Inspection on 05/07/06 for Cross Park House

This inspection was carried out on 5th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Cross Park House 29/06/07

Cross Park House 15/11/05

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 Stella Lindsay Unannounced Inspection 9:45 5th July 2006 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 Park House DS0000018341.V288993.R01.S.doc Version 5.1 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 Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cross Park House Address Monksbridge Road Brixham Devon TQ5 9NB 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) 01803 856619 01803 859040 Stonehaven (Healthcare) Ltd Mrs Arleathea Ann Mead Care Home 23 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (23), of places Physical disability over 65 years of age (23) Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include two service users, named elsewhere, in the Category of DE(E) 15th November & 21st December 2005 Date of last inspection Brief Description of the Service: Cross Park House is located on the outskirts of Brixham, on the hillside above the town centre. There is a driveway to the front door, and car parking space beside the house. Residential care is offered for up to 23 persons within the categories of old age and physical disability. Living accommodation is on three floors, with two shaft lifts. At one side of the house there is a lift to the first floor, and at the other side of the house is the shaft lift to the lower ground floor. There are bathrooms on each floor. All bedrooms are single occupancy. One has on suite facilities. There are two lounge areas, one of which has easy access to the patios. A large conservatory is used as a dining room. To the front of the home there is a garden and patio, to the rear there is a small garden and terrace. Current fees range from £303 - £390 per week. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, and took place over two days in July 2006. It involved a tour of the premises, and examination of care records, staff files, health and safety records and the medication system. The inspector met with the Registered Manager, the consultant to Stonehaven, 16 residents, and four staff on duty. Additional and supportive information was received from visiting professionals, staff member questionnaires, discussions and feedback received from relatives and pre-inspection documentation provided by the Registered Manager. What the service does well: What has improved since the last inspection? What they could do better: All information provided for prospective residents and their supporters must be accurate and unambiguous, to help people make a sound decision. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 6 All pre-admission assessments must recorded, for the information of all staff, and the letter of confirmation must be sent to assure the resident that the home is suitable to meet their needs. A risk assessment must be carried out before any form of restraint – such as a bed guard (cot-side) is used, to minimise any potential harm to the resident. A specific risk assessment should be considered when a resident wishes to keep their own medication, to ensure that they are safe to do this. It is recommended that more time and resources are made available for social activities, in line with the information gathered in the People Centred Activity Programmes. A high proportion of tinned, dried and frozen food is served. It is recommended that more fresh meat, vegetables and fruit be provided for the improved appetite and enjoyment of residents. It is recommended that a record be kept of any minor complaints and concerns, and any action taken, so that any recurring problems can be noted, and people can be shown that action has been taken. All toilets must be kept supplied with toilet rolls, liquid soap and paper towels. A suitable place or facility for washing commode pots must be provided. It is recommended that a separate area for drying and ironing laundered clothes be made available, to further improve the separation of clean and dirty washing. The home must maintain its staffing levels, and be able to provide cover for absences, so that a good level of service is maintained. Management must review staff levels at night, and ensure that residents’ needs are being met. There must be support for staff and residents where English is not their first language, to aid communication, especially where there are additional difficulties such as sensory loss. More staff must be enabled to work towards NVQ achievement, in order to provide a qualified workforce. Care staff should be provided with training on the particular needs of residents, including specific conditions and sensory loss, in order to help the residents in the most appropriate way. A supervision and appraisal system is planned to be implemented for all staff. All staff should have formalised one to one time with the Manager or Senior Carer to review their care practice and training and development needs. Training in Moving and Handling had been provided, including practical guidance and use of the hoist. All staff need to be up to date with this training, to assure the safety of residents. A system is in place to maintain bath water at a suitable temperature, but it needs to be checked periodically, to ensure the safety of residents. 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 Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 7 contacting your local CSCI office. