Inspection on 04/01/06 for Cross Lane House

This inspection was carried out on 4th January 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 but made no statutory requirements on the home.

Other inspections for this house

Cross Lane House 13/07/09

Cross Lane House 29/09/08

Cross Lane House 19/10/06

Cross Lane House 21/08/05

Cross Lane House 12/01/05

Cross Lane House 24/08/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Cross Lane House Cross Lane Ticehurst Wadhurst East Sussex TN5 7HQ Lead Inspector Caroline Johnson Unannounced Inspection 4th January 2006 10:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cross Lane House Address Cross Lane Ticehurst Wadhurst East Sussex TN5 7HQ 01580 200747 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) Mrs Amanda Patricia Newport Mr Vincent John Newport Mrs Amanda Patricia Newport Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is eighteen (18) Service users must be aged sixty-five (65) years or over on admission Date of last inspection Brief Description of the Service: Cross Lane House provides care and accommodation for 18 older people. The registered providers are Mr V and Mrs A Newport. Mrs Newport is also the registered manager. The home itself is a large detached converted country house, situated in the village of Ticehurst. The house is set back from a quiet road just off the high street. Accommodation is provided in 14 single and 2 double bedrooms on three floors. The homes current policy is to offer the large double bedrooms as singles unless a married couple wish to share. This means that numbers of residents does not go usually go above 16. A shaft lift is available for residents who may have mobility problems. The home is situated within large well-tended gardens. Stonegate railway station is approximately three miles away and bus routes run through the village high street, which is within a few hundred yards from the home. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second inspection of the year running from April 2005 to March 2006. The inspection lasted from 10.10am until 3.50pm. During the morning the deputy manager facilitated the inspection. At lunch time the owner/manager joined the inspection and she facilitated the remainder of the inspection. A full tour of the building was not carried out on this inspection. However, the lounge and dining room were seen. There was also an opportunity to meet with two care staff and two residents. A range of documentation was examined including care planning, staff recruitment records and training records. There was an opportunity to speak briefly with the district nurse who was in the home at the time of inspection. This report should be read in conjunction with the report dated 21 August 2005. Standards not covered on this occasion will have been covered during the August inspection. Since the inspection the owner/manager has confirmed in writing that they have now started providing formal supervision to all care staff. In addition they have introduced a format for the reporting of all notifyable incidents to the Commission and they have had occasion to use the form already. What the service does well: What has improved since the last inspection? The manager continues with her studies for the Registered Manager’s Award. Three staff have completed NVQ level two and another five staff have almost completed the course. In addition the deputy manager has almost completed NVQ level three. Alongside NVQ training staff also have regular opportunities to attend short courses to keep them up to date. Some progress has been made with the introduction of the new care plan format. The home has revised Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 6 the application form used during staff recruitment. The new format allows for more detailed information to be recorded. A new format for the recording of formal supervision had been drawn up but the system had still to be implemented. Staff spoken with were also more aware of times when they would need to report incidents to the Commission. 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. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 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 the following standard(s): EVIDENCE: These standards were not assessed on this occasion. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 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 the following standard(s): 7,8 The new care plan format needs to be introduced as soon as possible and all staff should receive training on the care planning process including keeping it up to date. More emphasis should be placed on recording in daily notes all progress made in addressing goals/needs highlighted in care plans. There are very good links with the community nursing team and this is a real benefit to the home. EVIDENCE: At the time of the last inspection the home was given six months to transfer all information from their care planning system into a new format. The home is still within this timescale, six care plans have been completed and the owner was confident that they could meet the date given. As there is still a lot of work to be done it was recommended that the home should prioritise the work to be done and start with updating all risk assessments. Staff spoken with during the inspection were clear about the needs of the residents but were not clear about what was written in care plans. They confirmed that care plans are available to read. Care staff have responsibility for updating daily notes but only senior staff update care plans. Discussion was held about how to involve staff more fully in the care planning process. