Inspection on 26/06/06 for Croft Nursing Home

This inspection was carried out on 26th June 2006.

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

Similar services:

Clovelly House Residential Home Ltd

Cherry Orchard Nursing Home

Coppermill Care Centre

Fountains Care Centre (The)

Eleanor Palmer Trust Home

Elmstead House

Bridgeside Lodge Care Centre

Dalemead

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

CARE HOMES FOR OLDER PEOPLE Croft Nursing Home 6 - 8 Holmwood Gardens Wallington Surrey SM6 0HN Lead Inspector Mohammad Peerbux Key Unannounced Inspection 26th June 2006 9:45am 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 Nursing Home DS0000066680.V288593.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 Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Croft Nursing Home Address 6 - 8 Holmwood Gardens Wallington Surrey SM6 0HN 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) 020 8647 3022 020 8647 4267 Mr Gordon Henry Phillips Mrs Mavis Penelope McCarthy Care Home 25 Category(ies) of Dementia - over 65 years of age (0), Terminally registration, with number ill over 65 years of age (0) of places Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 5 service users in the TI category aged 40 years and over. Day care provision for a maximum of 5 service users in the old age service user category. 25th January 2006 Date of last inspection Brief Description of the Service: The Croft is a care home registered with the Commission For Social Care Inspection to provide nursing care for up to twenty-five adults with a variety of conditions associated with old age including dementia, physical disabilities and sensory impairment. It is also registered to provide care for service users who are terminally ill and up to five of them at any one time may be aged from forty years.The Croft is a large detached building (formerly two houses joined together) that is situated in a quiet suburban area of Wallington. The home is close to the centre of town with its shops, eating establishments and local transport links, which include local buses and a train station. The home is built over two floors and comprises of seventeen single and four double bedrooms. There is a separate dinning area on the ground floor and numerous other communal spaces located throughout the home. Sufficient numbers of bathroom and toilet facilities are available for service users. The range of weekly fees is between £580 and £680 and this information was gathered on the day of the inspection (26/06/06). Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first inspection for the year 2006/07. It was an unannounced inspection and took place over four and half hours. Some times were spent looking at the policies and procedures, talking to staff, manager and to some of the service users. They are all thanked for their time and assistance. A tour of the building was also carried out. Service users spoken to stated that they were happy with the care being provided. Requirements and recommendations from the previous inspection were also discussed with the registered manager. Overall the inspection confirmed that the home provides a good level of care for the service users who live there. What the service does well: What has improved since the last inspection? At the last inspection it was required that the manager must ensure that medication administration records are accurately completed at all times. It was positively noted that they were all signed for accordingly. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 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 Nursing Home DS0000066680.V288593.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 Nursing Home DS0000066680.V288593.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Changes are needed to both the Service Users Guide and the Statement of Purpose so that they accurately provide full information about the service. This will provide the correct information to enable people to make informed decision about the home. The home has its own assessment plan to ensure that any new service user’s needs are fully assessed prior to their admission. EVIDENCE: The ownership of the home has changed since the last inspection. The registered manager must amend the statement of purpose and service users guide to reflect this change and update any relevant information in both documents. This is to ensure that prospective service users have the information they need to make an informed choice about where to live. The manager is reminded that the service users guide and the statement of Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 9 purpose should be kept under review (by the registered person) and revised should any changes to the service occur. It is also recommended that the service user’s guide is made available in a language and/or format suitable for intended service users. Service users are only admitted to the home after a full assessment of their needs has been carried out by the home and the Placing Authority for individuals referred through Care Management, involving the prospective service user/recognised representative. The home has a contract with the Health Authority to provide intermediate care for one service user at any one time. A dedicated bedroom is provided together with specialist support from the relevant professionals, such as OT’s and physiotherapists. Croft Nursing Home DS0000066680.V288593.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Generally suitable arrangements are in place to ensure that service users’ physical and emotional health care needs are identified, planned for and met. Personal care is carried out in a way that service users prefer so that dignity and choice are maintained. Medication is well managed to maximise good health. EVIDENCE: A sample of service user’s care plans were examined and it was evidenced that all aspects of service users’ physical and cognitive needs are being appropriately addressed. Service users expressed their satisfaction with the help provided by care staff, and felt that their care needs are being well met. It is recommended that service users sign their care plans if they are able to do so. The registered manager was able to demonstrate, through individualised healthcare records, that service users are in regular contact with General Practitioners and other health care specialists as required. The home also Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 11 keeps records of all the service users healthcare appointments, in addition to individual daily progress notes. In general, medication records, including medicines received, administered and returned were all being appropriately maintained. The registered person has met all the requirements made at the last inspection with regards to medication. Observation of the staff team interacting with the service users showed that the carers were mindful how they addressed service users, and they were seen to be polite and friendly. Service users are always treated with respect and dignity in accordance with the homes statement of purpose. The manager stated as part of the admission assessment process service users wishes regarding arrangements after death are discussed and recorded in individual care plans. Croft Nursing Home DS0000066680.V288593.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are being provided with a range of opportunities for recreational and social activity that is in accord with their social, cultural and religious needs. They are assisted to maintain contact with family and friends, and links with the local community are encouraged. Service users are able to exercise choice and control over their lives. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. EVIDENCE: Service users are evidenced as being provided with a range of opportunities for recreational and social activity that is in accord with their social, cultural and spiritual needs. The home is very well situated for local shops and public transport - which enables participation and integration into the local community. Service users are encouraged to maintain contact with friends and relatives and to develop links with the local community. Service users are encouraged to Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 13 receive visits from relatives and friends, and to go for outings with them wherever possible. The service users’ comments and observation confirmed that the home is run in a manner that promotes choice and independence. One of the service users stated, “ I am very happy here”. Service users can bring in their own possessions and furniture if they wish and this was observed in service users’ rooms, which had been individualised. The home has some responsibility for small amounts of money held for service users. Records were seen to be accurate and well maintained. It was clear from the menus that a wide variety of different food options were available in the home with a lot of consideration given to the nutritional value of the meals provided. The menus offer a choice of meals, and when the published menu options are not desired on the day, alternatives are offered. The manager informed that the advice of dietician is sought as necessary. It was positively noted that the manager is in the process of carrying out a quality audit as far as the menu is concerned. Croft Nursing Home DS0000066680.V288593.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Complaints are generally managed well, which should ensure that service users’ and relatives’ concerns are listened to. The home’s policies and procedures help protect service users from abuse and help staff if they need to tell someone about any bad care practice they may see. EVIDENCE: The home has a complaints procedure that is conspicuously displayed in the home for all to view. The procedure explains how to make a complaint and that the complainant can expect a response about the outcome of any investigation to a complaint within 28 days. There have been no complaints since the last inspection. The home has in place procedures for responding to suspicion or evidence of abuse, including whistle blowing, and passing on concerns to the Commission For Social Care Inspection. The London Borough of Sutton’s adult protection procedures were available in the office on request. There have not been any adult protection concerns raised. The manager informed that she carries out abuse awareness training for staff on a regular basis. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 15 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): 19,25 and 26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home is generally hygienic, clean, homely and comfortable however the call bell system is not working and this potentially places service users at risk. EVIDENCE: The home is suitable for its stated purpose. Furnishings and fittings were of good quality and the home was decorated to a reasonable standard. The garden is well maintained and there is a patio area with furniture for service users to sit and enjoy the garden. During the course of the inspection, the manager informed that the call bell system was not working however she stated that staff were checking on the service users every 20 minutes. The registered provider was contacted and he gave assurance that the issue was being looked into. In the meantime it was agreed with the manager that staff should check on the service users every 15 minutes and to have an extra member of staff on night duty until the call Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 16 system is repaired. The registered provider is required to ensure that the call system is in working order at all times for the safety of service users and staff. The home is clean, hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. The home has an infection control audit that was carried out in April 2006.The manager stated that some of the recommendations made, have already been met. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has the numbers and skill mix of staff sufficient to meet service users’ needs and ensure their safety. The home’s recruitment procedures protect the service users through vigorous staff vetting. There is a staff training and development programme in place. This ensures that staff fulfil the aims of the home and meet the changing needs of service users. EVIDENCE: Copies of the off duty rotas were seen. Staffing numbers and skill mix of staff are appropriate to the assessed needs of the service users, the size, layout and purpose of the home. From the Pre-inspection questionnaire that has been completed by the manager it was noted that 9 staff members holds NVQ2 qualification. The home currently employs 19 care staff excluding registered nurses. Recruitment procedures seemed appropriate. Three staff files were examined at random and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 18 There is a staff training and development programme in place. The manager is very proactive in respect of staff training. The manager was able to produce documentary evidence of staff attendance of a variety of different training courses that were relevant to the work staff were expected to perform. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 19 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): 31,33,35,36 and 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home is generally managed well however the health, safety and welfare of service users and staff are not being promoted/protected and this potentially places them at risk. EVIDENCE: Throughout the course of the inspection the manager demonstrated a good competent management skills and appears to have created a skilled, positive and enthusiastic workforce. She has many years experience of working with this client group and displayed an insight into the relevant issues. She is presently doing the Registered Managers Award course and hoping to complete it by the end of the year. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 20 The home has a good quality monitoring system. This ensures the home is run in a way that is in the best interests of the service users. The families of all the homes service users attend to their relatives’ finances, and in some cases solicitors are involved. The manager informed that small amounts of money are kept in separate envelopes for each service user with a running balance sheet appropriately maintained for sundries, such as hairdressing costs. A sample of these was seen and was accurate and well maintained. The staff supervision records were not sampled as the deputy manager stated that they were not up to date. The registered manager is required to ensure that formal supervision sessions are held with all care staff at least six times a year, and that these sessions are recorded and signed by both the supervisor and supervisee. One health and safety issue arose during the inspection. The call bell system was not working for which a requirement has been issued (see standard 25). Certificates relating to health and safety were up to date. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 21 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 2 X 3 X X 3 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 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 and 5 Requirement The registered manager must amend the statement of purpose and service users guide to reflect the change in registered provider’s details and update any relevant information in both documents. The registered provider is required to ensure that the call system is in working order at all times for the safety of service users and staff. Timescale for action 31/08/06 2. OP25 23(2)(c) 13(4)(c) 07/07/06 3. OP36 18(2) The registered manager is 15/08/06 required to ensure that formal supervision sessions are held with all care staff at least six times a year, and that these sessions are recorded and signed by both the supervisor and supervisee. Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 23 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 OP1 Good Practice Recommendations It is also recommended that the service user’s guide is made available in a language and/or format suitable for intended service users. It is recommended that service users sign their care plans if they are able to do so. 2. OP7 Croft Nursing Home DS0000066680.V288593.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. 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