Inspection on 31/07/07 for Croftside

This inspection was carried out on 31st July 2007.

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

Croftside 20/04/06

Croftside 23/11/05

Croftside 29/06/05

Croftside 22/11/04

Croftside 06/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Croftside Beetham Road Milnthorpe Cumbria LA7 7QR Lead Inspector Mrs Margaret Drury Unannounced Inspection 31st July 2007 10:15 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 Croftside DS0000036503.V342554.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. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Croftside Address Beetham Road Milnthorpe Cumbria LA7 7QR 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) 015395 63325 www.cumbriacare.org.uk Cumbria Care Mr Terence Michael Pollard Care Home 35 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (34), of places Physical disability (1) Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The home is registered for a maximum of 35 service users to include: - up to 34 service users in the category OP (Old age, not falling within any other category) - up to 15 service users in the category DE(E) (Dementia over 65 years of age) - 1 named service user in the category of PD (Physical Disabilities) may be accommodated within the overall number of registered places 20th April 2006 Date of last inspection Brief Description of the Service: Croftside is owned by Cumbria Care, an internal business unit of Cumbria County Council. The home is registered to provide care and accommodation for up to thirty-five older people, including fifteen with various forms of dementia. Croftside is situated in a residential area of Milnthorpe and is close to all local amenities, shops and bus routes. It is purpose built and situated over two floors, the upper floor being serviced by a passenger lift. All rooms are single and personal to each resident. The ground floor of the home is used for the care of those residents suffering from dementia. It is comprised of a large, airy lounge and a dining room with kitchen facilities, a small smoking lounge and residents’ bedrooms. There are also bathing and toilet facilities available. The first floor is spilt into two units caring for frail elderly residents. There is a lounge/dining room on each unit together with residents’ rooms. All bedrooms have wash hand basins and there are three with en-suite toilet facilities. The toilets and bathrooms on both floors are equipped to assist people with a physical disability. There are well kept gardens around the home for the residents to enjoy and car parking facilities are provided at the front of the building. The fees in this service range from £317.00 - £422.00 per week as at the date of the visit. There are extra charges for chiropody, hairdressing, newspapers, toiletries and taxi fares. This home does not provide intermediate care. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit, that forms part of the key inspection, took place over one day in July. Information regarding this service had been received in a variety of ways: • An Annual Quality Assurance Assessment document completed by the manager • Returned survey forms from residents • The service history • Interviews conducted during the visit A discussion with the manager about the administrative procedures and general running of the home and a tour of the building was undertaken. During this visit all the key standards were assessed. What the service does well: All residents are fully assessed prior to admission to ensure all needs can be identified and met. Family members are invited to b part of the assessment process providing the resident is in agreement. People living in this home are encouraged to exercise choice and control over their own lives. This was confirmed by a small group of residents who were sitting together after lunch. “We can sit here for a chat with our friends” and “this home is great, I can do what I like” were comments made. Social, health and personal needs are outlined in each resident’s care plan. The information contained gives the care staff the ability to provide a high standard of care. Although there have been staff shortages in recent months steps are now being taken to address this problem. Some comments made about the staff team included, “you won’t find better carers anywhere” and “ they are lovely girls, and very kind” Croftside DS0000036503.V342554.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Croftside DS0000036503.V342554.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 Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service and their representatives have the information they require to make an informed choice about moving in. EVIDENCE: Information about this home and the services it provides is available to all who visit to look at available rooms. There is a statement of purpose and resident’s guide, copies of which are on display at the front of the home. A copy of the latest inspection report is also available. The manager is currently looking to prepare an information pack containing all the necessary information about the home. This will be available for anyone interested in visiting the home on behalf of a family member or friend looking for accommodation. A new brochure is currently being prepared by Cumbria Council and should be ready shortly. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 9 The home manager ensures that individual care needs assessments are carried out for each prospective resident. Admissions do not take place without this information and consideration is also given to the needs of those people already living in the home before a place is offered. Discussion with the manager evidenced that the assessments are carried out in a professional and sensitive manner involving the individual,their family or representative where appropriate. Residents who spoke to the inspector said they were able to visit the home to look around prior to moving in. if they were not able to do so, a family member or friend visited on their behalf. They agreed that this gave opportunity to meet the staff and others who live at Croftside. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans are implemented to help ensure that residents’ needs are identified and met. People living in the home are treated with dignity and respect. EVIDENCE: All residents have an individual plan of care that is prepared from information gathered during the care needs assessment. Care plans were detailed and individualised and included aims to help residents maintain their independence. These documents are reviewed each month but the “tick box” system that is used does not always show a true reflection of any changes in the level of care required. Cumbria Care is in the process of changing the format of the care plans in order to introduce a more “person- centred” approach. This will take into account the social, health, spiritual and cultural needs of the residents and provide more details of the life of the resident before they moved in. The plans Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 11 will also show the resident and/ or their family’s involvement, where appropriate, in the preparation of the plan. Daily notes are kept in respect of each resident showing details of significant events and occurrences. Records are kept of G.P and other healthcare professional visits. Nutritional screening is being introduced with a member of the care staff having delegated responsibility for weighing residents and monitoring the outcomes. The home has designated staff that is responsible for the administration of medication and work to the corporate practice of having a second member of staff to act as a “checker”. All the staff involved have completed training to ensure they carry out this duty competently and safely. Records were checked and found to be in order and completed correctly. Medication is correctly stored and there is provision for the safe storage and recording of controlled drugs. Staff were seen to speak to residents in a polite manner and assist them in a way that ensured dignity and privacy were maintained. Residents told the inspector that “the girls are lovely” and “ the staff are always polite but you can have a laugh and joke with them”. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to maintain contact with families and friends. Some social and leisure activities are offered for residents to enjoy if they wish. EVIDENCE: Residents living in the home said there were some activities available but the manager confirmed that these have been limited lately due to a shortage of staff. This is particularly relevant to those taking place outside the home. As staff are currently being recruited this should improve in the near future. Some residents do help in the garden, as they enjoyed this activity before they came to live in the home, whilst others just enjoy sitting outside when the weather is warm. One part of the garden has new fencing that has made the area completely safe for the residents to enjoy. Routines are flexible to meet the changing needs of the residents and staff in the dementia care wing were observed sitting and chatting to the residents after lunch. The manager is hoping to introduce more activities in the future Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 13 but also realises there are those residents who prefer their own company on occasions. Spiritual needs are met through regular church services and communion is provided for those wishing to receive it. Lunch was served to residents on each of the units in a relaxed manner with help given appropriately when required. There is always a choice at each meal and comments such as, “ the food is very good”, and I always get plenty to eat” were made. Menus are currently being revised after a recent meeting between the manager and the catering staff to take into account nutritional needs and healthy eating. The home has two cooks who speak regularly with the residents to ask for opinions and suggestions. Family and friends are welcome to visit the home anytime and are always offered refreshments. There are a number of places in the home that residents can meet with their visitors in private if they do not with to use their room. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that their concerns are listened to and acted upon. They are protected from abuse by the procedures in place and staff training that is available. EVIDENCE: The home has policies and procedures in place in relation to complaints and concerns, with details on display in the hall. The complaints procedure is also contained in the resident’s guide that is given to all new residents. Those who spoke to the inspector all said they would speak to the manager or one of the supervisors if they had any concerns to discuss. They did also say that they “had no complaints anyway”. There is a complaints log, which the manager said she would ensure is always kept up to date. Some adult protection training has been provided for the staff and there are policies and procedures in place covering this subject. The home also has a copy of Cumbria Council’s protocol that is available for the staff to read. There was an incident recently, prior to the appointment of the new manager. This was referred to social services department although initially the correct procedure was not followed. The manager is currently trying to arrange further adult protection training for herself and the care staff, although places are Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 15 limited. In the meantime she is going to see if she can access external training from another source. