Inspection on 17/05/06 for Cromer House

This inspection was carried out on 17th May 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cromer House 17/06/09

Cromer House 04/05/07

Cromer House 12/09/05

Cromer House 19/05/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Cromer House 15 Redan Street Ipswich Suffolk IP1 3PQ Lead Inspector Jan Davies Unannounced Inspection 17th May 2006 10:00 Cromer House DS0000062387.V295951.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 Cromer House DS0000062387.V295951.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. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cromer House Address 15 Redan Street Ipswich Suffolk IP1 3PQ 01473 226399 01473 226396 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) www.caringhomes.org Consensus Support Services Ltd Mr James Boyd Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 The home may accommodate one person, whose name was made known to The Commission in June 2005, aged 17 years. 12th September 2005 Date of last inspection Brief Description of the Service: Cromer House is owned and operated by ACH Ltd. It provides 24 hour support for up to ten residents with learning disabilities. All bedrooms are single with en suite facilities. The home is situated near the centre of Ipswich with good access to community facilities and public transport. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a key unannounced inspection, carried out on a weekday between the hours of 11.30am and 6.00pm. The Registered Manager was not present during the inspection, however the Deputy Manager and staff of the home fully contributed to the inspection process. The inspection involved a tour of the premises, discussions with staff and residents and the examination of all residents care plans and four staff files. The Inspector also looked at a variety of other documents including policies, procedures and medication records. What the service does well: What has improved since the last inspection? Prospective residents can have trial stays, followed by a review to determine whether the home is able to meet the individual’s needs. Care plans are improving by reflecting the resident’s own priority personal goals. Risk assessments are in place and, as appropriate, residents have risk assessments in place to protect them from potential incidents of aggression. The staff training programme has been developed further and had also included training on specialist syndromes within autism i.e. Aspergers Syndrome, to ensure that staff have adequate knowledge and skills to work with individuals with specific needs. Cromer House DS0000062387.V295951.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. Cromer House DS0000062387.V295951.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 Cromer House DS0000062387.V295951.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): 1,2,3,4,5 Prospective residents can expect to have their needs assessed prior to admission and be provided with for trial stays. Residents can expect to have a contract which details the home’s terms and conditions. EVIDENCE: During the inspection all residents care plans were examined. Each of them contained a copy of the home’s Service User Guide. The guides were appropriate to the residents needs and provided clear information about the home and its service using plain language and pictures to aid understanding. Resident’s records contained comprehensive pre admission assessments and personal information. Local authority care managers had undertaken assessments of need and further information had been sought by the home via questionnaires. The questionnaires demonstrated that the home had consulted other relevant professionals, the individuals concerned and their relatives. The home had used the assessments to develop personal support plans and individual risk assessments. Cromer House DS0000062387.V295951.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 Residents can expect to make informed decisions about their lives and matters in the home. They can also expect to be consulted about their plan of care, however care plans need to be developed to ensure residents needs and aspirations are recorded when they are met. EVIDENCE: During the inspection all residents care plans were examined. Each plan contained detailed information about the resident’s needs, wishes and aspirations. The home had then used the information to formulate a list of priority goals, action plans and risk assessments. Generally, the care plans examined were of a good standard and demonstrated the fact that residents had been involved in the development of their plans. However it is recommended that where residents have identified their own priority needs, these needs should be recorded in their support plans. Cromer House DS0000062387.V295951.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): 11,12,13,14,15,16,17 Residents can expect to have opportunities for personal development and be encouraged to participate in appropriate social and leisure activities. Residents can expect to be involved in the planning and preparation of their meals. EVIDENCE: Care plans evidenced that residents have access to a wide range of opportunities to maintain and develop social and independent life skills. Staff confirmed that residents are given opportunities within the house and wider community to fulfil their needs and goals. On the day of inspection residents were observed being actively encouraged to practice their skills with appropriate support. Residents were seen participating in the day to day activities within the home but were also seen coming and going throughout the day to school / college and the local shops. The staff confirmed that they were supporting residents in the development of structured weekly programmes and gave examples of some of the activities being considered including college and further education courses. Care plans evidenced that residents are supported to ‘get out and about’ on a daily basis. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 11 As well as local facilities such as the shops, cinema and football ground, the residents have enjoyed travelling further a field in the home’s own ‘people carrier’. Residents spoken with said that they had enjoyed visiting nearby towns, the zoo, bowling and pub meals. Conversations with staff and residents indicated that the home provided good support to maintain family relationships and offer opportunities to create and maintain social networks. However, this was not always reflected in the care plans and daily records. On the day of inspection staff were observed respecting service users rights to privacy. Bedrooms were not entered without resident’s permission and all communication observed between staff and residents demonstrated that staff were respectful and polite. The home had a communal kitchen, which was seen to be clean and hygienic with sufficient facilities. Staff reported that the residents are encouraged to participate in preparing and cooking their own meals and this was observed on the day of inspection. Staff and residents confirmed that residents are involved in shopping for groceries and able to chose their own meals with encouragement and advice about healthy and balanced diets. Records of meals taken and choices offered were seen and satisfactory. Cromer House DS0000062387.V295951.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): 18,19,20 The home has appropriate arrangements in place for ensuring residents health needs are met and personal support is provided according to individual’s needs and wishes. However they cannot always be assured that their long term plans for care will be taken into account nor that medicine will always be clearly and correctly recorded. EVIDENCE: Care plans, daily records and conversations with staff and residents indicated that staff provide personal support appropriately to individuals. Support was being provided flexibly and in consultation with residents. Staff reported that there were no fixed times for meals, getting up, going to bed or any other activities. Observations on the day of inspection were that residents were supported according to their needs and wishes. Individual care plans identified health care needs and included formats for monitoring health and weight and records of medical visits such as GP’s, community nurses and outpatient appointments. However a resident had been admitted since the last inspection who has health and mobility problems and who is significantly older and with different care needs to the rest of the group. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 13 There was no detailed plan to address their health and mobility difficulties in the longer term future, for example, when areas of the home become more difficult for them to access and if staff need training in manual handling techniques to lift them. The medication records were inspected and there was inconsistent use of symbols to indicate why medicines had not been taken. Records in care plans for one resident referred to medicine not being given in line with the health care plan but did not detail the medicine in question nor give the date of when the medicine had not been given nor why this occurred. Cromer House DS0000062387.V295951.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): 22,23 The home has an appropriate complaints procedure in place and residents can be assured that there are sufficient strategies in place to protect them from harm. EVIDENCE: The home has a complaints procedure in place and this is summarised in the Statement of Purpose and Service User Guide. It includes information on how to make a complaint and the stages and timescales of the complaints process. The complaints procedure was available in different formats to ensure that residents could understand it. Staff spoken to confirmed that they had training on the protection of vulnerable adults as part of their induction. The deputy manager confirmed that the home works within the guidelines of the Suffolk Inter Agency Policy and Procedures for the protection of vulnerable adults. Staff also confirmed that they had training in relation to dealing with challenging behaviour and physical restraint. Records of incidents were seen during the inspection and discussed with the deputy manager. The home had a Physical Intervention Policy written by ACH Ltd in place and this has been used by the home to develop clear advice to staff trying to manage any aggressive behaviour. Training records and conversations with staff indicated that physical restraint training had taken place. Staff records contained evidence of appropriate recruitment checks including Criminal Record Bureau (CRB) checks. Cromer House DS0000062387.V295951.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, 29 and 30. Residents can expect to live in a clean, comfortable and safe environment with a good standard of facilities to meet their individual needs. EVIDENCE: During a tour of the building all areas were seen to be clean and hygienic and the home was modern, spacious and freshly decorated throughout having been refurbished before opening in January this year. Generally the home was well maintained although there was a window blind missing from one resident’s room and also from the landing area outside their bedroom following damage by a resident. From discussion with staff repair and replacement was in process. One resident told the inspector they had been waiting for a piece of furniture to store their possessions. Discussion with the deputy manager revealed that the resident had chosen a particular type of furniture and that this was on order but that there was a delivery waiting period. Furniture and fittings were in keeping with the style and décor of the home and created a comfortable and homely environment. