Inspection on 15/11/05 for Cross Park House

This inspection was carried out on 15th November 2005.

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 Park House 29/06/07

Cross Park House 05/07/06

Cross Park House 12/04/05

Cross Park House 17/08/04

Cross Park House 27/04/04

Cross Park House 16/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Cross Park House Monksbridge Road Brixham Devon TQ5 9NB Lead Inspector Sharon Goldsworthy Unannounced 15 November & 21 December 2005 th st 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 V260008 151105 Stage 4.doc Version 1.40 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) Stonehaven (Healthcare) Ltd 01803 856619 01803 859040 Mrs Arleathea Ann Mead CRH 23 Category(ies) of Old age not falling within any other category(23) registration, with number Physical Disability over 65 Years (23) of places Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NVQ in Care and Management taken by Mrs Arleathea Mead in next 6 months. Imposed on 26.04.2004 Date of last inspection 12th April 2005 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 V260008 151105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and is the second inspection to take place this year. It took place over two days – 15th November and 21st December 2005. The Inspector spoke with fourteen residents over the two visits, met with staff on duty and the Manager and toured the premises. Prior to both inspection visits the CSCI received two separate complaints (one from the ambulance service and one from a visiting chiropodist) – both of these were investigated at these visits and both were found to be upheld. Details of these complaints can be found in the body of this report, or further details can be obtained from the CSCI local office. What the service does well: What has improved since the last inspection? What they could do better: The hoist was found to be stored in a basement bedroom and was not charged on the first visit. It was however, found to be available and fully charged at the second visit. It is vitally important that the hoist and other manual handling equipment is available and ready for use at all times, particularly given that most residents have physical difficulties of some sort. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 Page 6 Statutory training, including manual handling training needs to be greatly improved in terms of its quality and availability to all staff. Staff need to be appropriately and sufficiently trained to meet the needs of the resident group. Fire safety and hot water temperature checks need to be kept up to date and recorded clearly, to evidence that residents safety is protected at all times. Residents need to be kept fully informed and fully consulted on all aspects of their care, and in particular their health care provision. 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 Park House D54-D07 S18341 Cross Park House V260008 151105 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 Cross Park House D54-D07 S18341 Cross Park House V260008 151105 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) None of these standards were considered in depth at this visit. EVIDENCE: Cross Park House D54-D07 S18341 Cross Park House V260008 151105 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, 9 Residents health, personal and social care needs are clearly recorded in the care planning documentation. Residents are protected by the home’s policies and practices of the administration of medications. EVIDENCE: Three examples of care records were viewed on the first day of these visits. All were found to be up to date, accurately reflect the residents’ current needs and evidenced weekly reviews of the care plan. Care plans demonstrate that resident’s health and personal care needs are being met. 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. The medication storage, administration and recording system was inspected and found to be accurate and up to date. The Manager confirmed that all staff who are responsible for the administration of medications have received in house training from her and are now felt to have a good understanding of the system. No errors in the system have occurred since the last inspection visit. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 Page 10 Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 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 standard(s) 15 Meals are well presented and balanced, but fresh ingredients, fruit, vegetables or milk are rarely used. EVIDENCE: All residents spoken with, all spoke very highly of the food provided in the home and that they were fully consulted on the menu and choices for each meal. Only one resident made a request to have bacon provided more often. The Inspector found that there was no fresh vegetables, fruit or milk available or used in the preparation of the meal on the day of this visit. The staff confirmed that fresh vegetables and fruit are only purchased on one day a week, and that they are instructed to buy powdered milk only for residents. Staff themselves are purchasing their own fresh milk. Whilst acknowledging that frozen foods can also provide the same level of nutrients and vitamins, they should not be used as a complete substitute to the use of fresh when caring for older people. The provision of fresh fruit must be greatly improved and residents should be consulted about their wish to have fresh milk or powdered. If any choose fresh milk, then this must be provided. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 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 The home has a satisfactory complaints system, with evidence that complaints are taken seriously and acted upon. EVIDENCE: As mentioned in the summary, the CSCI have received two complaints. The first complaint was made by the West Country Ambulance service, following their attendance at the home. The complaint was in relation to staff’s competencies and the availability of manual handling equipment – in particular the hoist. At the visit of 15th November, the hoist was found to be stored in a basement bedroom, behind some unused furniture and boxes and was not charged and therefore not available for use. An immediate requirement was made following this visit. At the visit of 21st December, the hoist was found to be stored in an unused bedroom, but was accessible and found to be fully charged. All staff have now received training from the manager in the use of this hoist. Staff spoken to on this visit, were aware of where they could access the hoist. A chiropodist who has been visiting the home for many years, but has now been asked to not return by the Proprietors made the second complaint. Ten residents were consulted about their chiropody care. All stated that they had been very happy with the service, and eight were not aware that the service had been stopped. None have so far been consulted about the future provision of their chiropody care. This complaint was therefore upheld and an immediate requirement was left with the home. The Manager did however, state that she fully intended to consult with residents about their future health care needs, in particular chiropody care. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 Page 13 Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 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, 22, 26 The home is well presented and maintained, clean and hygienic EVIDENCE: The home was found to be generally clean and well maintained and presented as being homely and comfortable. Some bedrooms have been redecorated since the last inspection and on the second day of these visits, a delivery of new pine furniture arrived for several bedrooms. There remain some bedrooms that are in need of redecoration and re-carpeting and two bedrooms that are currently vacant have damp to the ceilings following a leak from the flat roof. The Manager stated that quotes have been sought for the repair of the flat roof and hopes to have this work completed by the end of January 2006. The remaining bedrooms and the communal rooms are due for refurbishment in the coming year. As mentioned in Standard 16, a complaint was made that manual handling equipment was not available for use. This is particularly an issue for this home, as most residents have some form of physical disability. It is essential that all manual handling equipment is accessible and available for use when required. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 Page 15 Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 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) 30 Not all staff are sufficiently trained to meet the needs of the current resident group. EVIDENCE: The home has a good induction programme in place and evidenced that all new staff have been taken through this. The Manager herself oversees this programme and has given the staff specific in house training in managing and caring for the needs of the current resident group. However, not all staff have received all statutory training and are therefore not sufficiently competent to meet the needs of the current resident group. The CSCI have been made aware (from inspection visits, discussions with staff and managers and observations) that training within their homes is not sufficient, accredited or externally certificated. The Proprietors are asked to ensure that all staff receive appropriate training from an external provider that is accredited and certificated. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 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) 38 The health and safety of residents and staff are not fully protected. EVIDENCE: A sample of health and safety records were viewed on the first day of these inspection visits. Most fire, COSHH, risk assessments were found to be up to date and recorded accurately. However, the last weekly fire alarm test was carried out on the 6th October 2005 and extinguishers were last checked on the 19th August 2004. The Manager confirmed that temperature valves are fitted to all hot water outlets in the home. However, no records are kept to evidence that the home is maintaining these valves and periodically checking the temperatures at these outlets. All above mentioned records and checks must be maintained to ensure the safety of both residents and staff within this home. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x 2 x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 2 Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 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 15 Regulation 12(3) Requirement All residents and/or their representatives should be consulted for their choice of menus, fresh vegetables and fruit and milk provision All residents should be fully consulted for their views and wishes in relation to their health care needs. All manual handling equipment must be accessible and available for use at all times All staff must receive all statutory training that is provided by external training providers and is accredited and certificated. Fire alarm checks must be reinstated Hot water outlets must be periodically checked to ensure that water delivered does not exceed 43 degrees centigrade Timescale for action 30/01/06 2. 16 12(3) 30/01/06 3. 4. 22 30 23(2) 18(1) 30/12/05 30/02/06 5. 6. 38 38 13(4) 13(4) 21/12/05 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 Page 20 No. 1. Refer to Standard Good Practice Recommendations Cross Park House D54-D07 S18341 Cross Park House V260008 151105 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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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