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Inspection on 23/05/07 for Croft House Nursing and Residential Home

Also see our care home review for Croft House Nursing and Residential Home for more information

This inspection was carried out on 23rd May 2007.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The management of the home has been successful in demonstrating its proactive approach to meeting the personal care and nursing needs of residents. Procedures and practices continue to be updated to ensure the quality of life experienced by residents, is person centred and takes account of identified need, diversity and individual choice. Staff and residents were observed interacting well together and a sense of humour added to the warmth and homely atmosphere. Comments made to the Inspector included "staff are good, caring and supportive". There was a 61% response rate to the quality assurance questionnaires distributed by the home of which 77% referred to the quality of the service provided as being very good or excellent. An action plan had been prepared to address any issues and to make improvements to the service. Other "in-house" surveys relating to specific aspects of the service are also carried out periodically. Health care professionals and local business representatives are invited to the home periodically to meet the manager and staff team. A copy of the last Commission for Social Care Inspection report was available in the main entrance. Care planning records and pre-assessment information was well documented and included all relevant information to help staff deliver appropriate care. Residents, their families and other health care professionals are given the opportunity of being involved in reviews and decisions relating to care needs and the support to be provided. The staff are good at maintaining a high standard of cleanliness and hygiene in the home and there were no unpleasant odours. The variety and choice of meals is good and menus are reviewed to take account of comments made by residents and relatives. Courses for staff training are arranged to cover specific care and nursing practices within the home and other tuition is provided by health care professionals who visit the home.

What has improved since the last inspection?

Requirements identified from the last inspection have been met. This includes improving the layout and information provided in personal care records and a fire safety risk assessment which has been completed. New initiatives have also been introduced to improve and fulfil the social aspirations of residents. Good working relationships and communication have been established with the management and staff team who are supportive of each other.

What the care home could do better:

The staffing levels for domestic cover should be reviewed to ensure there is always adequate personnel available to carry out cleaning duties particularly where there are absences due to sickness or holidays.

