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Inspection on 28/02/07 for Crosshill Nursing Home

Also see our care home review for Crosshill Nursing Home for more information

This inspection was carried out on 28th February 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a homely environment for those who live there. Service users and relatives all felt the staff were caring and responded to their needs. One relative commented on the survey "As a family we feel our relative is well looked after with dignity and respect. All of the staff can be approached at any time". The home has clear admission procedures, assessments and care plans which help to make sure it can meet the needs of service users. The home is run with an open door policy, which gives it a welcoming feel and makes people feel comfortable. There is a varied programme of activities for the service users, which they can take part in as and when they feel like it. The home`s staff felt supported in their work through training and supervision. Over 50% of care staff have achieved an N.V.Q. in care at level 2 or 3.

What has improved since the last inspection?

Since the last inspection the kitchen staff have attended a `Focus on Food` course, which is about nutrition. This should make sure that all of the nutritional needs of the service user are met. The last inspection report required that records of food provided to service users be kept, so that any person inspecting the record could determine whether people`s diet was satisfactory. These records are now being kept.

What the care home could do better:

At the time of the inspection the electrical wiring certificate was out of date. The manager has told the inspector since the inspection that the test will be carried out on 28th March 2007. A copy of the certificate must be submitted to the CSCI when this work is completed.The fire risk assessment needs to be reviewed and updated to ensure that it complies with the recent changes in fire legislation.

