Inspection on 03/06/08 for Croft House Care Home

This inspection was carried out on 3rd June 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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Croft House Care Home Main Road Eastburn Keighley West Yorkshire BD20 7SJ Lead Inspector Valerie Francis Unannounced Inspection 3rd June 2008 09:00 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 Care Home DS0000071168.V365919.R01.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 House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Croft House Care Home Address Main Road Eastburn Keighley West Yorkshire BD20 7SJ 01535 654989 01535 655014 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 Home Ltd Mr Giles Bateman Care Home 29 Category(ies) of Dementia (7), Old age, not falling within any registration, with number other category (21), Physical disability (2) of places Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, Physical disability - Code PD and Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 21 First inspection since re-registration 2. Date of last inspection Brief Description of the Service: Croft House is a privately owned care home that does not provide nursing care. It is situated in the village of Eastburn on the outskirts of Keighley. The home is close to local amenities including shops, a church, and a public house and is on a main bus route. The building itself is an adapted property, which has been extended to provide care for up to 29 people. All the bedrooms are single, and are on the ground and first floor. People have a choice of lounges on the ground floor. There are plenty of communal toilets and bathrooms, which are in easy reach of lounges and bedrooms. There is a passenger lift to the first floor. There is good disabled access into the home and adequate car parking in the grounds. The home is surrounded by well kept grounds and gardens where there are a number of seating areas for people and visitors. The fee charged is between £400 to £460 per week. This information was provided on 3RD June 2008 during the inspection. Croft House Care Home DS0000071168.V365919.R01.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 stars. This means the people who use this service experience good quality outcomes. The home was first registered in 1987 and re-registered in December 2007 therefore it is inspected as a new home and this was it’s first key inspection. The inspection process included looking at the information we have received about the home since their re- registration in December 2007. We have not received any complaints or concerns about the home since then. The purpose of this inspection was to look at how the needs of people living in the home are being met. We also did this unannounced visit, which was carried out by one inspector between the hours of 11:15 am and 6:15 pm. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including care records and looked around the building. Before the visit we sent surveys to people living in the home, their relatives and staff, in total 18 surveys were returned. We sent a self-assessment form Annual Quality Assurance Assessment (AQAA) to the home and a copy was given to us at the inspection, it was clear and contained all the information we asked for. Information from the surveys and the AQAA is included in this report. What the service does well: The home provides people with a homely environment and a stable staff group to care and support them. People who live at the home have their needs assessed before they come to stay. This ensures that the home can meet their needs. All people who returned surveys indicated that overall they were happy with the care and support they get at the home. Relatives in their survey said. “A very kind and caring staff. Issues raised are always addressed and rectified promptly.” “The carers take time to talk to the residents.” Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 6 “Everyone is greeted with a smile and staff are always friendly the place is homely and clean and tidy. And all staff are caring and kind to everyone.” “ The staff are always very kind and helpful. They do an excellent job to make my mother happy and look after her needs.” “The home is well run by the manager and staff.” “ Cannot fault Croft House at all.” “ I think they do a really good job.” “Care and friendship offered by the staff and proprietor. The attitude of the staff toward concerned relative is excellent.” “ The care home is brilliant all the staff are very friendly and helpful.” Routines are flexible and people can exercise choice in key areas of their lives, for example getting up and going to bed times, what to wear, and what activities they want to do. The home is very clean, homely and well maintained. The home has good access and there is a lift and wide corridors that meet the needs of people with mobility problems. 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 House Care Home DS0000071168.V365919.R01.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 House Care Home DS0000071168.V365919.R01.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& 3. 6 do not apply to this service. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who want to come to live at the home have their needs assessed before their admission, to make sure that the home can deliver the care they need. EVIDENCE: During the visit we saw an information pack; the statement of purpose and the service user guide which is made available to people who may want to live at the home. This tells them about the care provided. We were told that the information is reviewed annually, to make sure that all information is current. The home told us that they carry out an assessment of people’s needs before they come to live at the home. People and or their relatives or friends are Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 9 encouraged to visit the home before making a decision. We were also told that people could have a trial visit before they move into the home. We looked at 3 people’s care files, two of which were new to the home. We found copies of assessments carried out by the home and other agencies. We saw information in the assessments such as the person “walks with a stick personal care and supervision,” this did not indicate if people could help themselves or needed assistance, or how mobile the person was or how safe they are they walking with a stick. There was nothing recorded in people’s care files to show that people’s relatives had been involved in the assessment process. However, a visiting relative told us that they had been involved in the assessment process. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are receiving the care they need but the care records would benefit from more detail so that all staff know exactly what care each person needs and how they prefer it to be given. EVIDENCE: The home told us that people’s care plans and risk assessments are done during their first two weeks in the home. Although each care plan had some good information generally the files did not have enough information to make sure staff provide the care people need and in the way the individual prefers. We saw three files and found care assessment information. Risk such as poor mobility and falling are identified and managed but the recording of this could be improved. The GP visits weekly to carry out a surgery this gives people the opportunity to see their GP for any health issue they may want to discuss. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 11 The home has good links with other health care professionals in the community and at the local hospital, with whom they can discuss issues relating to people’s health needs and for staff training. People’s care records were not kept in individual files but collectively in ring binders. We spoke to managers about developing a personal file for each person to make sure that confidentiality and data protection is not breached. People living at the home and their relatives said they had been asked about their needs, but there was no evidence of this on any of the files seen. During the visit we talked about the home making the care plans more personalised, such as including social histories and individual likes and dislikes. This will mean that staff can be sure to provide care the way people want. Relatives in their surveys said: “ The carers take time to talk to the residents.” “ I am please with all aspect of care given to my sister her medication is closely monitored.” “They always inform me of any changes and they care for their clients with dignity and respect and treat them as individuals.” “ My mother is much happier than she was, and likes being there.” During the inspection we saw care staff helping people move from wheelchairs, helping them at lunchtime and to their rooms. Staff talked to people as they helped them and gave them the time they needed to get from one place to another. Staff talked to people all the time they were assisting them and gave guidance and support. This is good practice. The home uses a monitored dosage system for medication and they have systems in place for monitoring and recording medications ordered, received, administered and returned. There were clear records of medicines disposed of according to current guidelines. Not all staff who administer medication had received the home’s one day training on safe medication awareness. The manager was reminded that all staff administering medication should have accredited training. So staff have knowledge and sound information about safe handling of medication. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have access to a variety of activities and maintain contact with families. EVIDENCE: People’s relatives and friends are encouraged to visit them. People’s care records did not reflect their social care needs. There was no information about people’s past life that would help staff to be better informed about people and give a more person centred approach to people’s care. The home told us that they plan to improve this by getting more information on people’s social needs at the time of their assessment before they move in. We saw a record book, which had a list of activities that people had taken part in. People are regularly taken out on trips to local beauty spots. On the day of the inspection several people took the opportunity to go out on a trip to the Dales. Some of the other activities we were told about included, Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 13 • • • • • • In the surveys we got back from relatives they told us: Outside entertainers Board games. Shopping trips. Hairdressing and manicures. The hairdresser was at the home and people had the opportunity to have their hair done. Gardening and baking groups. “ My mother loves the activities, especially the Arts and Crafts and the coach rides up into the Dales.” One relative said what the home does best is “They supply the entertainment needed and take people out on trips.” One relative also said how the home can improve is “ More stimulation for all residents would help to give them a higher level of self motivation.” People choose what they want to wear and how they spend their time. One person told us that he prefers to stay in his room to have breakfast. We were also told that people decide what time they would like to get up and to go to bed. We were told that although there is a fixed menu people still have the opportunity to have an alternative. There is a menu board, which tells people what meal is being served for the day. There is a three week rotating menu, which is changed seasonally. The Matron told us they are going to introduce a four week menu plan which she said had been discussed with people at their meetings so that their choice of food is included. Although there was some written information about people dietary needs and nutritional assessments are carried out, there was no plan in place specifically for people who may be at risk. The meal we saw was diced pork, mashed potatoes, broccoli, carrots and coconut tart or semolina for pudding. Everyone we saw or spoke to at lunchtime had the same meal. Relatives told us “ the food is good.” “My sister has good home cooked meals.” “The food is not all microwaved like in most places but good homemade food.” During meal time people were assisted by staff in a discreet manner, people were able to eat their meal at their own pace and were not rushed. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People know that any complaints they have will be responded to and that staff are trained to keep them safe from abuse. EVIDENCE: We were told that people are given information on the complaints procedures for Croft House as well as the CSCI complaints procedures. They are also provided with information on advocacy services and the local social services office. We saw the home’s complaint procedure displayed in the communal sitting area of the home. Relatives said if they had any concerns they would go to the manager and felt it would be dealt with. One person said, “ Any issues raised are always addressed and rectified promptly.” We have not had any complaints since the re-registration of the home. A log is kept of any complaints received, with action taken, to make sure all complaints are taken seriously. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 15 The home told us that they have up-to-date policies on reporting abuse and bad practice and whistle blowing. This was discussed with staff who knew what to do if the issue was brought their attention. Staff told us that they have had training on adult protection and it is also covered in the National Vocational Qualification (NVQ) training, which they said have given them a better understanding of how to deal with any issues that may come up. All new staff have a POVA First and CRB check before they are employed and an employment history is also obtained to make sure that staff are safe and suitable to work with people living in the home. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in surroundings that are homely, clean and free from odours. EVIDENCE: Relatives told us that the home was clean and tidy. We looked at all areas, including bedrooms, bathrooms and toilets. All were clean and smelt fresh although some bedroom carpets are stained. The home told us that people who want to move in can bring with them furniture and other personal items to make their rooms personalised and homely. We saw that rooms were personalised and it was clear that people had brought with them many personal items. Relatives said: “The place is immaculately clean.” Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 17 “Some of the lounges could benefit from a make over, but other than that I am very satisfied with all other aspects.” During the walk around the building we noted that that some of the walls in bedrooms and communal areas were Artexed, which had several sharp areas. Although no person living at the home, staff or visitors had hurt themselves the manager agreed that these areas were a potential health and safety hazard and he would get the handyman to sand down the areas, so that everyone is safe. We were told that all staff have had training in infection control as part of their induction training, and there are systems in place to prevent the spread of infection; this includes staff being provided with protective clothing. The home requested an inspection visit from West Yorkshire Fire Service to inspect the work they have carried out to meet fire safety requirements. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,28& 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are looked after by staff who are trained to provide good quality care. EVIDENCE: The rota showed that the present staffing level is enough to meet people’s needs during the day. Staffing level in the home is good during the day, where people have access to five members of care staff, catering and domestic staff. During the night there are two members of staff. There is an on-call rota, which is covered by the manager, matron and senior care worker. Relatives said that staff are: “very kind and caring and interact very well with residents.” “Staff look after and care for their residents by making sure they are always well dressed, washed, haircut/ set by the hairdresser nails cut and manicured and well fed with good home cooked meals, and above all patience.” Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 19 The home also employs a handyman and domestic assistants, which said gives the care assistants more time to spend with people. The home told us that they are going to display photographs of staff so that people can identify staff and the job they do. This is good practice. The home has a good recruitment and selection procedure to make sure clear guidelines is followed. We saw lots of training certificates displayed for training such as moving and handling, first aid in the corridor. However, most had dates going back as far as 1990’s. Which could mean in most cases these certificates were out of date and staff may need to attend refresher courses, to make sure they have current up to date information to help them to provide good quality care. We did not see any record of planned training for staff, to make sure that there is ongoing planned training for staff. We saw that staff treated people with respect and as an individual taking into account their right, choice and dignity. The home provides care for people with dementia. To makes sure that staff have good understanding and knowledge how to provide care and support to people with dementia, dementia awareness training courses should be given. The home told us they knows where they need to improve, such as looking at ways in which they can expand their training programme. For instance their induction training can be broaden to take more account of the Mental Capacity Act, so that staff have a better understanding of people’s rights. And ways to improve training by staff cascading information after any training they had undertaken, so that they all have information on all training. The home have 24 care staff, 19 of which have a NVQ at level 2 or above. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Management of the home is good and ensures that policies and procedures are maintained. EVIDENCE: The owner is also the manager of the home. He is qualified and has many years experience of working with and managing people and a business. The matron who is also experienced in working with the group of people using the service, supports the manager. All relatives indicated that they were overall happy with the home and the manager and his staff, in the way they look after their relatives living in the home. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 21 The home has sent us evidence of having a wide range of policies and procedures in place that are regularly reviewed. The home told us in the last twelve months they have updated their annual service users questionnaire and developed new questionnaires for the district nurses and local surgeries, to get more feedback about the service provided at the home. The home told us people’s finances, are handled by themselves, relatives or their solicitors. There is ongoing refurbishment of the premises with risk assessments in place to ensure health and safety are minimized and managed. We saw up to date records of regular checks on equipments used in the home, to make sure people and staff are safe. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X X X X 3 Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? New Registration. 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 OP30 Regulation 18 Requirement Staff must have specialist training such as dementia awareness to meet the needs of the people they are caring for. Staff designated to administer medication must have training that would provide them with good information and knowledge that is appropriate for their role. Timescale for action 31/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Consideration should be given to make people’s care plan more person centred, so that their care will be delivered in a way they would like. Croft House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 House Care Home DS0000071168.V365919.R01.S.doc Version 5.2 Page 25 - 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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