CARE HOMES FOR OLDER PEOPLE
Cross Park House Monksbridge Road Brixham Devon TQ5 9NB Lead Inspector
James Rose Announced 12/04/05 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. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Cross Park House Address Monksbridge Road, Brixham, Devon, TQ5 9NB 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) 01803 856619 01803 859040 info@stone-haven.co.uk Stonehaven (Healthcare) Ltd Mrs Arleathea Ann Mead Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability over 65 years of age of places (23) Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: NVQ4 in care and management is undertaken by Mrs Arleatha Mead in the next six months Date of last inspection 27/04/04 Brief Description of the Service: Cross Park House is an extended detached building that stands in its own grounds, it offers 24-hour residential care for up to 23 persons within the categories of old age and physical disability. All bedrooms are single occupancy one has on suite facilities. There are two lounge areas; meals are taken in a large conservatory area, which is used as a dedicated dining room. To the front of the home there is a well-tended garden and patio that has easy access, to the rear there is a small garden and terrace. At the side of the home there is a large hard standing car park, which is large enough for several vehicles. Bedrooms are situated over three floors in the home with vertical lifts provided for persons, with mobility issues. The front door of the home has level access from the driveway. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and took place over 7.5 hours on 12th April 2005. A pre inspection questionnaire had been completed by the management of the home. A complete tour of the home was undertaken during the inspection and a sample of care records were examined, four in all. Seven residents were asked for their views of their experience of living at Cross Park, this was undertaken in private and three care staff were also consulted. The management of the home assisted throughout the inspection. What the service does well: What has improved since the last inspection?
Two requirements raised in the last report have been satisfied, the uneven slabs on the patio have been replaced by gravel to provide a level walking surface for residents and the regulations calling for all harmful cleaning chemicals to be stored securely are in place which will protect residents. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 6 The laundry area of the home is improved and a protocol has been introduced to ensure that there is no contamination between clean and soiled laundry, which will ensure appropriate infection control. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 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 Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 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 - 6. The home provides detailed information to prospective residents about what life is like at Cross Park. Contracts are provided and needs assessed. Prospective residents and their familes/friends are encouraged to visit the home prior to making a decision about being admitted. EVIDENCE: The home has a statement of purpose and a service user guide available to provide information to a prospective resident. Residents consulted at the home during the inspection felt they had enough information to make a judgement about the home and confirmed that they were encouraged to visit with their families. The service user guide states that the home supplies a television in a resident’s room, however, this is not the case and the guide should be corrected, a requirement has been raised concerning this issue. Four assessments were examined and these contained all the needs of the residents who were then consulted and confirmed that their needs were met by the home. Some further development of the social needs of residents was discussed and is recommended in this report.
Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 9 A contract/terms and conditions document was provided by the home to all new residents and samples were seen. Standard 6 refers to a service that is not provided at Cross Park House. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 10 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 - 11. Health, personal and social care needs are given attention and health needs are met. The recording of the administration of medication had errors but this did not place residents at risk. Service users are treated with respect and their rights are upheld. EVIDENCE: A plan of care was available for each person receiving a service at the home and four of these were examined in detail during the inspection. Health needs were addressed and appropriate access was provided to healthcare professionals for residents. Social care needs should be developed further. The home does not have available a meaningful programme of activities. Carers undertake most activities when they have time from their busy schedule. An activities person is retained by the home for one hour every three months. Some residents did express the view that they would like more to do. The home does have an administration policy and procedure in place for medication that demonstrates that residents who wish and are capable can self medicate. No resident at the home currently is able to take advantage of this approach. At the time of the inspection some staff that administered
Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 11 medication had not used the code system correctly, the manager is going to provide additional training on this issue and this is a requirement of this report. Seven residents were interviewed in private during the inspection process and all confirmed that they felt they were always treated with respect and that their privacy and rights were upheld. Two carers advised that they felt all their needs were met by the home. Carers were observed to knock on doors before entering a resident’s room. The home has many letters of thanks for the service provided that were seen from relatives and friends of past residents. There is also a detailed policy and procedure available in the home that deals with the issues raised by the terminal phase of a residents life. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 12 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 - 15. In general residents were happy with their lifestyle at the home, however, two said they would like more to do. Residents were able to maintain contact with faimily and friends. The food provided by the home was praised by residents. EVIDENCE: Seven residents were consulted during the inspection, all advised that they were happy at the home and liked the meals provided by the new cook. Meals are served in the conservatory dining room, which residents said they liked. Residents are consulted daily about what foods they would like from the menu. Two residents said that they would like more activities to be available. The home has an unrestricted visiting policy and procedure in place. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 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 standard(s) 16 - 17. Any complaints received were dealt with appropriately. Residents were able to vote at election time and were protected from abuse. EVIDENCE: The home has a detailed complaints policy and procedure in place and carers are trained in its use. All seven residents consulted on the day of the inspection were confident that if they raised an issue it would be quickly resolved by the manager to their satisfaction. The home makes sure that a postal vote is provided to all residents that wish to express their view. The home has a detailed policy and procedure to protect residents from all forms of abuse and carers are trained in its use. No complaints have been made since the time of the last inspection and none were received during the inspection process. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 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 standard(s) 19 - 26. The lounge and dinning areas of the home were liked by the seven residents consulted and they also stated that their rooms were comfortable. However, there is an unreasonable delay in completing the maintennence programme in the home. EVIDENCE: A complete tour of all areas of the home was undertaken at inspection. The lounges of the home were appropriately furnished and a television was provided. Radiator covers that had been fitted have remained unpainted for at least twelve months and one window has a rotted window frame. Some redecoration is also needed. A refurbishment programme is understood to be implemented in the near future. Residents consulted advised that they were happy with their rooms, which they have personalised; level access was available to the garden area where additional seating was provided.
Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 15 Appropriate aids had been provided to residents that needed them. The aid for getting into the bath on the lower ground floor bathroom had been given to another home in the company. This situation should be reviewed and a replacement should be provided if it is required for residents. In general the home is clean, one room had a strong malodour and was understood to be cleaned twice weekly. A review should be undertaken to find a solution to provide a more suitable environment for the resident. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 16 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 - 30. The home has a varied skill mix of staff. Further training was needed for some of the team, however, residents are safe. EVIDENCE: The seven residents consulted during the inspection advised that they had their needs met and their emergency call bells were answered in a timely fashion. The deployment and number of staff available day and night is sufficient to meet the needs of residents. The recording of the induction training given to new carers was unclear; this was discussed with the manger of the home who is going to ensure that all induction training is undertaken by her in future. The home has a suitable recruitment policy and procedure in place that pays due regard to the equal opportunities legislation. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 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 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) 31 - 38. The manager of the home provides good leadership. The home is not involved with the finances of any service user. Improvements have been made concerning the health and safety issues in the home. EVIDENCE: The home is run in the best interest of residents who are able to decide when they eat and can change the timing of the cleaning of their rooms. Seven residents were consulted in private and stated that they had a good relationship with the manager of the home and that she had their confidence. Improvements have been made to the health and safety issues in the home, the patio area is now level and the recommended laundry protocol has been adopted. Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 2 2 3 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 3 3 2 2 3 Cross Park House D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 19 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 OP9 Regulation 13 Requirement The Registered Manager must ensure that staff adhere to procedures for the receipt, recording, storage, handling, administration and disposal of medicines. The Registered Manager must ensure that care staff are appropriately inducted and trained which should include infection control Timescale for action Forthwith 2. OP30 18 31/05/05 3. 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 7 12 26 Good Practice Recommendations It is recommended that the social elements of the care planning process are developed further. It is recommended that a review should be undertaken and more resources made available for leisure activities in the home. It is recommended that a review should be undertaken on the malodour present in one bedroom and a solution found to improve the environment.
D54-D07 S18341 Cross Park House V214605 120405 Stage 4.doc Version 1.20 Page 20 Cross Park House Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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