Inspection on 03/11/05 for Croft, The

This inspection was carried out on 3rd November 2005.

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

Croft, The 28/03/08

Croft, The 09/03/07

Croft, The 11/05/05

Croft, The 13/10/04

Croft, The 08/06/04

Similar services:

21 High Street

Vale House

Chestnut Walk

Dunwood Manor Nursing Home

The Old Vicarage

Excelsior

Cherwood House Care Centre

Durban House Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Croft, The Hooke Hill Freshwater Isle Of Wight PO40 9BG Lead Inspector Lynda Mosling Unannounced Inspection 3rd November 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Croft, The Address Hooke Hill Freshwater Isle Of Wight PO40 9BG 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) 01983 752422 01983 752422 Mrs Patricia Anne Foster Mrs Caroline Joy Metcalf Care Home 16 Category(ies) of Dementia - over 65 years of age (12), Learning registration, with number disability over 65 years of age (2), Mental of places disorder, excluding learning disability or dementia (2) Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11/05/05 Brief Description of the Service: The Croft is a large detached house in a residential area of Freshwater, close to all amenities. It is registered as a care home for a total of 16 residents, 14 over 65 years of age and 2 under 65 years. The home specialises in caring for people with dementia and/or mental health problems. The home is on two levels and as there is no passenger lift the residents living upstairs need to be mobile. None of the bedrooms are en-suite. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and was undertaken by one inspector. There were 15 residents accommodated on the day of the inspection and were observed with staff in the lounge area. There are many residents with communication difficulties but those who were able to spoke to the inspector. One resident was interviewed separately and was clear that the care is good and the staff ‘patient and kind’. The inspection included speaking to staff, the manager and examining records. The previous inspection assessed most of the key standards, so only the remaining ones were covered at this inspection. Evidence seen points towards this being a caring home for people with dementia and mental health difficulties. Staff were observed treating the residents with respect and affection. What the service does well: The home provides thoughtful and tolerant care for residents with dementia and mental health difficulties. The staff have good knowledge of the individual needs of the residents and plan the care to meet these needs. Training is seen as a priority and the majority of staff have gained the NVQ 2 or 3. The staff are competent and enjoy their interactions with the residents. Recruitment processes are thorough and prospective staff are invited to the home to meet the residents prior to interview. There have been more enquiries about jobs than there are vacancies to fill as the home has a good reputation for holding on to staff. The staff enjoy the interaction with the residents and treat them with affection and respect. Residents are encouraged to retain control of their lives and staff are skilled at interpreting the non-verbal responses of residents. There is a resident and visitor feedback form that invites comments about the home and the way the care is provided. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 6 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. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5. Written contracts are provided for each resident and set out the fees to be paid and by whom. Prospective residents, relatives and representatives are invited to visit the home to assess whether it is suitable for their needs. EVIDENCE: Residents have contracts and terms and conditions of the home that set out the expectations of the home, the cost of the service and how the fees will be collected. Social services do annual financial reviews of the funded residents. Residents who are able pay their fee by cheque, others have their invoices dealt with by the family. Contracts were seen and the resident spoken to said that he has total control of his finances and pays his fees direct to the home. The manager confirmed that all of the residents have their weekly allowance and do not miss out financially. The manager encourages the prospective resident and their family/friends to visit prior to placement to help them make an informed decision about the suitability of the home. The manager feels this is particularly important given the needs of the residents currently placed. The home is well known by the Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 9 local care managers and rarely get inappropriate referrals. Prospective residents can visit the home and stay for trial periods prior to agreeing to the placement. A brochure giving details about the home is available to interested parties. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 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): 9. Medication is correctly stored and administration is recorded and checked by the manager. EVIDENCE: The staff have had medication awareness training provided by Bournemouth University and the local college. This has helped the staff understand their responsibilities and also gain an awareness of the effects of the medication they are administering. The drugs are provided by the local pharmacy in a Nomad system that the manager checks on a weekly basis. Reviews of the medication are regularly undertaken by the GP for each resident. There are frequent changes of medication and these are written on the medication administration records. Some of the residents do not like taking tablets so the manager negotiates with the surgery to get the medication in liquid form. This removes the anxiety of ensuring the residents take their correct dosage. There are no residents currently self-medicating. The medication records were seen and were up-to-date, signed by the administrating staff and signed once checked by the manager. Policies and procedures covering medication are in the staff room. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 11 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 and 14. Residents are able to follow their interests and activities are planned around the needs of the individual. Although many of the residents are dependent on the staff they are all able to make their feelings known and staff encourage them to make choices and retain control of their lives. EVIDENCE: In discussion with the staff and manager it was clear that each resident is well known and their likes and dislikes respected. The residents like one to one activities mainly, with some enjoying going out in the car, shopping etc. Others do not enjoy leaving the home and will be given individual attention indoors. This can include hand massage, chatting, brushing hair etc. Group activities are not generally enjoyed, although music is appreciated by all, including sing-alongs and soothing background music. Two residents choose to spend the majority of their time in their rooms. One of these likes to read, talk to friends on the telephone, watch television and purchase paintings to place on the walls. He said that he is supported to do whatever he wishes by the manager and staff. There are plans to link the home with a day centre next door which will provide residents with additional activities, including hairdressing, massage etc. When the extension is built there will be a covered link to the centre. It is hoped that Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 12 this will provide enough security for the more anxious residents to make use of the resource. Staff are skilled at understanding the non-verbal communication of the residents and can interpret the residents’ reactions. This ensures they are able to keep as much control over their lives as possible. The care plans record the most useful ways to communicate with each resident and staff were seen helping residents make choices and respecting their views. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 13 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): These standards were assessed at the last inspection so were not covered during this inspection. EVIDENCE: Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 14 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): 20 and 22. The communal space within the home is limited but appears to meet the needs of the current residents. Plans for an extension are in the process of being drawn up. Specialist equipment is provided where needed i.e. wheelchairs, but the home would benefit from larger doorways and space to move around more freely. EVIDENCE: There is a garden that is accessible to the residents, but most will only go out if accompanied by a member of staff. The indoors communal space is limited, although the residents appear content to sit with the group in the lounge. There are plans for an extension of the home that will provide a private room for residents and additional communal space. The Commission has been involved in discussions regarding this extension. The residents were observed enjoying their interactions with staff and other residents in the lounge. If residents are risk assessed as being able to freely move around they are able to do this both inside and outside of the home. However, many residents like staff to accompany them during their walks around the house. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 15 The home has sliding sheets, pressure mattresses etc. The staff have all been trained in manual handling and have experienced, as part of the training, being lifted by hoists etc. This has helped them to appreciate the anxiety of some of the residents who require lifting equipment and has made them aware of how vulnerable it can make residents feel. Wheelchairs are used to assist some residents with mobility, but the home is not designed to take wheelchairs and it can be a struggle. In the planned extension the doorways will be wider and space for wheelchairs taken into consideration. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 16 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): 29 and 30. The home has a safe, thorough recruitment procedure to ensure the safety of the residents. Training of staff is supported by the manager and over 75 of staff have NVQ 2 or 3. EVIDENCE: The staffing situation is good at the moment with a waiting list of people wishing to work at the home. The recruitment process includes taking up personal references, enhanced CRB and POVA checks. A sample of staff files was looked at and confirmed that the appropriate records have been kept. The manager confirmed that she will be starting to update CRBs in the new year as some are now 3 years old. Prospective staff are given the opportunity to meet with the residents and staff prior to interview and the manager will listen to the feedback from staff and residents before making a decision. New staff undergo a period of induction without providing personal care until they feel confident and competent to provide the necessary care. Training for staff this year has included: dementia awareness, medication administration, adult protection, manual handling and first aid. In addition NVQs have been completed. There are now only 4 staff without a NVQ qualification. The home has the Investors in People award and will be re-assessed for this next year. Foundation and induction courses are completed by all new staff. Staff spoken to confirmed that they are ‘strongly encouraged’ to undertake NVQs and most found the training useful and informative. The manager is very keen to undertake all the training she expects her staff to undertake and actively seeks Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 17 out appropriate training for herself. She is currently doing an Occupational Therapy course. The staff display good knowledge of the residents’ needs and feel they have made a positive choice to work with this group of residents. One said ‘it is really rewarding and never boring’. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 18 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): 33 and 38. The home has a resident and visitor feedback leaflet to help assess the success of the home at meeting residents’ needs. Policies and procedures are in place to promote the safety of the residents. EVIDENCE: The home has designed some simple response cards for residents and visitors to complete. These can be used at any time but the manager encourages residents to complete them annually. Relatives have open feedback with the staff and the manager and speak to them after each visit about how the resident is doing. There are care reviews on all but one of the residents and Mencap is a visitor to one. All these contacts are used to look at how well the home is meeting the assessed needs of the resident. Although very skilled the manager is aware of the limitations of their expertise and has built up a good relationship with the local psychiatric services. Residents are therefore able to access residential re-assessments at local hospitals when needed. Residents Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 19 spoken to said they feel they are considered as individuals and not only feel well care for but ‘cared about’. The quiet and competent way the staff provide care at the home has raised residents’ self-esteem and confidence. Risk assessments for each resident were seen as well as those for the home generally. Residents’ care plans include risk assessments covering such things as swallowing difficulties, risks of falls, risk of aggressive behaviour and the action required to minimise these risks. All staff accept that they have a responsibility for the health and safety of the residents and report any concerns they have. One of the staff does the maintenance and is available most days to do repairs and arrange for larger maintenance issues. The records of checks on the fire equipment was seen and the report of the recent fire officer’s visit was copied to the Commission. The only requirement had been with regard to signs and this has been actioned. The manager completes most of the paperwork relating to risk assessments but the staff confirmed that they access this from the residents’ files and discuss any additional risks in the keyworker meetings. Staff safety is also taken seriously and assessments regarding safe handling and the need to use two carers for some tasks are recorded. Policies and procedures regarding infection control, dealing with aggression etc. are in place. Staff sign these to confirm they have been read and understood. Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 20 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 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x X 2 X 3 X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 21 No Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Croft, The DS0000012480.V249333.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!