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 8 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 Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 9 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): 1,3 Quality in this outcome area was adequate. Information that is provided is good but not always accurate. Admission procedures are good but need to be fully recorded prior to admission. EVIDENCE: Stonehaven has provided information about the home and the company for prospective residents and their families. The factual information is very good. This includes the room sizes and the training achievements of staff. Description of the registration categories (p4) is muddled. There are inconsistencies, and some information is misleading. The claim is made that communal space exceeds the National Minimum standards, while it is in fact below it. Careful reading shows that much of the content describes good practice, rather than what is on offer at Cross Park House eg ‘ People who are hard of hearing may need the staff to use forms of communication other than speech, such as signing. It may be possible to have a loop system installed’ (p.10). There are no qualified signers on the staff, and communication with staff was mentioned as a problem by residents, relatives and visiting professionals. Stonehaven’s web site claims that they use only the Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 10 finest ingredients and from local Devon producers but residents and relatives told the inspector they were not happy with the proportion of tinned and frozen food that is served. A Resident User Guide has been produced in a brochure, with clear and attractive photos of the house. Leaflets about an advocacy service and the local council’s short break voucher scheme have been included, which is good practice. Documentation of pre-admission assessment by the home was examined and found to be variable. The Manager uses an assessment format, and some were seen to have been properly completed, and a letter sent to the individual to say that accommodation could be offered, and that this assessment would form the basis of the resident’s care plan. This is good practice. A Community Care Worker stated that she had found the Manager particularly helpful while admitting a resident (in 2005). The most recently admitted resident had been to visit for one day, to be able to look around and for the manager and staff to consider whether they were able to meet the person’s needs, but no assessment had been recorded. The Manager stated that she had discussed this placement with the resident’s Care Manager, but there was no record of this. Full recording is needed so that all staff can be aware of the needs of the incoming person, and the letter of confirmation needs to be written in all cases. Stonehaven offer a free overnight stay to prospective residents, for them to get a full experience of the home before moving in. This is good practice. One recently admitted resident was observed whose care needs were not being met appropriately. Their care records showed that staff were not able to meet their needs appropriately or ensure their safety. Staff were aware of the difficulties, and doing their best to be vigilant on their behalf. The Manager requested a professional review of their care needs. Intermediate care is not offered at Cross Park House. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 11 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): 7,8,9,10 Quality in this outcome area is good, with good care plans resulting in individuals’ care needs being known, although risk assessments were not entirely satisfactory. EVIDENCE: A plan of care was available for each person receiving a service at the home and six of these were examined during the inspection. The company is in the process of introducing new care plan formats, and the Manager and a Senior Carer had started work on implementing these. They include many useful triggers for health problems. A summary of the care actually needed, written in plain English, will be needed, drawn up in consultation with the resident or their representative. Life histories and personal profiles had been written for some residents, or were in progress. The Manager had written People Centred Activity Programmes for most residents, detailing their interests, preferences and outside contacts. This is good practice and should be completed for all, and should be signed by the resident or their representative as evidence of involvement. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 12 Two files contained a record of the resident or relative having examined the documents. Health needs were addressed and appropriate access was provided to healthcare professionals for residents. Many residents were physically frail, and there was considerable evidence of District Nurse involvement, and of referrals to Physiotherapists and Occupational Therapists. Vulnerability to pressure areas was recorded. Risk assessments were an integral part of the new care plans. One resident was at considerable danger because they wished to leave the home, but were not safe to do so unaccompanied. Measures to deal with this were being considered by management, but no risk assessment or interim plan for staff was documented. Two residents had bed guards fitted to their beds. The Manager had asked the District Nurses for advice on this usage, which was good practice, but risk assessments must be carried out, to identify and minimise potential harm, and introduce a system of recording regular checks by Night Care staff, to assure the residents’ well being. Medications were stored securely, and the system for administration was sound, with the exception that an informal record sheet had been drawn up for one individual, which was incomplete. The Manager was considering a change to this service which would improve the safety and availability of medications. One resident was judged to be competent to administer their own medication, and had signed a document to accept this responsibility. It would be good practice to complete a specific risk assessment, to judge whether the resident were competent to know when they should take their medication, what the dose is, and that they can manage to open the container. Staff were seen to treat residents with respect. All have their own private room, and suitable locks are fitted to bedroom doors. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 13 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): 12,13,14,15 Quality in this outcome area is adequate. Good work is being done to promote individual attention and social activities, but the standard of food provision still needs to improve. EVIDENCE: Staff described how they help residents to get up, or go to bed, at the time of their choice. Staff were heard consulting residents about what they wanted to be doing during the day. One had found out about the particular Church of one of the residents. They informally worked with particular residents, to promote good relationships and satisfaction. Some staff thought a keyworker system would help promote this work. There were no formal activities during the inspection. The News Letter says that reminiscence quizzes, craft and agility sessions had been successfully introduced, but the worker who leads these was on holiday. Residents were happy to get out into the garden in the sunshine. Cross Park House is a busy home, with many personal and professional visitors. The Statement of Purpose states that visitors are welcome at any time, and also records the security arrangements necessary. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 14 Management informed the inspector that the provision of fresh food has increased. Cooks said that they could buy from the local shop, for any ingredient they needed. The inspector found that though there was a small amount of fresh fruit and vegetables in the building, the proportion of tinned and frozen food was still high. Relatives said they were not impressed by such items as frozen sprouts or spam being served. Further effort is needed to approach the claims made on Stonehaven’s web site, and thought given to the presentation. Ham with parsley sauce was served during the inspection. The ham was good quality, but residents were seen to have difficulty eating it, as it had not been sliced thinly enough for them to manage. The only fresh vegetable or fruit in the entire meal were the potatoes. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 15 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): 16,18 Quality in this outcome area was good. Matters brought to the attention of management had been dealt with effectively. EVIDENCE: The complaints procedure is displayed in the home, and published in the Residents User Guide. There is no record kept of minor complaints made, and action taken. The proprietors were asked to investigate a complaint made to the Commission for Social Care Inspection, with regard to staff induction, attitudes and language. It was thoroughly investigated, partially upheld, and disciplinary action taken. The home has a detailed policy and procedure to protect residents from all forms of abuse. It should be amended to include the local reporting arrangements. The Manager was aware of this, and in possession of the ‘Alerters’ Guidance’. All staff had received training on the Protection of Vulnerable Adults during the previous month, and those who spoke to the inspector were clear about what to do if they suspected any abuse. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 16 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): 19,20,21,23,25,26 Quality in this outcome area is adequate. Maintenance and refurbishment were on-going, but some health and safety measures were still needed. EVIDENCE: Cross Park House is a detached building on three floors. The entrance and communal rooms are on the middle floor, with two shaft lifts – one to the lower ground floor, and the other to the first floor. There are two separate lounges. The larger of the two has access to patios on two sides, and is a light airy room. The small lounge is more enclosed, and is adjacent to the large conservatory which is used as the dining room, and gives residents plenty of light and garden views while they eat. Several residents enjoy getting out into the garden, and were seen to be delighted during the inspection when the rain stopped and they were able to go out and enjoy the sunshine. Solid wooden garden furniture had been provided, with parasols, along with a fishpond for residents’ interest, and garden lighting. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 17 The total communal space has been calculated as 3.53 square metres per resident, which does not meet the National Minimum Standard of 4.1 sq. m. per person, and this is published in the Home’s Statement of Purpose. The lounges and dining room were seen to be bright and comfortable. The Manager stated that a new carpet had already been ordered to replace a badly worn carpet along a corridor. The bathrooms and toilets would benefit from a general consideration of their appearance. Some bathrooms and toilets were in need of new flooring, as cracks were evident, and some bath edges and skirting boards were not sealed, which causes a risk of contamination. The water in the first floor bathroom was above the permitted temperature, and not all toilet doors had suitable locks. The window in the first floor bathroom had no restrictor, and the paintwork was flaking. The contractor who carries out maintenance work for Stonehaven was on site during the inspection, and stated that he would deal with these items, and confirmation was received from the home owners on 13th July that he was attending to these issues. All bedrooms are for single occupancy, and all those seen were in a good decorative state. Some had pleasant views of the gardens and patios. The size of the rooms range from 10 to 12.83 square metres, which is in line with the National Minimum standards, but only three rooms are over 12 sq. m which is the size considered