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 10 Care plans are updated at least six monthly or if there are any changes to the needs of the residents. Monthly updates are not carried out. Daily notes are kept and it was noted that staff make regular entries through the day. If there are changes to the care needs of an individual resident, a record is entered on the notice board in the office advising staff where to locate information about the changes. A District nurse visited the home on the day of inspection. She advised that they have a good rapport with the home and visit as required to meet the individual needs of residents. At the time of inspection they were visiting regularly to support the home to meet the needs of one resident who was receiving terminal care. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 11 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 the following standard(s): 12,13,14 Activities provided are varied and stimulating. Residents are encouraged to participate in activities but decisions to opt out of activities are respected. EVIDENCE: A small number of residents are able to use local amenities independently. One resident uses a community bus to go shopping regularly. The local Vicar visits regularly and he was providing a service on the day of inspection. Residents participate in an armchair exercise session weekly. The home has booked an external entertainer to provide a sing-a-long session and the owner confirmed that if this session proves to be a success they would arrange further sessions. The owner encourages staff to organise an activity daily and some of the activities provided include bingo, carpet bowls and armchair basketball. They also have memory games including memory bingo and reminiscence games. Birthdays are always celebrated with a buffet tea and cake. At Christmas the local choir came to the home to provide entertainment. Residents spoken with were happy with the activities provided. Relatives are welcome to visit the home at any reasonable time. The home tries to ensure that they maintain good links with relatives and visitors are welcome to join their relatives/friends for meals provided the cook has adequate notice. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 12 The home’s normal practice is to arrange regular outings to places of interest. Last year due to the refurbishment programme outings were put on hold. However, the owner confirmed that they would be reinstating the outings. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 13 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 the following standard(s): 16 Residents and visitors to the home are encouraged to raise any complaints or suggestions that they might have and the procedure for doing so is easy to follow. EVIDENCE: Records showed that there had been no complaints since the last inspection of the home. There is a complaints/suggestions box available to encourage residents and visitors to have their say. The owner also stated that they make a point of talking to relatives when they visit to ensure that if there are any problems they can be addressed immediately. Staff confirmed that they had received training on the protection of vulnerable adults. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 14 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 the following standard(s): 19,20,26 All areas seen were well decorated and work carried out had been to a very good standard. The environment is pleasant and furniture provided is comfortable and homely in design. EVIDENCE: A full tour of the building was not undertaken on this inspection. The lounge and dining room and the reception areas were seen. The owner confirmed that they have come to the end of a major refurbishment programme with only minor areas requiring attention now. One bedroom has yet to be redecorated and the furniture in the lounge will be replaced next year. At the last inspection a requirement was made to cover the remaining four radiators. The owner confirmed that the radiators would be guarded within the timescale set. Residents spoken with stated that they were very pleased with the redecoration of their bedrooms. They also commented on the lovely garden areas and said that they particularly enjoyed spending time in the garden in the summer months. All areas of the home seen were clean and there were no unpleasant odours. The district nurse also commented positively on the cleanliness of the home. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29,30 There are good training opportunities available to staff and staff spoken with demonstrated that they have been able to put the knowledge obtained through study into everyday practice in the home. Staff recruitment records should be kept in the home at all times and be available for inspection. EVIDENCE: A member of staff spoken with stated that their induction to the home was very thorough. They were shown all relevant paperwork and were shadowed in their work until there were assessed as competent in their role. Records were seen in relation to two recently recruited staff members. In both cases the application forms and in one case the references were not on file. The owner confirmed that she had this information stored securely elsewhere. Both staff members had provided copies of recently obtained CRB checks but the home were also in the process of making an application to the CRB. As recommended at the last inspection, the home’s application form has been adapted to enable prospective staff record all previous employment history. Three staff have completed NVQ level two and another five staff have almost completed the course. In addition the deputy manager has almost completed NVQ level three. Staff spoken with confirmed that they had received training in moving and handling, first aid, medications and basic food hygiene. One staff member spoke about her training for NVQ level three. She spoke about Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 16 three of the units that she is studying and gave examples of how she is able to put the knowledge she is gaining into practice in the home. