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Inspection on 29/09/05 for Crosshill Nursing Home

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

This inspection was carried out on 29th September 2005.

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

A good standard of care is provided for the people who live at the home. Residents said they enjoyed living there, and that the staff were kind and helpful. There were written care plans in place for each resident. This helps staff make sure that each resident gets the support and assistance that is needed for them to live safely and comfortably. Residents said they enjoy the food and there was a choice of meals available. There was a range of activities offered and the residents said they really enjoyed this. People living at the home were comfortable and well cared for. The staff were motivated and enthusiastic in caring for older people.

What has improved since the last inspection?

The requirements from the last inspection have been met and the improved lighting has made the home brighter, providing a more homely environment for service users.

What the care home could do better:

Whilst training is generally up to date and appropriate to meet the needs of service users, several staff now require an update with regard to fire safety. The home must continue to maintain and to build upon the good service it gives to the residents who live at the home.

CARE HOMES FOR OLDER PEOPLE Crosshill Nursing Home 2A Paragon Street Stanhope Durham DL13 2NN Lead Inspector Mrs Sue Lowther Announced Inspection 29th September 2005 13:30 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.V251870.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 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.V251870.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2005 Brief Description of the Service: Crosshill is a care home registered to provide care (including 24 hour nursing care) for persons aged 65 years or older. It is located in the centre of the historical town of Stanhope with easy access to all local amenities. Accommodation is provided in a modern single storey building. There are 13 single rooms and 6 double rooms all of which are en-suite. The current owners Mr. & Mrs. Rayson registered the building in 1992. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. CSCI has a statutory duty to inspect all care homes at least twice a year. This announced inspection was carried out in accordance with this duty. The inspection took place on the 29th September 2005. Records were examined and a tour of the building took place. Time was spent talking to 6 service users and 4 staff and 3 relatives. In line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be raised during the next inspection of the home. What the service does well: What has improved since the last inspection? The requirements from the last inspection have been met and the improved lighting has made the home brighter, providing a more homely environment for service users. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The assessment process in the main demonstrates how the home will meet the individual needs of the service users placed. EVIDENCE: Assessments from Care Managers are obtained for all new admissions funded by the Local Authority. The home also carries out its own assessments on service users. 3 care files were reviewed, which contained comprehensive assessments. These form the basis from which the individual plan of care is written and demonstrate how the home will meet an individuals needs. The home does not currently provide intermediate care and therefore inspection of standard 6 is not required. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 The care planning system was found to be comprehensive providing the information that staff would need to satisfactorily meet the needs of service users. EVIDENCE: During the course of the inspection of the 3 care files audited, 2 were discussed with service users, who were aware of and agreed with the care that had been planned for them. Staff write in the care plan when people are seen by other health care professionals such as GP’s, Chiropodist’s and Dentists to demonstrate that all of the peoples health care needs are met. Qualified nurses administer medications. A sample audit of medications was undertaken and found to be in order. Service users spoken to confirmed that staff treat them with dignity and respect and always knock before entering their rooms. This was observed during the inspection process. Several staff have undertaken training courses in the area palliative care. Policies are available for staff to consult and specialist services are utilised when required. No concerns were raised during interviews with service users, staff or visitors and no adverse observations were made during the inspection process. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 10 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 The recreational and social needs of service users are well catered for which enables service users to make daily choices and promotes independence. EVIDENCE: There was good practice relating to the promotion of independence and social contact with people outside the home. Service users said that they are able to see their relatives and friends when they wish and this was also observed. Staff organise activities within the home and there was a varied range of activities offered. Service users were able choose whether or not they wish to be involved. One service user visits the local shops on a daily basis and sometimes brings confectionary items back for other service users. She said that this makes her feel ‘useful and valued.’ Service users said that the food was good. Observation of the lunchtime meal provided evidence that service users were able to make choices about the meals they wished to eat. Staff were available to assist any service users should they require help over the lunchtime period. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 11 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 The home has a satisfactory complaints procedure in place, and some relatives confirmed that they are aware of the procedure to follow. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staffs knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. Staff training has taken place in the protection of vulnerable adults in abuse, with further sessions planned. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 12 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&26 Crosshill is safe and well maintained. The home is clean, tidy and free from offensive odours. EVIDENCE: The home is located in Stanhope with easy access to all local amenities. The building can accommodate up to 25 service users in a variety of single and double rooms. There are adequate communal sitting/dining areas available. During a tour of the building, it was seen to be adequately maintained. There are no outstanding maintenance issues. The home was clean, tidy and free from offensive odours. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 13 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 Sufficient staff are currently employed. The home has a settled and well-led staff team. EVIDENCE: From discussions with management and staff, and from an examination of duty rosters, sufficient staff are employed within the home. There is a settled staff team. Most of the staff spoken to have worked at Crosshill for 5 years or more. For staffing purposes, the homes waking day runs from 8 am to 8 pm. On morning shifts, 1 or 2 qualified nurses and 4 care assistants are rostered. Where service users’ needs increase, staffing levels are adjusted to provide an additional carer. On afternoon shifts, 1 or 2 qualified nurses and 3 care assistants are rostered. After 8 pm, staffing levels are: 1 qualified nurse and 1 care assistant. The previous report required a review of night staffing. This has resulted in the home producing a contingency plan should an emergency arise during the night. Such a situation has arisen and the plan therefore has been tested and found to work. Staffing levels are therefore considered to be adequate to meet the needs of the people currently accommodated. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 14 The manager has reviewed staff files and the requirement from the last inspection with regard to the documents to be kept on file has now been addressed. CRB (Criminal Records Bureau) disclosure checks are carried out for all staff. A copy of each person’s birth certificate and a photograph is kept in their personnel file; these documents are copied when completing the Criminal Records Bureau disclosure. Applicants for employment complete an application form and 2 references will now be obtained, including a reference from the last employer. Each member of staff receives a contract of employment and a job description. Staff training is given a high priority. 70 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. In addition to NVQ and core training in for example moving and handling and health and safety. However several staff now require an update with regard to fire training and must be arranged as a matter of urgency. Although it is acknowledged that staff training needs are identified, and individual staff training records are kept, benefit would be obtained from collating individual training needs into a document setting out the overall collective training needs of the whole staff team. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 15 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, 33,36 & 38 The Registered manager is positive towards self-development to enhance her skills and abilities to provide a good standard of care delivery to service. EVIDENCE: The registered manager was previously the deputy and has worked in the home for several years. She has completed a management qualification. Staff confirmed that they receive supervision and feel supported in their role. The home is a small home and most of the service users have lived there for several years. The Registered provider was previously the manager and service users, relatives and staff confirmed that they feel comfortable to approach both the current manager and him when they have a problem. Maintenance records were available to confirm that as far as practicable equipment is maintained to promote the safety and welfare of service users and staff. However as previously stated fire training must be arranged for all staff. Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 16 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 2 Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 17 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 OP30OP38 Regulation 18(c)(1) 23(4)(d)& (e) Requirement Staff must receive appropriate training on a minimum of a 6 monthly basis, with regard to fire prevention. The Registered Person must ensure that by means of fire drills and practices that all persons working in the home must be aware of the procedure to follow in the case of fire Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Crosshill Nursing Home DS0000060995.V251870.R01.S.doc Version 5.0 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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