CARE HOMES FOR OLDER PEOPLE Croft House Nursing and Residential Home Braintree Road Great Dunmow Essex CM6 1HR Lead Inspector Trevor Davey & Carolyn Delaney Unannounced Inspection 23rd May 2007 10:00 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 Nursing and Residential Home DS0000015400.V341832.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 Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Croft House Nursing and Residential Home Address Braintree Road Great Dunmow Essex CM6 1HR 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) 01371 872135 01371 874727 hollancl@bupa.com www.bupa.com BUPA Care Homes (BNH) Limited Miss Clare Louise Holland Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (7), Physical disability (2), Physical disability of places over 65 years of age (31) Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. A person of either sex, aged 55 years and over, who requires nursing care by reason of a physical disability (not to exceed 2 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 31 persons) Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 7 persons) No more than 2 persons may attend the home on a daily basis in addition to those 38 accommodated The total number of service users accommodated must not exceed 38 persons 17th January 2006 Date of last inspection Brief Description of the Service: Croft House is a large established care home providing nursing and personal care for up to 38 residents over the age of 65 years, which includes up to 2 residents over the age of 55 years. The home can also provide day care for up to 2 people. Croft House is in a purpose built two-storey building. The home has 32 single and three double rooms. All rooms have en-suite facilities. The home is on two floors and a passenger lift is available. There is a sitting room on each floor and a large dining room on the ground floor. The home has attractive gardens and a paved area with seating. The home is located five minutes from Dunmow town centre and there is a bus stop outside the home. The current range of fees is £566 to £950 per week and there are additional charges for private telephone lines, hairdressing, chiropody and newspapers. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection site visit which was covered by two Inspectors, took place over a period of 7.50 hours and covered all key standards. The Registered Manager and deputy together with other staff, residents and visitors were spoken with during the site visit. Their comments and contributions received were helpful in assisting the Inspector to compile the report. As part of the inspection process, the relatives of fifteen people living at the home were contacted by post so as to provide them with the opportunity to comment about the service. Eleven of these responded. Overall, very positive comments were received about the care and service provided. Some reference was made regarding improvements needed in communication relating to language and for issues raised by relatives to be followed through. As part of the site visit, a tour of the premises took place and some of the personal care records and other official records within the home were also assessed. The management of the home had conducted their own survey and quality assurance exercise with residents and relatives in December 2006. A summary of the feedback received was made available to the Inspector together with a copy of the action plan, which is being implemented by the home. Overall, the responses received by the Inspector and other information gathered by the home was complimentary and very positive regarding the standard of care and services provided. The home has also provided additional information which was included in their annual quality assurance assessment (AQAA) which has been submitted to the Commission for Social Care Inspection. What the service does well: The management of the home has been successful in demonstrating its proactive approach to meeting the personal care and nursing needs of residents. Procedures and practices continue to be updated to ensure the quality of life experienced by residents, is person centred and takes account of identified need, diversity and individual choice. Staff and residents were observed interacting well together and a sense of humour added to the warmth and Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 6 homely atmosphere. Comments made to the Inspector included staff are good, caring and supportive. There was a 61 response rate to the quality assurance questionnaires distributed by the home of which 77 referred to the quality of the service provided as being very good or excellent. An action plan had been prepared to address any issues and to make improvements to the service. Other in-house surveys relating to specific aspects of the service are also carried out periodically. Health care professionals and local business representatives are invited to the home periodically to meet the manager and staff team. A copy of the last Commission for Social Care Inspection report was available in the main entrance. Care planning records and pre-assessment information was well documented and included all relevant information to help staff deliver appropriate care. Residents, their families and other health care professionals are given the opportunity of being involved in reviews and decisions relating to care needs and the support to be provided. The staff are good at maintaining a high standard of cleanliness and hygiene in the home and there were no unpleasant odours. The variety and choice of meals is good and menus are reviewed to take account of comments made by residents and relatives. Courses for staff training are arranged to cover specific care and nursing practices within the home and other tuition is provided by health care professionals who visit the home. What has improved since the last inspection? Requirements identified from the last inspection have been met. This includes improving the layout and information provided in personal care records and a fire safety risk assessment which has been completed. New initiatives have also been introduced to improve and fulfil the social aspirations of residents. Good working relationships and communication have been established with the management and staff team who are supportive of each other. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 7 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 Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 8 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 Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 9 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): 3 People who use the service experience good quality outcomes in this area. Pre-admission assessment details for care/health needs had been completed to give staff suitable information and to assure potential residents that their needs could be met. Intermediate care is not provided by the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Pre-admission assessments had been completed by senior staff and included background information relating to social/home environment, communication, eating and drinking as well as the assessed personal assistance required to Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 10 maintain safety for residents in the home. Previous medical history had been recorded including history of falls and other health needs. Comments had also been included regarding the emotional needs of potential residents and lifestyle preferences. Information was both comprehensive and relevant in assisting staff to provide appropriate care and support for residents. End of life preferences and arrangements had also been recorded which reflected the wishes of residents. Dates of subsequent care plans and when these had been discussed with residents were also recorded. Comments made by residents were positive regarding the information provided by the home and how their care needs had been discussed with them prior to admission as well as since coming to live in the home. Where prospective residents had been visited prior to admission, they also have the opportunity of visiting the home as part of the assessment process to give residents time to ask questions and to get to know familiar faces. Although the Statement of Purpose and Service User’s Guide were not inspected on this occasion, these documents are available for residents in their bedrooms and are reviewed and updated periodically. The management have acknowledged in their AQAA form that as part of their plan for improvement in the next twelve months, more details regarding the range of fees need to be included in the Statement of Purpose. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 11 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 excellent quality outcomes in this area. The personal care and nursing needs of residents were being met appropriately. Care records were clearly documented and person centred. Medication administrative procedures were in place to ensure the safety and protection of residents. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A selection of care plans and other case records were examined. This also involved sampling various information relevant to individual cases. There were Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 12 good examples of clearly recorded information which was easy to follow and highlighted the identified needs of residents and the aim of the planned intervention together with the care and support required. These instructions were clear which enabled staff to respond consistently in meeting residents’ needs which included communication, mobility, mental state in cognition as well as other routines during the day and night. Associated risk assessments had also been included. Care plans had also been completed for dealing with pain, washing and dressing as well as end of life preferences taking into account residents wishes. Samples of pressure sore risk assessments were examined and where a high risk had been assessed, no pressure sores had occurred demonstrating that good prevention care was being provided by the home. Pressure relieving mattresses are used where required. Detailed assessments were in place for promoting continence as well as procedures for safe bathing. Moving and handling plans had been agreed with residents or relatives and involved regular monthly reviews. Some of the residents spoken with confirmed that staff were kind, supportive and that their care plans were discussed with them. Residents also spoke positively of additional care provided by health care professionals such as physiotherapy and that they felt confident and safe with staff who looked after them. The home has a good working relationship with local doctors and other health care professionals some of whom, attend to provide additional information to staff e.g. dental care. Medication administered of records (M.A.R.) were being completed in accordance with agreed policies and procedures. A sample inspection was made of tablets and controlled drugs which were properly accounted for. Signatures of staff had also been provided to support hand written transcribing of medication. The Inspector also gave good practice advice regarding documentation for the return of discontinued drugs. The local pharmacy frequently come to the home to audit and discuss medication practices with staff. Nursing staff working at the home receive training updates in respect of the safe handling and administration of medicines. The arrangements for the storage and disposal of medicines were seen to be satisfactory. Feedback from the home’s quality assurance surveys included a number of positive comments confirming that much of the medical care was excellent but sometimes medication runs out before it is re-ordered or doctors prescriptions are not sent for on the same day. There was no evidence during the inspection to suggest that medication was not always available for residents as prescribed. An updated policy regarding the administration of medication was available. The wishes of residents in the event of them becoming unwell and as they approach the end of their lives were obtained and recorded wherever it was appropriate to do so and where the resident wished to discuss this aspect of care. Where one resident had expressed that they do not wish to be Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 13 resuscitated in the event of a cardiac or respiratory arrest these wishes had been clearly recorded. Where residents have chosen to be cared for in the home rather than be sent to hospital, this also was recorded. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 14 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. People living at the home benefit from a range of activities to meet social, cultural and spiritual needs. Residents receive wholesome and an appealing variety of meals. This judgement has been made using available evidence including a visit to the service. EVIDENCE: From conversations with residents, staff and observation during the inspection, residents are encouraged to pursue their own preferred lifestyle and daily routines. Feedback from the homes own quality assurance questionnaires indicated that 64 of residents felt the amount of choice they were able to make was either good or excellent. Residents spoken with, confirmed they had the freedom to spend time in their rooms whenever they chose which included breakfast in bed in the mornings. They also had opportunities of taking part in Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 15 various social activities including quizzes, armchair exercises and painting pictures supported by the activities organiser. Residents really enjoyed being involved in making Easter bonnets and creating pot plants which they were able to take back to their rooms. As a result of a suggestion made by one resident, chocolate fondue parties now take place which have become very popular with residents. Another recent initiative which has become popular in the home is a special day which is focused upon an individual resident on a rotating basis. This includes providing flowers, arranging favourite songs, hairdressing at reduced cost, facials and outings. Feedback from surveys conducted by the home showed that 92 of residents and relatives, considered the social and recreational activities in the home to be either good or excellent. The management have also identified further improvements that can be made which includes arranging more outings to different places for the residents. This demonstrates the home are wanting to improve still further communication with residents with a clear action plan to see this implemented. Where there are communication difficulties, word boards are used and staff have had training with speech therapists. Although 72 of surveys completed regarded the standard of food and presentation as either good or excellent, menus and the variety of food offered have been revised after discussion with residents and relatives. The home is also planning to redesign menus for different seasons. As well as main meals being served, hot and cold snacks are available all through the day as well as hot and cold drinks. Residents have a choice as to where they would like their meals and drinks served in the home. Menus were seen to be nicely presented with an alternative selection available. A menu board was also on display. Residents were observed eating dinner on the day of inspection which included home-made soup, beef and vegetables or salmon as well as a desert selection. Staff were also observed assisting residents who required help with eating their meals . One or two visitors were also spoken with who live locally and have their lunch each day with residents with whom they have formed good friendships. Five-week menus were made available for inspection although this is to be changed to cover four weeks. A record of meals served to residents was in place and food in the fridge was properly labelled and dated together with temperature checks. Meat and fish temperatures had also been logged. Cleaning schedules were also seen which had been properly completed. The chef advised the Inspector that fresh fruit was always available for residents. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 16 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. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Some of the residents spoken with, were aware of the complaints procedure and were confident that they could approach the management should they have any concerns. Since the last inspection, six complaints had been recorded and documentation was available to show that these had been investigated thoroughly. Appropriate responses had been given to the complainants giving details of outcomes. Appropriate action had been taken by the home where complaints had been upheld. All residents have details of the homes complaints procedure and a copy was also displayed in the entrance hall. From the information submitted by the home in their (AQAA) form, the management have acknowledged that more training needs to be provided for staff in dealing with complaints. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 17 Staff receive training and were aware of the policies and reporting procedures to follow relating to the prevention of harm to vulnerable adults. The manual of induction given to new members of staff also includes information about P.O.V.A. The Inspector updated the Manager of the telephone contact number at Essex County Council Adult Protection Unit which must be used in all cases of abuse or suspected abuse. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 18 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 excellent quality outcomes in this area. . The premises are well maintained to enable people who use the service to live in a safe, comfortable environment. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The premises were clean, hygienic and smelt fresh. Bedrooms have ensuite facilities but the management are planning to replace some of the bathing facilities with showers which will be more suitable for residents who have mobility problems. Residents are able to bring in some of their own furniture when being admitted to the home. When bedrooms need redecorating, Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 19 residents are consulted regarding their choice of colour schemes . There is a lounge and dining room on the ground floor and an additional lounge on the first floor which are suitably carpeted and furnished. Wide corridors with hand rails are ideal for the mobility of residents and the use of wheelchairs. Records were available of routine maintenance carried out including the upkeep of grounds which are assessable to residents. Of the surveys returned as part of the home’s quality assurance assessment, 93 of the residents regarded the overall cleanliness, upkeep and maintenance of the home to be either good or excellent. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 20 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 & 30 People who use the service experience good quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. Recruitment policies and practices are in place to ensure residents are adequately supported and protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The staff team are led by the Registered Manager and the deputy manager who is head of care. In addition, there are qualified nurses on duty at all times, senior care staff and care assistants. Night cover its provided by one trained nurse plus three other care staff. Staff rotas were made available showing the deployment of staff. Staff spoken with were positive regarding the support received which included regular supervision sessions and training courses. Staff also confirmed that regular staff meetings take place and they are invited to contribute items for the agenda. Staff felt that communication between staff groups and management was effective. Records of training completed were available which included fire prevention, food hygiene, moving Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 21 and handling as well as health and safety. Other specific training takes place to take account of the needs of residents and to enhance the knowledge and skills of staff in such areas as peg feeding, foot care, physiotherapy and dental hygiene. Specially invited health care professionals visit the home to take these sessions. Other courses planned for 2007 include Parkinsons disease, dementia awareness, care of dying and their families as well as dealing with challenging behaviour. There are currently 15 of care staff who have achieved N.V.Q.Level 2 and another eight staff members are to commence training. A housekeeper is responsible for domestic staff and there is also a head of catering, activities organiser, administrator and a person responsible for maintenance. Domestic staff spoken with, had a clear understanding of their roles and responsibilities and had completed training relating to control of substances hazardous to health (COSHH) and infection control. Some concern was expressed regarding the pressure on domestic staff to complete their duties on occasions where there were absences due to sickness or holidays. A check was made of the home’s recruitment records which included application forms, photo and proof of identification, written references, medical forms and confirmation of Criminal Record Bureau & P.O.V.A. First checks. Induction manuals are given to new staff which are completed with their mentor who is a senior care assistant. The induction also includes information relating to prevention of harm to vulnerable adults. Overall, feedback from the survey information which was returned to the home, indicated that 86 of residents and their families felt the quality and response of staff was either good or excellent. This included issues relating to respectfulness, promptness of staff attending to needs and quality of care received. Some of the survey information received from relatives indicated that there were areas where staff communication with residents could be improved in respect of language issues. In a few cases, relatives felt that they needed to be kept better informed of any follow up action taken as a result of raising concerns or changes implemented following visits from other health care professionals. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 22 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 excellent quality outcomes in this area. The management and administration of the home is based on openness, respect and has effective quality assurance systems in place. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The Registered Manager has been in post for nine months, is a qualified nurse and is studying towards N.V.Q.4 Registered Manager’s Award. The deputy has just recently been appointed to the home and is also a qualified nurse. From Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 23 information submitted to the CSCI, conversations and observation during inspection site visit, the manager of the home is competent and has been able to demonstrate an awareness of the need to maintain effective practices to ensure that the quality of life for residents is maintained to a high standard. Policies and procedures have been updated as well as working practices which take into account feedback from quality assurance monitoring involving comments and opinions submitted by users of the service. As well as existing quality monitoring information, further in-house surveys are also being used to look at specific areas of the service e.g. activities, catering and housekeeping. Action plans for improvements are also drawn up as a result of feedback received. Records of meetings which had taken place with residents were also available. This demonstrates that the management are listening to the opinions of people who use the service. Regular visits are also made by the Regional Manager as part of the monitoring process and reports were made available for inspection. Review of the management systems within the home have taken place and various responsibilities have been delegated to the staff team. The deputy manager is to take responsibility for staff training and is currently arranging review meetings with relatives. The records of personal allowances which were being held by the home on behalf of residents were inspected and from the sample checks made, transactions had been properly completed showing income and expenditure. Receipts were also available. These records are also periodically checked by the Regional Manager and Finance Officer. Since the last inspection, a fire risk assessment of the home has been completed and this was reviewed in January 2007. Remedial work has been completed. In addition, records of fire drills with staff were available together with other monitoring checks of fire equipment, checks and procedures. Weekly maintenance plans had been followed and hot water temperatures had been regularly checked and recorded. Other servicing and maintenance checks had been recorded including electrical and gas safety, and portable appliance testing. Equipment and hoists within the home had also been regularly serviced. Risk assessments are carried out within all parts of the building. This demonstrates that the home give high importance to the health and safety of residents together with staff and that procedures are in place for these to be monitored and updated on a regular basis. Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 24 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 4 x x x x x 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 4 Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 25 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. 1. Refer to Standard OP27 Good Practice Recommendations A review of the levels of domestic staff should take place to ensure that effective housekeeping duties can be carried out in the home at all times particularly when covering for staff absences. Future quality assurance surveys should also include the views of health care and other professionals who visit the home. 2. OP33 Croft House Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Nursing and Residential Home DS0000015400.V341832.R01.S.doc Version 5.2 Page 27 - 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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