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 The owner is now clear about what needs to be covered during supervision and there is also a format in place to record these sessions. It is now essential that each staff member receives formal supervision on a regular basis. The home needs to have a policy in place in relation to Regulation 37 and draw up a format for recording all notifyable incidents. They also need to review the procedures in place for managing residents’ finances and draw up a new policy clearly stating how monies are to be handled. EVIDENCE: The owner/manager is working towards NVQ level four and the RMA (Registered Manager’s Award). She has completed the Assessor’s course. Staff spoken with during the inspection described the owner as very supportive and they stated that `you can go to her if you have a problem, she listens and if she can help she will’. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 18 Requirements have been made at previous inspections relating to staff supervision. The home now has a supervision policy and they have produced a format for carrying out supervision. However, they have yet to begin the process of supervising staff. Discussion was held about what should be covered during supervision. The owner confirmed that they would start supervising staff as soon as possible. The last staff meeting was held in August. A staff member spoken with stated that they had been informed that staff meetings would be arranged in the near future. The owner stated that she would be holding a general meeting this month for all staff and following this there would be regular staff meetings for day staff and separate meetings for night staff. The owner and deputy manager are aware of the types of circumstances when it would be appropriate to contact the Commission. It was recommended that they have a policy on this and draw up a format for recording information under Regulation 37. The owner confirmed that the home’s quality assurance questionnaire is due to be distributed to residents and relatives again. Following this process the results will be published and made available to residents and their relatives. Results will also be included in the service user guide. The home manages small amounts of money on behalf of residents. Record keeping was found to be in order. The home is planning to introduce individual books for each resident. As part of this process it was recommended that the home encourages residents to sign when they give money to or receive money from staff and that the home provide relatives with a receipt if they receive money on behalf of a resident. It was noted that on occasions money if one account is short of money, money could be taken from another resident and the money reimbursed later. This practice should cease and there should always to be a float available to cater for these situations. In addition the home should draw up a policy in relation to the management of residents’ finances. Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 X X X X 2 3 STAFFING Standard No Score 27 X 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 2 2 X 2 Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement Timescale for action 20/03/06 2. OP25 13[4] 3. OP29 19 Sch 2 para 1-9 4. OP36 18[2] That the Registered person must ensure that each Service user [Resident] has a comprehensive and clearly presented care-plan, which details the individual needs of the residents and how they are to be met in practice. That care-plans are regularly reviewed. That all service user information is transferred over to the new care-planning format within the timescale indicated. That the four remaining radiators 31/03/06 accessible to service users are covered within the extended timescale indicated. Information obtained (application 15/02/06 forms and references), as part of the staff recruitment process must be kept in the home and available for inspection. That all staff must receive formal 15/02/06 written supervisions based on the requirements of the standard. To be scheduled to occur at least six times yearly. [Requirement of the last 6 inspections – last timescale given was 21/11/05] DS0000032397.V268880.R02.S.doc Version 5.0 Cross Lane House Page 21 5. OP35 17(2) Sch 4 p. (a,b) The home must draw up a policy relating to the management of residents’ finances. As part of this process residents must be encouraged to sign when they hand over money to the home for safekeeping and when money is returned to them. Receipts must be given to relatives when money is received on behalf of residents. 31/01/06 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 OP7 Good Practice Recommendations Staff should receive training on the new care planning system and should be encouraged to be more involved in the care planning process. Care plans must be reviewed and if necessary updated monthly. More emphasis should be placed on recording in daily notes all progress made with care plans. That the results of residents’ surveys are collected into a report and published and made available to existing and prospective residents. A policy should be drawn up highlighting examples of when it would be appropriate to contact the Commission. (See Regulation 37) The home should cease the practice of borrowing from residents’ monies temporarily to help out another account. 2. 3. 4. OP33 OP33 OP35 Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Cross Lane House DS0000032397.V268880.R02.S.doc Version 5.0 Page 23 - 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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