Inspection on 29/09/05 for Cromwell House

This inspection was carried out on 29th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Cromwell House 26/04/07

Cromwell House 14/01/05

Cromwell House 10/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Cromwell House Cecil Road Norwich Norfolk NR1 2QJ Lead Inspector Linda Wells Announced inspection 29/09/05 at 9.30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cromwell House Address Cecil Road, Norwich, Norfolk. NR1 2QJ 01603 625961 01603 660581 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Methodist Homes for the Aged Mrs E J Pitcher Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Thirty-eight (38) Older People may be accommodated Date of last inspection 1st April 2005 Brief Description of the Service: Cromwell House is a residential care home and is one of a number of care homes operated by Methodist Homes for the Aged which is a registered charity. It offers accommodation and personal care for up to thirty-eight people and is sited in a residential area of the city of Norwich close to local amenities and the city centre. The home stands in its own grounds and is on two floors with a passenger lift to the first floor. All bedrooms are single and thirty-seven bedrooms have ensuite facilities and the remaining one bedroom has a private bathroom next to it. There are two commual bathrooms and two toilets on each floor and those living at the home have commual use of a large lounge, two small sitting rooms with tea making facilities, a large dining room, conservatory and chapel for daily prayer and worship. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection undertaken on the 20th September 2005 over five hours and was carried out as part of a routine inspection plan. Prior to the inspection thirty comment cards were received from residents, twenty-one from relative/visitors and five from visiting professionals. All of those who returned the comment cards indicated that the home was friendly, always clean, staff members were caring and residents were well cared for. Residents wrote “the staff make life pleasant for you” and “it is home from home”. Relatives/visitors wrote, “my relative enjoys all that goes on and is involved” and “excellent care”. On the day of inspection thirty-eight residents were living at the home and residents were seen to be having a meal, sitting in the lounges, their bedroom or the garden listening to the radio, reading or watching television or taking part in a “sing-a-long” with the activities co-ordinator. The inspection took the form of a tour of the premises, individual discussion with eight residents, six staff members, a senior care assistant and the manager, group discussion with two residents, examination of care plans, records, certificates and compliance of requirements and recommendations from the last inspection. What the service does well: The home has a friendly, relaxed atmosphere and the residents spoken to said that they liked living at the home, they were well cared for, staff treated them with respect and assisted them with all necessary tasks in a kind and considerate manner. Two residents said that they “could not wish for anything better”, three said that they “enjoyed the church services and talks” and they all said that the routine of the home could be flexible and that the home was always clean and tidy. Staff members were well trained, enthusiastic and said that they put the needs of residents first. This was demonstrated in the records held and the comments received from residents and visitors. The staff members spoken to said that they liked working at the home and that they were encouraged to promote resident choice and independence. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 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. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 4, 5 The admission procedure and written information available is good and fully enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: The homes Statement of Purpose, Service User Guide and Terms and Conditions contract were seen and found to contain relevant information. The manager said that prior to admission as much information as possible was collected from a prospective resident, their family and other professionals. She said residents, their family or friends sometimes visited the home, that she often visited residents in their own home and that residents were admitted on a one-month trial basis. A resident who had lived at the home for six weeks said that she and her relative had visited the home prior to admission, had been given enough information about the home to help them make a choice, that staff had made her feel welcome and that her key worker had helped her to settle into the home. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 11 The health, social and personal care needs of residents were met, they were well cared for but not all records were completed. EVIDENCE: Residents said they were well looked after and four individual plans of care were examined and found to contain relevant health, social and personal care information, photograph, data protection agreement, care needs, weight records, reviews, daily records, risk assessments, choices, past history, list of falls, visiting professionals and the signature of the resident. However, they did not contain the wishes of each resident upon death and a requirement was made that the wishes of residents at death be recorded in their plan of care to demonstrate involvement, consultation and agreement of each resident on their funeral arrangements. Medication policies and procedures were seen, a member of staff was observed safely administering medication and the records held demonstrated that medication was administered, recorded and stored correctly. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, 14, 15 There are some social and creative activities and a choice of meals is available but they do not fully meet the interests and preferences of the residents. EVIDENCE: Residents said that their family and friends were always made welcome at the home and that staff assisted and encouraged them to make choices and take part in local church and community activities. They said that they were not fully stimulated by the activities provided daily in the home and some said that they were often “bored”. Records were seen to demonstrate that some activities were provided and the activity co-ordinator was spoken to and said that she had undertaken training in providing activities and gave residents choice but found it hard to encourage some residents to join in with the activities she organised. The manager said that occasionally a quiz or bingo took place but it was found that the activities advertised in the home were not always available and that most residents were not aware of the range and choice. A requirement was made that a review of the daily activities provided is undertaken with residents and the activity co-ordinator to ensure residents are offered a program of activities that is varied and meets their interests. The main meal and menus were seen and were balanced and varied. Records showed that residents were given a choice and an alternative offered. The cook said that he was in the process of ensuring that all menus reflected the choice of residents however, everyone spoken to say that the tea menus were limited Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 11 and repetitive and a recommendation was made that a review of the tea meal option is carried out with the residents. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: No complaints had been received about the home and the home’s records demonstrated that any complaints made to the home are investigated and the appropriate action taken. The home is dealing with one internal issue at the moment and discussion with the manager identified that she was following the appropriate policy and procedures. The residents spoken to all agreed that if they had reason to complain they would speak to staff or the manager and all felt confident that the problem would be resolved quickly and to the satisfaction of all involved. Residents are able to exercise their legal rights and are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home and records showed that staff have undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,22,23,25,26 The standard of the environment within this home is good and fully provides residents with an attractive, safe and homely place to live. EVIDENCE: A tour of the building revealed that residents live in a home that is decorated and furnished to a good standard with the hallways on both floors being redecorated on the day of inspection. Residents said that they benefited from a home that was comfortable, clean and tidy and this was found in all areas during the tour of the building. The dining room had been redecorated and new dining chairs, pictures and table decorations provided giving residents a much lighter and brighter room to eat in but the carpet in the dining room which is soiled spoils the overall ambience of the room and a recommendation was made that the dining room carpet be deep cleaned or replaced to further enhance the look of the dining room. Residents were seen to have personalised their bedrooms, specialist equipment was provided and each floor of the home had adequate bathrooms and toilets that were adapted to suit the needs of the residents. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Staff members are competent and the procedure for the recruitment and training of staff provides safeguards to offer protection for the people living in the home, but staffing levels need to increase before needs can be fully met. EVIDENCE: Residents said that they were well cared for but that staff members were often busy caring for frail residents and they had to sometimes wait longer than usual for assistance. Staff spoken to said that there were enough staff on duty if all shifts are fully covered and that when they were not they were under pressure some of the time to complete all tasks. The manager said that an additional member of staff had been provided in the morning but that the home had two care staff vacancies. She said that she was in the process of recruitment and that it had been extremely difficult to fill all shifts with the full complement of staff, especially at the weekend. A requirement was made that all shifts must be covered to ensure adequate staffing levels are in place at all times. The four staff members spoken to said that they are supported by the senior care staff and the manager, handover, staff meetings and supervision and demonstrated that they were aware of their role and responsibilities. Records showed that residents were protected by the staff recruitment checks that had been carried out. CRB checks, references, personal details, proof of identity and a photograph of each staff member were seen to be held in the file of each staff member. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 15 Records demonstrated that staff members had a mix of experience and skills and those spoken to had all completed NVQ2 and one senior staff member was undertaking NVQ4 training. Certificates showed that an induction, foundation and updated training programs were undertaken by all staff to enable them to gain the knowledge necessary for the range of needs of residents living at the home. Once the 50 target is reach this standard will be met. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35,36,38 The manager is supported by the senior staff in providing leadership, guidance and direction to staff to ensure that residents receive a good standard of care. EVIDENCE: The manager has been in post for eighteen months, has twelve years past experience of working in the care setting, has completed the NVQ4 Registered Managers award and is now undertaking an Advanced Care course. Residents and staff members said that the home was well run and that the manager was approachable. Records demonstrated that the management, accounting and financial administration procedures carried out in the home offer safeguards and protect residents. Policies and procedures have been produced and were seen on all aspects of the home and service provided. The records held were found to promote and protect the rights and best interests of each service user. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 17 The handover, staff meeting minutes and supervision records demonstrated that staff members worked as a team and were supported and regularly supervised by the senior staff to ensure that their knowledge of the needs of each resident, their work practice, commitment and training needs were identified, clarified and reviewed. The records seen showed that incidents of poor practise were identified, discussed with the staff member and monitored to ensure that a good standard of care was provided to residents. The servicing and testing of all equipment had been carried out and relevant and timely certificates were held to ensure that the health and safety of residents is protected. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 x 3 3 x 3 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 3 3 3 x 3 Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 19 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. Standard OP11 Regulation 12.3 Requirement The registered person must ensure that records are held in the plan of care of each resident on their arrangements at death. The registered person must ensure that a review of the daily activities provided is undertaken with residents. The registered person must ensure that adequate staffing levels are available at all times. Timescale for action 31st December 2005 1st December 2005 Immediate and ongoing. 2. OP12 16.2. m n 18.1 3. OP27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP15 OP19 Good Practice Recommendations It is recommended that a further review of the tea option be undertaken with residents to ensure that their choice is reflected in the menus. It is recommended that the dining room carpet be deep cleaned or replaced to further enhance the look of the dining room. Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 Cromwell House I55 s27269 Cromwell House v236269 AN 200905 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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