appropriate for a wheelchair user, for manoeuvrability and storage of equipment. One bedroom has an en suite toilet and bath. All the other bedrooms seen by the inspector had a commode. The inspector was advised that any radiator not already fitted with a cover to assure the safety of residents, are of the type with low temperature surfaces, and therefore not putting residents at risk of harm. The maintenance contractor stated that a system is in place at Cross Park House that eliminates the risk of Legionella without the need to store water at a high temperature. The major project of the refurbishment of the kitchen was carried out in September 2005, and it now has sound surfaces throughout, to enable hygienic cleaning. Care staff were washing crockery and cutlery after lunch, which is not the best for hygiene, as a dishwasher can clean at higher temperatures. Also, residents need the staff’s attention following meals. On 13th July 2006 the home owner advised the Commission for Social Care that a dishwasher had been ordered. The house was seen to be reasonably clean during the inspection, with just slight odours in one bedroom. However, the inspector received comment cards from some relatives saying that they had had to clean their own relatives’ rooms themselves when no cleaner was available. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 18 The inspector found some of the toilets lacking toilet paper, and met a resident approaching one carrying their own roll. When asked why, they said there was often none. Not all toilets had paper towels and liquid soap available. Each bedroom the inspector visited had a commode, for use by residents through the night as they are unable to get to the communal toilet, and only one room has its own en suite. There is no dedicated place for commode pots to be cleaned. The laundry is on the lower ground floor and has a separate entrance. Staff had a system for keeping clean and dirty laundry separate. It was recommended that it could be further improved, as there is space adjacent that could be used as a drying and ironing area. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 19 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): 27,28,29,30 Quality in this outcome area is adequate. Planned staffing levels are sufficient, except by night, but not enough staff are always available in the event of staff absences. There have been difficulties with communication between some staff and residents. There is a low level of NVQ achievement. The system of recruitment is sound, and there have been improvements to training and induction for staff. EVIDENCE: There is a written rota, showing that four care staff should be on duty every morning, as well as a cleaner from 9 – 3pm, and a cook from 8 – 1pm. The Registered Manager is additional to this. During the inspection this level was not reached, due to the unexpected absence of a Senior carer, on sick leave, and the planned absence of the cleaner, on annual leave. Staff confirmed that the amount of staff is sufficient when all are present, though the need for one carer to spend considerable time in the laundry was noted. The home needs better provision for covering for absence, as there is too much of a rush to get tasks done when they are short-staffed. As recorded under standard 26, the home was seen to be in a reasonable state, but two relatives gave the opinion that the home was not always clean, and that they had sometimes to clean their own relative’s room. Arrangements should always be made so that the service does not deteriorate in the absence of any member of staff. At night, there was one waking Night Care Assistant, and one sleeping in. One resident told the inspector that they sometimes had to wait for attention at night, as the carer was busy helping other residents. The Manager said that Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 20 night staff had been very busy recently. The residents now have high care needs, and their bedrooms are ranged over three floors. Management must review night care needs and ensure that enough staff are provided. Some residents, relatives and visiting professionals gave the view that there were too often problems with communication with overseas staff. It is important to ensure that there is always someone available who has English as their first language, as many residents have communication problems of their own, through speech problems or sensory loss. The inspector had met one of the overseas staff working in another Stonehaven establishment the previous month. Continuity is important when staff are learning their language skills, because there is so much for them to learn with each resident’s individual requirements. Four staff files were examined, and it was found that all documentation that is required during recruitment for the protection of residents was present. Evidence of induction training was seen, and the home’s consultant stated that he had supplied the company with the Skills for Care Induction programme. Two of the twelve care staff had achieved NVQ2 or 3, and one started working towards it in January 2006. All staff had received training in fire safety, the Protection of Vulnerable adults, and health and safety, and some had received training in other mandatory areas including moving and handling, first aid and infection control. Some staff but not all were up to date with Moving and Handling training, including use of the hoist. The Manager and a Senior carer had attended a course on the care of people with dementia. Care staff should be provided with training on the particular needs of this service user group, including specific conditions suffered by individuals, and in particular how to help people with severe sensory loss. The Manager has a system of appraisal with staff, to consider their performance and training needs. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 21 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): 31,33,35,36,38 Quality in this area was found to be adequate, as there is a qualified and caring Manager in post, but not all issues of staffing or health and safety were dealt with without prompting. Quality audit is carried out and is being reviewed; residents’ money is cared for efficiently. EVIDENCE: The Registered Manager completed her Registered Managers’ Award in January 2005, and the NVQ4 in Care and Management in January 2006. She has continued her training by undertaking a course in Management Coaching in February 2006. There was a difficulty with the management of the home at the time of this inspection, as both established Senior Care staff were on sick leave, leaving the home in the care of inexperienced and overseas staff in the manager’s absence. The company made prompt arrangements for management support from elsewhere within the company. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 22 The Manager had completed monthly and weekly audit forms to report on the performance of the home. The weekly check has included details of maintenance work still outstanding, which forms a useful record of work done and also requests which had needed repeating. Stonehaven had appointed a consultant to assist with quality audits and to report monthly to the Commission for Social Care Inspection. Improvement in the objectivity and accuracy has been noted. Cash was kept in the office for 12 residents, by their choice, although they had lockable storage space in their room. All transactions were recorded on a clear form showing the running balance and two signatures. One account was checked and found to be accurate. The Manager was dealing with the personal income of one resident who still received giro cheques, but no money was paid into any account on behalf of any resident. The Manager had distributed appraisal forms to care staff for their consideration before meeting with them one to one. They had not received individual supervision sessions as required for consideration of their performance, practice issues, and their own development needs. The Manager and a Senior Carer had received training in ‘Manager as Coach’ this year. The Fire precaution system had been checked professionally on 05/04/06, and weekly checks had been reinstated. All staff had received fire safety training. Many private bedrooms had hold-open devices fitted in case the occupant wished to have their door open through the day. The maintenance contractor informed the inspector that a system was in place at Cross Park House which eliminated risk of Legionella without the need to store water at 60degrees. Nevertheless, there should be thermometers available for staff to check and record the temperature of bath water. Training in Moving and Handling had been provided, including practical guidance and use of the hoist. The Manager must ensure that all staff are up to date with this training. Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 23 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 X 3 X 3 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? one 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 2 3 Standard OP1 OP3 OP8 Regulation 4 14 13 Requirement All information must be accurate and unambiguous. All pre-admission assessments must be recorded, and the letter of confirmation sent. The Manager must carry out risk assessments with regard to the use of bed guards, minimise potential harm, and introduce a system of recording regular checks by Night Care staff, to assure the residents’ well being. A suitable facility for washing commode pots must be provided. All toilets must be kept supplied with toilet rolls, paper towels and liquid soap. The Home must maintain a sufficient level of competent staff, and be able to cover for staff absences. Management must review staffing levels by night, and send a report to CSCI. The Manager must enable more staff to work towards NVQ achievement. The Manager and Senior Carer must provide supervision DS0000018341.V288993.R01.S.doc Timescale for action 31/08/06 31/08/06 31/07/06 4 5 6 OP26 OP26 OP27 23(2)k 13(3) 18(1)a 30/09/06 31/07/06 31/08/06 7 8 OP28 OP36 18(1)a 18(2) 31/12/06 31/12/06 Cross Park House Version 5.1 Page 25 9 10 OP38 OP38 13(5) 13(4) sessions for all care staff a minimum of six times a year. The Manager must ensure that all care staff are up to date with Moving and Handling training. Hot water outlets must be periodically checked to ensure that water delivered does not exceed 43 degrees centigrade; previous timescale 30/01/06. 30/09/06 31/07/06 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 2 Refer to Standard OP9 OP12 Good Practice Recommendations It is recommended that a risk assessment for selfmedication be drawn up. It is recommended that a review should be undertaken and more resources made available for leisure activities in the home, in line with the information gathered in the People Centred Activity Programmes. Further progress should be made in providing fresh meat, vegetables and fruit. It is good practice to keep a record of minor complaints/concerns, and any action taken in response. It is recommended that the drying/ironing area for clean clothes be separated from the laundry room. Care staff should be provided with training on the particular needs of this service user group, including specific conditions suffered by individuals, and in particular how to help people with severe sensory loss. 3 4 5 6 OP15 OP16 OP26 OP30 Cross Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Ashburton Office 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 © 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 Park House DS0000018341.V288993.R01.S.doc Version 5.1 Page 27 - 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. 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