Inspection on 18/01/06 for Crossley House

This inspection was carried out on 18th January 2006.

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.

Other inspections for this house

Crossley House 22/08/06

Crossley House 19/07/05

Crossley House 08/02/05

Crossley House 07/07/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

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

CARE HOMES FOR OLDER PEOPLE Crossley House 109 High Street Winterbourne South Glos BS36 1RF Lead Inspector Helen Taylor Announced Inspection 18th January 2006 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 Crossley House DS0000003318.V266430.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. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crossley House Address 109 High Street Winterbourne South Glos BS36 1RF 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) 01454 777363 Ablecare Homes Mrs Jacqui Woodman Care Home 17 Category(ies) of Dementia - over 65 years of age (5), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (17) Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 17 persons aged 65 years and over requiring personal care only May accommodate up to 5 persons with dementia May accommodate one person with learning difficulties Date of last inspection 19th July 2005 Brief Description of the Service: Crossley House is registered with the Commission for Social Care Inspection to provide personal care for 17 persons aged 65 years and over. Within this registration the home may care for 5 persons who have a dementia, and one person who has a learning disability. Crossley House is situated in Winterbourne, a village on the outskirts of Bristol. The accommodation is arranged over three floors in an elegant Georgian listed building surrounded by well-kept gardens. The home is close to local amenities with bus routes to nearby Yate. Ablecare Homes Ltd. own and operate the home as part of a group of homes owned by the company in the Bristol area. The registered manager is Mrs Jacqui Woodman. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and conducted as part of the annual inspection programme to examine the care provided, and monitor progress in relation to a recommendation made during the last inspection conducted in July 2005. There were no requirements from the previous inspection. The inspection took place over one day and information was gathered from the following sources; comment cards from friends or relatives, a pre-inspection questionnaire completed by the provider, discussion with residents, a visitor, staff, the manager and the provider. Observation of interactions between staff and residents, a tour of the building, and a review of records held in the home also provided evidence in relation to the delivery of care. Mrs Jacqui Woodman the registered manager, and Mrs Sam Hawker a director of Ablecare Homes, co-ordinated the inspection process. The staff and residents conveyed a positive attitude to the inspection process. What the service does well: Crossley House provides a high standard of individual care in a warm, comfortable, homely environment. The property is well maintained and residents are encouraged to personalise their own rooms. Residents are encouraged to air their views at regular residents meetings, and observations of staff and residents interactions indicated that positive relationships had been developed. The residents told the Inspector they were happy in the home, and the staff treated them with respect and sensitivity. It was evident the manager and staff team were motivated to provide a warm caring environment for those individuals accommodated. Family members are encouraged to visit the home and be actively involved in their relatives care. Relatives and friends are also encouraged to attend garden parties or other activies organised by the home. There are good systems and procedures in place for the training and supervision of staff, which means the residents can be assured their needs, will be met. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Crossley House DS0000003318.V266430.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 Crossley House DS0000003318.V266430.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): 1,2,3,4,5. Information is available to prospective residents and their representatives about the home and the admission process, which enables an informed choice to be made before moving in. EVIDENCE: The home have a comprehensive statement of purpose and resident guide detailing the facilities and services provided. The information is written in plain English, and copies were on display in the entrance hallway. A review of care file information provided evidence that each resident is provided with a contract of terms and conditions. The contracts seen were signed and dated and contained the following information: • Allocated room number • Information about insurance cover for residents personal belongings • Summary of complaints procedure The contracts are comprehensive and comply with the National Minimum Standards. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 9 There is a structured admission process to the home that includes assessments of need which informs the initial care plan. As stated in the contract the first month of any stay is a trial period and further in-depth assessment takes place during this time. Information is gathered from other professionals involved and residents together with family members are encouraged to be involved in the development of the care plan. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10. Information was held demonstrating that individual needs were assessed, however this could be improved. The health care needs of the residents are monitored and action taken if concerns arise. EVIDENCE: A review of the care file information revealed that each resident has a care plan, and a health needs assessment. Risk assessments were seen relating to mobility, self-medication, and for one resident an assessment of risk was in place to enable the use of a kettle in their room. The home provides care for up to five persons who may have a Dementia and there was evidence in records reviewed that some residents had presented behaviour that may challenge, and impact directly on other residents accommodated. There was no written guidance for staff on how to manage behaviour of this nature. A recommendation was made that behaviour management strategies be developed to ensure consistency in practice, and provide appropriate support for all residents. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 11 There was evidence that staff members have received Dementia awareness training, and this is ongoing at the home. The staff members spoken with were able to demonstrate a good understanding of the individual needs of the residents, and had developed strategies to meet those needs. The records reviewed indicated a high level of sensitive support was being provided on a day-to-day basis, however formal recognition of the issues that may arise would ensure staff are appropriately supported during and after these incidents. Residents spoken with confirmed they were treated with respect, and staff members knocked their doors before entering. The residents also confirmed they were happy in the home and that staff members and the manager are very supportive and listen to their views. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14. The lifestyle experienced in the home suits the individuals living there and matches their interests and preferences. Residents are supported to exercise choice and control over their lives. EVIDENCE: Those residents spoken with confirmed that activities took place on a regular basis and included visiting musicians. There are occasions when events are planned to include all homes owned and operated by the organisation, and this enables residents to meet new people. Family members are always invited to these events. Two residents at the home confirmed involvement in local amenities, and information about local clubs and groups was displayed on the notice board. The residents confirmed the manager and staff support them in whatever their choice or preference is for example: • • Two residents have been provided with tea making facilities in their rooms. One resident is being provided with sensitive and appropriate support in relation to the development of a friendship with another resident. DS0000003318.V266430.R01.S.doc Version 5.0 Page 13 Crossley House • • • Residents are encouraged to make their views known at residents meetings. Choice in relation to meal preferences is discussed on an individual basis each day. Involvement in audio description performances for visually impaired residents. There are no restrictions on visitors to the home, and one relative who visits on a daily basis confirmed the staff team were helpful, friendly and encouraged contact. Good communication between the home and relatives was confirmed by this visitor and reaffirmed in comment cards received from relatives as part of the pre-inspection information. The residents are provided with a varied diet, and the food was well presented and tasty. The dining room is well furnished, and central serving dishes are used to encourage independence for those who are able. The atmosphere in the dining room was relaxed and unhurried. The kitchen was clean, tidy and well organised. However it was noted that there was no dishwasher and staff members spend a lot of time clearing up after each meal. During the morning and lunchtime shifts a cook and domestic staff member are employed, and therefore there is less impact on the time care staff spend with residents. However at teatime, and supper time, there are only two care staff on duty and the time spent in the kitchen impacts directly on the care provided to the residents. Consideration should be given to the installation of a dishwasher or domestic support during this peak time to ensure adequate support is available for the residents. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. A clear complaints system is in place and residents can be confident their views will be listened to. The risk of residents suffering from abuse is appropriately minimised. EVIDENCE: A comprehensive complaints procedure is in place at the home and was displayed in the entrance hallway. There have been no complaints since the last inspection. The organisation deal with all complaints in an appropriate manner. Residents spoken with confirmed to the inspector that they felt able to raise any concerns with the manager or staff on duty. Communication links with family members are good, and records reviewed and a visitor spoken with during the inspection confirmed this. All aspects of the residents legal rights are protected and promoted including organising postal voting for those residents who wish to exercise their legal rights to vote in local parish or government elections. Policies and procedures are in place to ensure residents are protected from any form of abuse, and abuse training has been provided for all staff. One staff member confirmed attendance on abuse training, manual handling and first aid training. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. The quality of the furniture and fittings in the home is of a very high standard, and overall a warm comfortable environment has been created. Arrangements are in place to ensure all areas of the home are maintained to a good standard, although the monitoring of environmental risks in individual rooms could be more stringent. EVIDENCE: The location and layout of the home is suitable for its stated purpose. The home is a listed Georgian building, set in its own grounds, which are well-kept and accessible to residents. It was noted at the front of the property a paved pathway that provides level access to the front lawn, has recently been widened to ensure those residents who may use a walking aid can use the lawn with a higher degree of independence. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 16 Two recommendations from the previous inspection have been implemented. A new carpet has been provided in one room, and an automatic door closer has been installed in another. Both residents were happy with the alterations. A tour of the environment was undertaken, and residents views were sought. The residents were happy and comfortable in the home, and individual rooms reflected each residents taste and preferences. Residents are able to have tea-making facilities in their own room as determined through the risk assessment process. Residents made the following comments: A wonderful room great staff new carpet is lovely staff work hard I enjoy the view from my window staff are easy to talk to. The home was clean and generally well maintained. The organisation has in place policies and procedures to ensure all issues or concerns in relation to health and safety receive immediate attention. For example, the kitchen is open plan and staff members raised concern about the possibility of residents wandering in during busy periods. Immediate action was taken and an unobtrusive gate has been installed which provides safety, but still allows residents to interact with the staff member preparing the meals. However, in the entrance to one bedroom an electrical wire is stretched across the floor. The resident has put a sign to warn of the risk when entering the room. The manager must ensure an electrical socket is provided in this room that meets the needs of the resident and removes this risk. A system needs to be in place to ensure all staff notifies management of any such risks if a resident moves furniture, fittings or if new personal possessions are acquired that may present a risk. Aids and adaptations are in place in the home to meet the needs of the residents. Service testing of the equipment is carried out at regular intervals and certificates were seen to evidence the tests. A random test of the call bell system showed it to be in working order. There are adequate toilet and bathing facitlies in the home, which were clean and odour free at the time of inspection. In relation to the environment it was recommended that the following actions be taken: • • • The provision of another handrail in one bathroom would provide a greater degree of safety for those residents who require minimal support when bathing. The sealant in the other bathroom needs attention to ensure a greater degree of cleanliness. In one bedroom the wallpaper is beginning to peel, a review of this room would improve the environment for the resident. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 17 The areas noted above should not detract from the high standard of provision at Crossley House, where a continual review of the fabric of the building ensures a safe and comfortable home for the residents accommodated. The communal areas of the home are spacious, with two lounges, and a bright airy dining room located in a conservatory to the rear of the building. The furniture and fittings are domestic in style and are appropriate to meet the needs of the residents. The residents were observed using all communal areas, including the large entrance hallway where seating is provided. Reports received by the commission of regular monitoring visits carried out by the registered provider as required by Regulation 26 of the Care Standards Act 2000 provide evidence of comprehensive reviews of all aspects of care provision at Crossley House. The summary actions include reference to maintenance and repairs to the building carried out on a regular basis. There were no odours in the home. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 18 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): 27,28,30. Appropriately trained and competent staff support the residents. EVIDENCE: Staff recruitment records were not viewed on this occasion, however there are no concerns about the organisations recruitment practices. A comprehensive induction programme is in place incorporating progression to the NVQ training programme. One staff member spoken with confirmed good progress in completing NVQ level 3 with an expected achievement date in the coming months. The staff member explained a recent change in the assessor provision had meant a higher level of regular support. A review of the staff training and supervision files indicated a high-level of support from the manager. Training has been provided to staff focussing on meeting the needs of the resident group. Crossley House may care for up to five people who have a Dementia, and it was noted that most of the staff group have attended Dementia awareness sessions. Further training confirmed by staff spoken with and certificates seen included: First Aid, Manual handling, Use of the Hoist, Protection of Vulnerable Adults, Fire safety, Skin care and Medication training. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 19 A visiting optician was due to attend the home to provide staff with training and guidance providing a greater understanding of the needs of residents who may have impaired vision. The organisation has developed a staff-training matrix that indicates when up dated training is necessary. In-house training delivered by appropriately trained staff is also included as part of the overall training package provided by the organisation. The staff members were observed interacting positively and sensitively with the residents, and those residents spoken with confirmed good relationships with the staff team. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 20 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): 31,32,33,36,37,38. The home is well managed ensuring the residents interests and choices are promoted by a supported and experienced staff team within a safe environment. Policies and procedures are in place that ensures the effective and efficient running of the home. EVIDENCE: Mrs Jacqui Woodman is the registered manager of the home and has significant experience of practice and management in the care industry. During the inspection the manager demonstrated a clear understanding of her role within the home, and a commitment to providing a high standard of care for the individuals accommodated. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 21 Those residents spoken with confirmed they felt able to approach the manager with any concerns about life in the home. One resident talked about support being provided with sensitive personal issues, and felt the manager understood and was able to alleviate any concerns. Other residents were vocal about the homely atmosphere created in the home. There was evidence of regular residents meetings being held and suggestions from residents and staff being put into practice. One example was a staff member suggesting a small shop being available for residents in the home to purchase personal sundries such as toiletries. This had been actioned and money had been made available to purchase stock, and adequate storage for the items. The residents were keen to start shopping. Policies and procedures are in place to guide daily practice and a review of the supervision records indicated the manager discussed these on a regular basis. Formal supervision of the staff had been taking place regularly, and staff spoken with confirmed this. The records were held securely, and provided evidence of an inclusive style of management with positive feedback to staff. Consideration should be given to including in the staff supervision records, guidance around the keyworker role and discussion relating to the individual needs of the residents whose care they co-ordinate. The fire safety records were up to date and in order, with evidence of regular fire drills, training and equipment checks. A valid certificate of insurance was displayed with an expiry date of October 2006. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 2 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 23 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. 2. Standard OP23 OP23 Regulation 23.2(c) 23.2(f) Requirement Put in place a system to ensure staff notify the manager of any environmental risks. Provide electrical sockets in bedrooms that meet individual needs. Timescale for action 30/03/06 15/03/06 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. 3. Refer to Standard OP7 OP23 OP36 Good Practice Recommendations Develop behaviour management strategies to ensure a consistent approach from the staff team. Take action in relation to the environmental issues as detailed in this report. Supervision notes should include comments/discussion in relation to practice guidance in meeting residents needs. Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Crossley House DS0000003318.V266430.R01.S.doc Version 5.0 Page 25 - 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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