Inspection on 06/07/06 for Cromarty House

This inspection was carried out on 6th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cromarty House 18/07/07

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 Elaine Bruce Key Unannounced Inspection 6th July 2006 08:45 Cromarty House DS0000044661.V298289.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.V298289.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.V298289.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 Miss Katherine Maggs Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cromarty House DS0000044661.V298289.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. 13th December 2005 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. Cromarty House DS0000044661.V298289.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 7th July 2006 and was unannounced. The inspection took place around the routine of the house (and was therefore shorter in hours: five hours) to allow the service users their afternoon visit/walk out of the home with the staff. During the morning the inspector had the opportunity to spend time with the service users and the staff on duty. The inspector was pleased one of the service users spent individual time with the inspector showing her his diary and bedroom. The early part of the afternoon was spent with management inspecting staff files and giving feed back on findings from the inspection. What the service does well: What has improved since the last inspection? Care plans that have been revised are now consistently in place and up to date with good daily record keeping to support them. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cromarty House DS0000044661.V298289.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.V298289.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: Cromarty House DS0000044661.V298289.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 The quality outcome judgement on these standards is good. Considerable progress has been made with care planning and daily records since the last inspection. This documentation is now detailed and evidences that the care needs of the service users are being met. EVIDENCE: The care plans for the service users have been revised and are now detailed with evidence of regular reviews taking place. The daily records that support the care plans are informative, detailed and evidence that the care needs of the service users are being met. Care plans include detailed risk assessments and the likes and dislikes of each service user are well documented. The staff can access the care plans as required and during the course of the inspection the staff (even new) presented as having a very good understanding of the needs of the service users at the home. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 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 the following standard(s): 11,12,13,14,15,16 and 17 The quality outcome judgement on these standards is good. A variety of opportunities are provided for service users to enable them to participate in activities of their choice and be part of the local community. Healthy eating is encouraged at the home and service users are involved in the planning of the meals and the shopping for the meals. EVIDENCE: The daily records held on the service users evidence that they have access to community facilities. On the afternoon of the inspection after buying food for the evening barbecue the service users were going for a walk. One of the service users attended a day centre for the day. A daily diary is kept by each service user and where they are able they fill in this information themselves. On the day of the inspection one of the service users spent time showing the inspector the diary that he had completed. During the course of the morning service users were encouraged to take part in the general cleaning duties of the home and where able service users are encouraged to make drinks for their visitors. One service user enjoyed listening to a music quiz with another spending time on his exercise bike. Photos are displayed in the home of some Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 11 of the places that the service users have been, a wide range of areas in Cornwall has been covered. The home has it’s own transport. Visitors to the home were expected (in the morning) and the home encourages visitors to make appointments rather than travelling and everyone being out of the home. Visitors to the home are asked to sign in to the visitors’ book. As some of the service users attend day care facilities/resources, the main meal of the day is taken in the evenings. Some of the service users 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. On the day of the inspection the menu was inspected but changes were to be made to the menu which involved having a barbecue. The service users are involved and encouraged to part of the planning of the meals to also include the shopping for the food. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 18,19 and 20 The quality outcome judgement on these standards is good. 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. There are no service users receiving attention from the community nursing service at this time and all the service users appear to be in reasonable health. Medication is administered by the staff who have received training to undertake this task. The medication policy and procedure was inspected as was the storage of the medication and the medication administration records. These were all found to be completed appropriately on the day of the inspection. The home has policies and procedures regarding the illness or death of a service user but these have not been required to date. These will be assessed at the next inspection. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 13 Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 22 and 23 The quality outcome judgement on these standards is adequate. Complaint information is available but some of the service users may need help to access and understand the complaints procedure. It is recommended that all staff receive adult protection training from an external trainer. EVIDENCE: A complaints procedure is displayed in the home. Some of the service users may need help to access and understand the complaints procedure. The senior staff member on duty had attended the County Council training on adult protection and it is recommended that all staff receive this training (or similar) to ensure that they are fully aware of protection issues. It is noted that staff receive in house adult protection training in their induction training. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 24,25,26,27,28,29 and 30 The quality outcome judgement on these standards is good. Service users 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 service users being encouraged to personalise their own rooms, which are all en suite. 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 and radiators (not guarded) are kept at low temperatures. The communal space to include a spacious lounge and dining kitchen is comfortable and homely. There are two night staff employed who sleep in at the home. One person has access to a bedroom the other uses the lounge. It was noted that there is a lock on the lounge door which could in an emergency deter a service user seeking assistance as there are no calls bells in the home. This should be reviewed. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 16 The grounds were noted to be tidy and pleasant. Staff on duty informed the inspector that a gardener has recently been employed. Parking for visitors to the home is generally on the road. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 34 The quality outcome judgement of these standards is adequate. The home is not following satisfactory recruitment procedures for new staff. Staff on duty were noted to relate well to the service users. EVIDENCE: Recruitment procedures are not satisfactory. Two new staff employed at the home have not had a protection of vulnerable adults check. This was included as a statutory requirement in the inspection report of the 13th December 2005 and is again included in this report. It was noted that the staff on duty could not access particular documentation requested for the inspection as management held the key. This should be reviewed. It was noted during the course of the inspection one of the new staff members and her colleague who is more long standing were very capable. The service users related well to them and they in turn were fully aware of their care needs. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,40 and 41 The quality outcome judgement of these standards is adequate. The manager should obtain her NVQ 4 management qualification as soon as possible. Policies and procedures are regularly reviewed by the manager. A recommendation is made to hold records on the finances of the service users where these are being held. EVIDENCE: It is recommended that the manger completes her studies as soon as possible to obtain the NVQ 4 qualification in management. All policies and procedures are reviewed and updated (if required) every six months by the registered manager. It is recommended that where the home is holding money on behalf of service users records are in place so an audit can be carried out. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 19 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 x 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 x 33 3 34 1 35 X 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x x 3 2 x x Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 20 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. Standard YA34 Regulation Requirement Timescale for action 01/08/06 7,9,19Schedule Protection of Vulnerable 2 Adults checks must be obtained prior to any employee starting work in the home. (This was included in the inspection report of the 13th December 2005 as a statutory requirement). 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. 3. Refer to Standard YA23 YA41 YA37 Good Practice Recommendations Staff should be trained in adult protection procedures and have a full understanding of the various forms of abuse. Financial records (where appropriate) should be held on the service users. The manager should compete her studies to obtain her NVQ 4 in management as soon as is possible. Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Cromarty House DS0000044661.V298289.R01.S.doc Version 5.2 Page 22 - 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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