CARE HOMES FOR OLDER PEOPLE Crosshill Nursing Home 2A Paragon Street Stanhope Durham DL13 2NN Lead Inspector Mrs Sue Lowther Unannounced Inspection 28th February 2007 09:30 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 Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 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. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crosshill Nursing Home Address 2A Paragon Street Stanhope Durham DL13 2NN 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) 0191 4881057 Rayson Homes Limited Julie Percival Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (25) of places Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 2006 Brief Description of the Service: Crosshill Care Home is situated in the historical town of Stanhope. The home provides 24hr personal care with nursing for up to 25 service users over the age of 65 years. The home is a single storey building, which is easily accessible to all service users and the corridors are wide enough to accommodate wheelchair users. There are 13 single and 6 double rooms, all of which are en suite. There is one large combined dining room and sitting room and 1 small quiet room. The staff team comprises of trained nurses, care staff and ancillary staff. Fees charged range between £365 and £1100 per week, depending on the level of care provided. These fees do not include the cost of newspapers, hairdressing, holidays, dry cleaning and transport for personal visits. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Crosshill Care Home took place on the 28th February 2007. Records were examined and a tour of the building took place. Time was spent talking to service users, staff and relatives. The manager supplied some information on a pre inspection questionnaire and service users and relatives completed surveys prior to the inspection. Information from these surveys and discussions on the day of inspection are reflected in the report. The inspection focussed on the key standard outcomes for service users. What the service does well: What has improved since the last inspection? What they could do better: At the time of the inspection the electrical wiring certificate was out of date. The manager has told the inspector since the inspection that the test will be carried out on 28th March 2007. A copy of the certificate must be submitted to the CSCI when this work is completed. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 6 The fire risk assessment needs to be reviewed and updated to ensure that it complies with the recent changes in fire legislation. 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. The summary of this inspection report can be made available in other formats on request. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 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 Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. The home does not provide intermediate care. Therefore assessment of Standard 6 is not required. EVIDENCE: The care plans examined showed that a full pre-admission assessment had been carried out. The manager said that she visits the prospective service user before admission to the home. The service user and their relatives are involved in this process. This is to ensure that the home can meet the needs of the prospective service user, before the come to live at Crosshill. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 9 Service users and relatives said that they were given enough information to decide whether the home was suitable. One service user said, “My daughter visited and asked locally about the home. She came to look around and the staff gave her a brochure which contained all of the information I needed to decide whether I wanted to come and live here”. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to ensure that the health care needs of service users are met. Medication is managed safely. Service users can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: The manager said that all of the service users have care plans. Four were looked at during this inspection. These were comprehensive and well written. This will help staff make sure that each resident gets the support and assistance that is needed. The inspector spent time with the service users and saw that they are well cared for and comfortable. Records examined showed that service users receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 11 Medication systems were looked at during this inspection. The home uses a monitored dosage system. All of the medication was signed for on the medication administration records. Service users and relatives said that the staff are polite, friendly and treat people with respect. One relative said, “The staff here are excellent and keep me us well informed. My relative is always dressed appropriately, her clothes are colour coordinated and she is always clean and tidy”. Another said on the survey form, “The staff are wonderful and the care is exceptional”. One service user said “They look after you well here and see to everything you want”. All of the people spoken to confirmed that their privacy is maintained. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities are varied and provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard, with varied menus and service users are given a choice. EVIDENCE: The care staff are responsible for organising activities within the home. Activities take place both inside and outside of the home. The indoor activities include board games, dominoes, talking books, and regular music sessions. Outside entertainers visit the home on a regular basis. Regular visits are made to the local resource centre, the Women’s Institute, and the Metrocentre, which is a large indoor shopping centre. One service user said, “Staff sometimes take me out and keep me entertained”. Another said, “I still go out in the village when I want to and I go on holiday every year”. Service users said they are encouraged to make choices about their lives. One said “I can get up and go to bed when I want. I have had a lie in this morning Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 13 until 9:30am. At night I ask the girls when I am ready for bed and they come as soon as they can”. Service users said that their relatives and friends can visit at any time and they can choose to see them in one of the lounges or their own room. Most of the people said that they liked the food and that a choice is usually available. One service user said, “ The food is really good and I have a choice most of the time”. Another said, “The staff got me eating again when I came here. The food is usually o.k. Staff will try to get me something else if I do not like the main meal”. The last inspection report required that records of food provided to service users be kept, so that any person inspecting the record could determine whether people’s diet was satisfactory. These records are now being kept. Nutritional assessments are undertaken and special diets are prepared when required. Staff have attended ‘focus on food’ training which covers the importance of good nutrition. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: Information is available for service users and visitors to the home on how to make a complaint. Service users and families views are obtained through regular contact and an ‘open door’ policy. Service users and relatives said that they feel confident in discussing any issues with the manager. One relative said, “I have no concerns whatsoever, but if I did I would be happy to approach the manager and I am confident that she would sort it out quickly”. One service user said, “I would tell the manager if I had a problem”. A record of complaints is kept which shows that the home has an accessible system in place for use by service users, relatives, staff and visitors. Training in adult protection is provided for all of the staff during their induction and is updated on a regular basis. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. EVIDENCE: Individual bedrooms and communal areas were suitably furnished and decorated in a style liked by people living there. Residents spoken to said they liked being able to bring into the home small items of furniture, along with pictures and photographs. This helped to make their own rooms more pleasant and feel more like home. One relative said, “This is a home from home”. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 16 The communal areas of the home were clean and residents confirmed that their bedrooms were also cleaned to a good standard. A visitor commented that the home is always clean and fresh. There were no unpleasant smells apparent on the day of inspection. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are appropriately recruited, trained and provided in sufficient numbers to meet the needs of the people who live in the home. EVIDENCE: The home had staff files in place, which provided evidence that new members of staff are selected through good recruitment processes. This includes the vetting of staff through the use of Criminal Record Bureau (CRB) checks, Protection of Vulnerable Adult checks (POVA) and obtaining written references. The staffing rotas were examined during the inspection. Staff felt that there are sufficient staff on duty to meet the needs of the people who live in the home. One service user said, “The staff are always available to talk to me or will take time with a phone call. They explain fully everything that happens to my relative”. The home has a commitment to staff training with 70 of care staff trained to N.V.Q. (National Vocational Qualification) in care at level two or above. Training has also taken place in fire safety, food safety, pain management and ‘Focus on Food’, which is specialist training for staff about nutrition. Certificates to confirm this training were seen in staff files. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. EVIDENCE: The manager is well qualified, with several years of experience in working with older people. She is a qualified nurse and has completed an appropriate management qualification. Staff said that the manager is always available for advice and support. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 19 The manager said that service users are asked to complete surveys about the home on a yearly basis. Service user and relatives views are also obtained through regular contact and an open door policy. The company carries out a quality assurance and monitoring audit on a monthly basis. This covers all aspects of care delivery and environmental issues. Records of these audits and checks were available in the home. Pocket monies are kept in the home for people who request this. Two signatures are obtained on financial records and receipts are kept, to ensure that service users’ financial interests are safeguarded. The manager confirmed that the home carries out regular health & safety checks. Records of these were available for inspection. At the time of the inspection the electrical wiring certificate was out of date. The manager has told the inspector that the test will be carried out on 28th March 2007. A copy of the new certificate must be submitted to the CSCI when this work is completed. The fire risk assessment also needs to be reviewed and updated to ensure that it complies with the recent changes in fire safety legislation. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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 OP38 Regulation 23(4) Requirement At the time of the inspection the electrical wiring certificate was out of date. The manager has told the inspector since the inspection that the test will be carried out on 28th March 2007. A copy of the certificate must be submitted to the CSCI on completion. Timescale for action 30/04/07 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 OP38 Good Practice Recommendations The fire risk assessment should be reviewed and updated to ensure that it complies with the recent change in legislation. Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Crosshill Nursing Home DS0000060995.V325319.R01.S.doc Version 5.2 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. 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