Inspection on 22/07/05 for Croftlands

This inspection was carried out on 22nd July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Croftlands 12/09/07

Croftlands 28/08/06

Croftlands 10/02/06

Croftlands 10/03/05

Croftlands 15/04/04

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

CARE HOME ADULTS 18-65 Croftlands 41 Durranhill Road Carlisle Cumbria CA1 2SW Lead Inspector Liz Kelley Unannounced 22 July 2005 14:30 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Croftlands Address 41 Durranhill Road Carlisle Cumbria CA1 2SW 01228 524296 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Croftlands Trust Penny Poxon Care Home 10 Category(ies) of MD - Mental Disorder registration, with number MD(E) - Mental Disorder, over 65 of places Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. To accommodate nine people in the category of Mental Disorder (1MD). 3. To accommodate one named person in the categroy MD(E) (1 MD(E) Date of last inspection 10 March 2005 Brief Description of the Service: Croftlands accommodates up to 10 people who have difficulties in maintaining aspects of their mental health. The intention of the service is that people can live in the home for up to three years. The goal is to help service users move onto other accommodation where they can live as independently as possible. The premises are a large detached three-storey Victorian style property, which has been modernised and converted for its current usage. The house is situated in a suburb of Carlisle and stands in its own walled gardens with a driveway leading upto the entrance. Each service user has an individual bedroom with wash hand basin, and each floor has a bathroom or shower room. There are two lounges and two kitchens on the ground floor; one of the lounges is designated as a no-smoking area. An office, staff room and staff sleeping in room is also provided. Croftlands is run by The Croftlands Trust; this is a non-profit making organisation, which runs a number of residential and community based services in the County for people with mental heath problems. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 3 hours. Six service users were in across the day and spoken to. Four staff members were on duty, and a staff meeting was observed. Feedback cards had been received from visiting professionals earlier in the year. What the service does well: 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. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 Prospective service users are given thorough assessments by the home, and supporting assessments from mental health professionals, which ensures suitability, and a good success rate at placing people at the Home. EVIDENCE: Documentation confirmed that service users were admitted only on the basis of a full assessment involving relevant professional input and consultation with service users and their families, where appropriate. A senior Community Psychiatric Nurse was contacted, and they confirmed this practice, with ample opportunities to visit prior to making a decision to move in. Since the last inspection a new service user had been admitted to the home and the appropriate assessments had been received prior to admission. Evidence indicated that all referrals to the home were agreed by the Carlisle Adult Community Mental Health Team and on an enhanced care programme approach, including a risk assessment. These measures all indicate that the service has good working knowledge of both good practice guidelines, and their legal obligations under the Mental Health Act. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 The home is skilled at including service users in developing care plans that promote the individuals responsibility in maintaining and stabilising their mental well-being. EVIDENCE: Individual plans contained comprehensive information on the needs of each service user and the reason for their placement, in-line with the Care Programme Approach as recommended by the Mental Health Act 1983. Service users spoken to were aware of their Plans and stated that they were fully involved in setting goals. The Home had a comprehensive computer system for recording daily and monthly notes, which in turn informed regular review meetings. Included in these plans were individualised contingency plans with indicators in changes in behaviour that would trigger staff to seek further advice or putting agreed strategies in place. The Home’s recording, communications systems and the on-going development of care plans is identified as good practice leading to service users having a responsive and informed service. The Home was able to demonstrate that limitations and restriction on choice had been made to prevent self-harm, self-neglect and harm to others and were made in the person’s best interest. In discussion with the staff team and Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 9 service users it was evident that the issues of duty of care vs. rights was a frequent topic for debate and in many cases was central to the individuals care plan. This ethos creates boundaries and promoted the home as a therapeutic setting were service users were supported to make positive changes in their life. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12 Service user are given ample opportunities to develop and maintain positive relationships with and outside of the Home. EVIDENCE: Service users were supported to maintain and develop relationships with the community and were in contact with relevant professionals, such as community psychiatric nurses, to assist in developing their social skills. Details of staff involvement in this process where found on individual care plans. Service users were observed interacting in a positive manner with staff and other service users. There was lively conversation and an interest in the welfare of others in the home. All service users had an individual timetable of weekly activities involving training and social activities. A typical timetable included activities at a day centre that would involve learning or developing practical skills or outings and evening activities to clubs, pubs and other social activities. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,20 The home had good policies and procedures for medicines handling including self-medication and staff gave good support to assist service users in staying healthy. EVIDENCE: The home encouraged and supported self-medication by service users and undertook thorough risk assessments. This was an example of good practice and measures were noted to put in place if problems arise with self medication. At a previous inspection the Pharmacy Inspector made requirements and recommendations which the manager has not yet responded to. The manager must also review how medications are administered and record to reduce the number of errors that were noted. Records confirmed that service users had access to a full range of general health care services and more specialised services, such as psychiatrists, community psychiatric nurses and behaviour specialist. On the day of inspection one service user was being supported to attend a GP appointment. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not looked at on this inspection. EVIDENCE: Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 Croftlands is a comfortable and well-maintained house which has ample space for service users to relax in company or spend time alone. EVIDENCE: The home had a convenient location for accessing local services, the town centre and the community; many facilities were within walking distance, and a bus service passed the end of the drive. All bedrooms were single and of a good size, allowing service users to spend time in their rooms. The house is well maintained, and a number of requirements made at the last inspection had now been addressed. Although, well maintained the Home would benefit from having a planned programme for renewals, replacements and redecoration. Staff have been endeavouring to keep the gardens tidy but the area is far too large for staff to spend time away from service users trying to keep on top of this large area. This gives a poor first impression when the rest of the home is well kept. The organisation must put proper arrangements in place to keep the grounds tidy. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,35 Service users benefit from a skilled and well trained staff group who are well supported by the organisation. EVIDENCE: A number of staff spoke of recent training which included: first aid, fire warden and health and safety courses demonstrating the organisations commitment to promoting a safe and well-run home. A staff member interviewed spoke of their induction and training and considered they were well prepared for the role, and had progressed onto NVQ3. A training profile for the home was not available at inspection and the manager should arrange for this to be made available for future inspections. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40, Good systems are in place to ensure the well-being and safety of those that live and work at Croftlands. EVIDENCE: Croftlands is part of an organisation that has systems in place to audit and check both the care provided and the physical aspects of the building and procedures conducted within it. A management visit is carried out at least monthly and new Quality Assurance systems are being trialled to seek views of service users. Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 x x x x x Standard No 31 32 33 34 35 36 Score x 3 x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Croftlands Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 3 x x x F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 17 yes 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. 1. 2. Standard 20 20 Regulation 13 13 Requirement Safe storage of medicines for self-administration must be provided(Previously 30.04.05) Record’s of consent to hold and administer medication for service users must be gained(Previously 30.04.05) The Home’s must have a five yearly electrical wiring certificate(Previously 30.04.05) A training programme and profile for the Home, must be developed and send this into the Commission for Social Care Inspection(Previously 16.05.05. Gardens must be kept tidy and the grounds well-maintained Timescale for action 30.09.05 30.09.05 3. 4. 42 35 23 18 30.09.05 30.09.05 5. 24 23 30.09.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 20 24 Good Practice Recommendations The homes systems of recording and dispensing should be reviewed to eliminate recurring errors A programme for renewal and refurbishment should be set up. F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 18 Croftlands Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Croftlands F58 F10 s22572 croftlands v232530 220705 ui stage 4.doc Version 1.30 Page 20 - 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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