensure that variable dosages of medication are recorded on MAR charts. The manager must ensure that there are suitable staff handwashing facilities in all rooms where personal care is carried out. The manager must also ensure that all staff are aware of the importance of good infection control measures. The manager must keep the staffing levels in the home under review to ensure that they meet the needs of service users. Particular attention should be paid to night staffing levels. Timescale for action 31/03/06 15/01/06 28/02/06 4 OP27 18(1)[a] 31/03/06 Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 24 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 3 Refer to Standard OP3 OP29 OP38 Good Practice Recommendations Pre admission assessments should be kept in service users personal files with care plans. He manager should ensure that full employment histories are obtained for all new staff. Records of emergency lighting tests should be maintained. Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Croft House DS0000016030.V274336.R01.S.doc Version 5.1 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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