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 16 Four bedrooms were seen during the inspection, each had an en-suite bathroom or shower with washbasin and WC. All were spacious and individually decorated and reflected the resident’s likes, dislikes and interests. Residents had been supported to personalise their rooms with their own belongings, for example photographs, computers and televisions. Residents were able to have a key to their own room unless identified as a risk and agreed in their plan. Residents spoken with on the day of inspection indicated that they were happy with their rooms and seemed to enjoy the privacy and independence they offered. All bathrooms and WC’s were well decorated and spacious with suitable working door locks. The deputy manager reported that one of the baths was soon to be replaced with a specialist bath to meet the needs of a new resident due to move in soon. Some other adaptations had been made to the home, including access ramps for the same resident. The home also had a shaft lift that provides access to the first floor and level access throughout the building. Three residents, one with mobility difficulties, showed the inspector how they use this lift to access their bedrooms. Cromer House DS0000062387.V295951.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): 32,33,34,35,36 Residents can expect to be safeguarded by the home’s recruitment procedures and be supported by an effective and committed team of staff. EVIDENCE: Staff spoken with on the day of inspection were clearly committed to training and development and reported that they had received comprehensive induction programmes to ensure that they were equipped to ‘do the job’. Training records reflected that training had taken place and included Moving and Handling, Health and Safety, Fire Safety, Abuse Training, Medication training, Understanding Epilepsy, Foundation Certificate in Food Hygiene, First Aid, Confidence to Care, Autism, Child Protection and restraint training. The deputy manager confirmed that there is a minimum of five staff on duty each shift to provide support to the residents. At times this includes the manager, the deputy manager and the assistant manager, at other times they are supernumerary. The staff rota examined on the day of inspection reflected this. Members of staff spoken with all had previous relevant experience before joining the team and were very positive about the mix of knowledge and skills amongst the team. Their comments included ‘it’s a good team, very cohesive…” ‘People are genuine, they are here because they like the job and it shows’ and ‘there are lots of very experienced staff here’. Staff reported that Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 18 staff meetings take place and include agenda items such as admissions, transitions, staff issues, resident’s holidays, health and safety and staff training. Four staff files were examined during the inspection. They contained evidence of recruitment procedures including two written references. However not all files included 2 professional references. The deputy manager explained that these were at the organisational office. However staff files must show when these were received and that they are appropriate. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 19 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): 37,39,42 Residents can expect to be consulted about life in the home. Care practices reflect that the health, welfare and safety of residents are promoted. EVIDENCE: Residents care plans, daily records and minutes of residents meetings demonstrated the home’s commitment to actively seeking the views of residents. The home had also recently completed an annual quality assurance review which had included some consultation with residents, relatives / advocates, other professionals and staff. The Quality Assurance Review report was a general summary of achievements since the opening of the home and includes an action plan based on the results of the review. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 20 The home’s policies and procedures were available for inspection and included health and safety codes of practice. Staff spoken with and training records examined also evidenced that the home ensured staff had essential health and safety training during their induction programme including Manual handling, Fire Safety, Food Hygiene and First Aid. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 21 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x 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 2 3 1 x 3 x 3 x x 3 x Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 22 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. 1. YA6 Standard Regulation 14.2 Requirement Care plans must be clear as to the long-term arrangements for people who have significant health with related mobility problems. Staff who administer medicine must comply with the home’s policy and procedure for the recording, handling and, administration of medicines. All staff files must show that 2 appropriate references have been received before confirmation of appointment can be made. Timescale for action 20/06/06 2. YA20 13 06/06/06 3. YA34 19 06/06/06 Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 23 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 YA6 Good Practice Recommendations Residents care plans should be developed to include their priority personal goals and aspirations. Cromer House DS0000062387.V295951.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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