Inspection on 18/07/07 for Cromarty House

This inspection was carried out on 18th 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

Cromarty House 06/07/06

Cromarty House 13/12/05

Cromarty House 26/05/05

Cromarty House 02/02/05

Cromarty House 29/07/04

Cromarty House 03/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Cromarty House 11 Priory Road Bodmin Cornwall PL31 2AF Lead Inspector Alan Pitts Unannounced Inspection 18th July 2007 10:00 Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 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 Cromarty House DS0000044661.V345365.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 Adults 18-65. 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. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cromarty House Address 11 Priory Road Bodmin Cornwall PL31 2AF 01208 78607 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) Mr Roger Tarrant Mrs Debra Tarrant Position Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 6 adults with a learning disability (LD) aged 18 to 65 years. 6th July 2006 Date of last inspection Brief Description of the Service: Cromarty House is a detached property set in its own grounds with private parking at the rear of the house. The home is within easy walking distance of Bodmin town and shopping area. Cromarty House provides care and accommodation for up to six younger people with a learning disability, some of who may present with challenging behaviour. The home provides six en-suite single bedrooms and well-furnished communal areas. The accommodation is on two floors, three ground floor bedrooms and three first floor bedrooms. There is a bathroom on the first floor and an additional toilet on the ground floor. Externally there is a garden area for the use and enjoyment of the service users. The accommodation would not be suited to anyone who was reliant on wheelchair for mobility although a person with limited walking ability could probably manage in a ground floor room. Fees range from £668 - £1200 per week. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection took place on the 18th July 2007 and was unannounced. Two inspectors carried out the inspection over a period of approximately five hours. The inspectors spoke with residents, staff, and the registered provider. The inspectors walked around the home, observed practices and examined documentation. What the service does well: What has improved since the last inspection? What they could do better: Cromarty House provides a safe, comfortable home for a small number of residents. The registered provider states that an application for a new registered manager will soon be made, which can only benefit staff and residents alike. More could be done to ensure that there is a consistent understanding of adult protection procedures. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 6 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. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are properly assessed prior to admission. EVIDENCE: A joint assessment was carried out with the persons’ social worker for the most recent admission to the home. The resident enjoyed a meal at the home, and then spent a further day at the home before deciding to move in. The residents’ family also visited. Terms and conditions of residence are available at the home and are provided to referring authorities and residents’ family/representatives. There is a Statement of Purpose, and a pictorial Statement of Purpose provided in residents’ rooms, the latter being suitable for purpose but could be expanded upon. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care needs and capabilities are clearly understood. Residents are involved in their care and assisted to make informed choices and to take risks responsibly. EVIDENCE: Discussion with staff and examination of care documentation confirms that residents are included and involved in developing their own plan of care. Care plans are regularly reviewed and include comprehensive risk-assessments. The care plan also includes any restrictions on choice and freedom, and staff provide the residents with the information they need in order to make informed decisions. Residents also complete a ‘my life, my plan’ section. The care plans include financial managements and the residents capabilities are recognised and encouraged where possible in this respect. There are relevant and appropriate procedures in place. The staff can access the care plans as required and during the course of the inspection the staff presented as having a very good understanding of the needs of the residents. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 10 Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given appropriate information and assistance in order to live a fulfilling life, which includes friends and family. Residents enjoy a health, varied diet. EVIDENCE: The daily records detail the activities that people are offered. These can include attendance at day centres, exercise sessions, trips out, visits to favourite local places, work placements, and time away with families. Residents help with the shopping for the home, and with general household chores and activities (e.g. shopping for and then assisting with planting new plants in the garden). Each resident completes a personal diary in which his/her activities and interests are included. When at home people like to watch television, listen to music of their choice or generally relax. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 12 Visitors tend to ring prior to visiting, not as a restriction, but more to ensure that the residents plans for the day are not disrupted, which could be upsetting for some residents. There are regular recorded collective ‘house’ meetings, and also meetings with individual residents. Residents are involved in deciding what’s on the menu. As some of the residents attend day care facilities/resources, the main meal of the day is taken in the evenings. Some of the residents have complicated care needs around meals and special diets have to be catered for. All the staff have responsibility for meal preparation and have received basic food hygiene certificate training. A healthy eating programme is encouraged with no biscuits or cakes being offered during the course of the day. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care needs are evidenced as being met in care planning and medication administration was found to be satisfactory on the day of the inspection. EVIDENCE: Health care needs are identified in care planning and daily records evidence that these are being met. Staff understand the key principles of giving personal support and are responsive to the varied and individual requirements of the residents. It is recognised that the delivery of personal care is highly individual and must be flexible, consistent and reliable. Attention is given to ensuring privacy and dignity when delivering personal care and staff are sensitive to changing needs of residents. Where possible residents are supported and helped to be independent and responsible for their own personal hygiene and personal care. Residents have access to health and remedial services, staff make sure that those residents who are fit and well enough are encouraged to be independent, have regular appointments and visit local health care services. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 14 Medication is stored securely. Staff have undertaken accredited training. The medication policy and procedure was inspected, as was the storage of the medication and the medication administration records. These were found to be in order on the day of the inspection. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaint information is available, and staff recognise that some of the residents may need help to access and understand the complaints procedure. All residents have access to external agencies/contacts. Residents are protected by an appropriate adult protection procedure. EVIDENCE: The Commission for Social Care Inspection has received one complaint since the last inspection. There is a relevant complaints procedure in operation and this is included in the Service User Guide. Some of the residents may need help to access and understand the complaints procedure. Residents are protected by their access to other agencies and professionals, and the contact details for useful agencies, such as advocacy services, are clearly displayed in the home. There is an adult protection procedure in operation, and training certificates were on display, including adult protection training. When asked one staff member was not completely sure about the steps to take in the event of an allegation of abuse. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have comfortable accommodation that is well maintained and meets their needs. The home is a pleasant, clean and safe place to live. EVIDENCE: Cromarty House is decorated and maintained to a good standard with residents being encouraged to personalise their own rooms, which are all en suite. Two residents gave the inspector permission to view their rooms. Bedrooms are available on the ground and first floor of the home. There is no stair lift facility to access the upstairs bedrooms. Thermostatic valves are fitted to hot water outlets. The communal space to include a spacious lounge and dining kitchen is comfortable and homely. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 17 The grounds were noted to be tidy and pleasant providing sufficient communal space in more clement weather. Parking for visitors to the home is generally on the road. The home was seen to be clean throughout. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and protected by a competent staff team that have been properly recruited and trained. EVIDENCE: The duty rota was seen to be current and accurate. There is always a minimum of two staff on duty for 6 residents, and this will increase according to needs and activities. At night there are two sleep-in staff, one upstairs and one downstairs. Observed interactions between staff and residents show that the latter clearly have confidence in the staff that cares for them. The staff confirmed that they have access to ongoing relevant training that is targeted and focussed on improving outcomes for residents. Staff also confirmed that they enjoy their work and that morale in the home is high. There is 6 care staff, of which 5 have achieved NVQ Level 2 or above. One staff member is starting the Registered Managers Award in October. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 19 The personnel records show that the home adheres to a robust recruitment procedure. Records and comments from staff also confirm that there is regular and frequent supervision happening. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager elect and registered provider are ensuring that the home is run in the interests of the residents, and that they have the opportunity to express their views. Resident safety and welfare is protected. EVIDENCE: The registered manager left approximately 7 weeks ago. The registered provider visits alternate days and the manager elect has taken over the reins of control. On-call duties are shared between the manager elect and a senior carer. A strong ethos of being open and transparent in all areas of running of the home was evident. The Commission for Social Care Inspection anticipate an application for a new registered manager soon. Comments from staff, observations of residents, and documentation show that there is good morale and clear leadership, with the residents having confidence Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 21 in the staff. There are regular ‘house’ meetings. Staff were observed to knock before entering residents’ rooms. The home does make use of quality assurance questionnaires, but this was not inspected at this time. The service has sound policies and procedures, which are regularly reviewed. The home was seen to be well-maintained and there is relevant maintenance documentation to support this. There is a variety of health and safety information available and on display. Cromarty House DS0000044661.V345365.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 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 23 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. 1. Refer to Standard YA23 Good Practice Recommendations Staff should continue to be trained in adult protection procedures to ensure they have a full understanding of the steps to take in the event of an allegation of abuse. Cromarty House DS0000044661.V345365.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Cromarty House DS0000044661.V345365.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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