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is warm and comfortable and is suitable to meet their needs. EVIDENCE: The home is purpose built with accommodation over two floors, the upper being accessed by a passenger lift. Since the last inspection the alterations to the dementia care unit on the ground floor have been completed. The changes mean that the residents have much more communal space available for them to enjoy. The atmosphere in the lounge was calm and relaxed with the residents enjoying their morning coffee. There is another smaller lounge that is available for private meeting with family and friends. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 17 The bedrooms on this floor are well maintained and many of them are larger than those on the upper floor. They have all been personalised by pictures and photographs from the residents’ own homes. The first floor has two separate units each having a lounge with dining and kitchen facilities and also residents’ rooms. There has been no redecoration on this floor since the last inspection and some parts are now in need of refurbishment. The home manager has been assured that there are now the financial resources available to redecorate rooms and communal areas. The residents have personalised their rooms and all who spoke with the inspector said how pleased they were with their accommodation. There are a couple of sitting areas on this floor and the inspector was able to speak with four residents who were enjoying an “”after lunch” chat. Comments made included, “ I am very happy here and am able to enjoy my day as I please” and “ the staff are lovely and so very kind, I would not live anywhere else”. Thee are sufficient bathrooms and toilet facilities and three of the bedrooms have en-suite toilets. All the bathing areas are large enough to accommodate any resident with a physical disability. There is outside space for the residents to enjoy and new fencing has been erected around parts of the garden that has made it a secure area. One of the staff vacancies covers domestic hours and currently existing staff are helping out. The home was extremely clean, fresh and tidy on the day of the visit. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff are recruited in a safe and responsible manner and able to understand and meet the needs of those living in the home. EVIDENCE: Although there have, in the past, been difficulties recruiting suitable staff the manager confirmed that she has ensured that there has always been sufficient to meet both the requirements and the needs of the residents. A new support worker was due to start work the day after the visit and permission has been given by the organisation to advertise for the remaining vacant hours. The home does employ only two waking members of night staff and Cumbria Care is recommended to give consideration to increasing this number. This takes into account that the home is registered for thirty- five residents, fifteen of which are cared for in the dementia care unit. Staff training is ongoing although the manager did advise that it is extremely difficult to access places on training courses. These are always on a “first come, first served” basis and very often the places are taken before she is able to apply. Staff said they enjoyed the training they received but did feel they sometimes missed out because of the lack of spaces. Almost half the care staff are qualified to NVQ level 2 with some currently working towards the award. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 19 The staff recruitment and selection follows the procedure put in place by Cumbria Care. It is robust and ensures no new member of staff starts work until all the Criminal Bureau (CRB) and protection of vulnerable adult (POVA) checks have been completed and references obtained. This ensures the safety of the residents at all times. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a qualified, experienced manager who gives the interests and care of those living in the home a high priority. EVIDENCE: The manager has worked for Cumbria Care for many years and has completed the registered manager award and NVQ level 4 in management. She has, only recently, been appointed to Croftside, having previously managed another home within the organisation. She has an open and positive style and realises she has a lot to do, as the home has been without a registered manager for some considerable time. Discussions with her and supervisor on duty confirmed that she has settled down and getting to know the residents. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 21 The residents who talked with the inspector said that they “saw Shirley every day” and that she “was available to speak to at any time”. The home is responsible for small amounts of residents’ monies used to pay for hairdressing, chiropody or newspapers. Records are kept with all receipts held on file and expenditure signed out by two members of staff as a safeguard for the residents. The manager has systems in place to ensure the home is run safely. Water temperatures are checked, fire safety equipment is tested and risk assessments are completed and reviewed. The annual health and safety audit carried out by Cumbria Care was recently completed and the manager is awaiting the report from the health and safety manager. All equipment is serviced under annual contracts. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 3 3 X 3 3 3 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 3 3 X 3 3 X 3 Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 23 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 It is recommended that consideration be given to increasing the number of waking night staff to deal with he increasing dependency of those living in the home. Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Croftside DS0000036503.V342554.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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