Inspection on 22/08/06 for Crossley House

This inspection was carried out on 22nd August 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 18/01/06

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 Vanessa Carter Key Unannounced Inspection 22nd August 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.V304045.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. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 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 sam.hawker@blueyonder.co.uk 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.V304045.R01.S.doc Version 5.2 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 18th January 2006 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 in South Gloucestershire, 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 four homes in the Bristol area. The other three homes are all in Westbury-on-Trym, Bristol - Rosewood House, Belvedere Lodge and Patron House. The registered manager is Mrs Jacqui Woodman. The cost of placement at the home is between £400-475 per week and is dependent upon assessed need. Additional costs are made for a range for services and these are detailed in the Homes Brochure. Prospective residents are able to find about the home by requesting a copy of this from the Home Manager. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over 5.5 hours and was completed in one day. The manager was present during the inspection and participated in the process. Evidence was gained from a whole range of different sources, including: • Information provided by the manager in the pre-inspection questionnaire • Information taken from resident survey forms • Directly speaking with residents • Case tracking a number of residents • Speaking with care staff • A tour of the home • Examination of some of the homes records • Observation of staff practices and interaction with the residents. The overall analysis is that the home is a good place in which to live and to work. What the service does well: What has improved since the last inspection? The home has addressed a number of environmental issues that were needed and have improved their systems for reporting any health and safety concerns that the staff wish to report to the management. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 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. Crossley House DS0000003318.V304045.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 Crossley House DS0000003318.V304045.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes assessment processes and the information available about the home ensures that placement is offered to those people whose needs they can meet. EVIDENCE: No changes have been made to the statement of purpose and homes brochure, since the last inspection and both contain all information as detailed in the National Minimum Standards. The documents are available in the home, along with the previous inspection reports. Each resident is provided with a statement of terms and conditions upon admission “Residents Contract”, and these were contained in the three files examined. The four residents who returned the survey forms to CSCI, stated that they had been provided with information about the home prior to moving Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 9 in and that they had been given a statement of terms and conditions (a contract). The manager visits any prospective resident, so that an assessment of their needs can be made. Where residents are admitted from “out-of-county”, a full history is obtained from other sources. Placement at the home is not offered to any person whose needs cannot be meet. Assessments by the manager were seen on file. Placements are arranged on a month’s trial basis with a review taking place at the end of this period with all necessary parties. Prospective residents are invited to visit the home prior to taking up residence, and examples were discussed where “day care” is offered prior to moving to the home, to ease the settling in process. Crossley House DS0000003318.V304045.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes care-planning processes will ensure that each resident receives the care they need. Medication practices are safe. EVIDENCE: Three care plans were looked including that of one person who had recently been admitted to the home. The plans each contained a full assessment of the residents needs and guidance for the staff on how the identified needs should be met. For one person that was specific instructions oh how to manage their continence, whilst there was details regarding how much mealtime support they needed, and how the family still wanted to undertake certain tasks. The plans had been reviewed on a monthly basis and a brief dialogue recorded of significant events in the month. The residents had signed their care plan reviews, evidencing that they had been involved in the process. For the resident who was newly admitted, the home had yet to review the care but were in the process of setting up the meeting with all relevant parties. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 11 Included with the care plan is a mobility and handling profile. For each person the level of risk associated in moving and transferring is determined and a safe system of work devised. The manager explained that the home has an allocated GP. A CSCI comment card was returned from the surgery, prior to the inspection, stating that they were “definitely satisfied with the overall care service”. Residents confirmed that they see the GP or District Nurse when needed. One survey form contained the comment “my mother receives the medical support she needs” A review of the homes medication systems showed that they have safe procedures in place for the ordering, receipt, storage, administration and disposal of all medicines. The staff that are responsible for administering medications have had training to ensure they are competent and evidence was seen to verify this. The staff were observed going about their duties in a friendly and calm manner and responding to the residents in a familiar style. There was a lot of friendly banter between the residents and the staff, and between the residents, evidencing that the home is a good place to live. Crossley House DS0000003318.V304045.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to participate in a range of meaningful activities and spend their time as they wish, and are provided with well balanced and nutritious meals. EVIDENCE: The residents are able to choose whether they want to participate in any activities that are arranged. Each month outside entertainment is brought in and residents talked about the various music sessions. An activities file is kept and this shows who was involved in each event. A ‘volunteer’ visits the home each week and will organise sing-alongs, games and chair exercises. There has recently been a trip out to see birds at the Wildfowl Centre in Slimbridge, along with residents from other Ablecare Homes. The home has recently had a garden party and families and friends were invited. One resident said they liked to dance and they enjoyed the music, but also that they liked to sit and chat. Residents are encouraged to continue with any activities outside of the home. One resident goes along to a club each week whilst another goes out to a Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 13 particular past time. Those that are able to, can go out into the village as they wish and there are no restrictions made on their movements. The home has an open visiting policy and visitors can come in at any reasonable time. Discussions with the manager evidenced that the home has very good relationships with the families of the residents. The home employs two cooks who each work three days per week, and on the seventh day one of the staff team is deployed to prepare the meals. The residents were all very complimentary about the meals, and enjoyed faggots in gravy, new potatoes and broad beans followed by fruit crumble, on the day of inspection. One survey form returned to CSCI stated “Mother speaks very highly of the meals”. There is only one planned choice per day but residents are able to have an alternative if necessary. The cook had a good understanding of the dietary needs, likes and dislikes, of each of the residents. The home provided copies of two weeks menus as part of the pre-inspection information, and these evidenced that residents are provided with a balanced diet. A roast meal is served twice a week. The cook explained that they consult with the residents and try new dishes on occasions – some are successful whilst others are not. The kitchen was last inspected by the Environmental Health Department in April 2006 and a Food Safety Award was issued. The report stated “all aspects were of a very good standard”. The previous inspector had noted that the home had no dishwasher and staff members had to spend a lot of time clearing up after each meal. This task is undertaken by the cook during the morning and lunchtime shifts, however at tea and supper time, there are only two care staff on duty and the time spent clearing away would remove staff from other caring duties. The manager stated that the installation of a dishwasher would reduce the storage capacity in the kitchen, and additional domestic support during this peak time, was not necessary as a workable routine has now been established. Crossley House DS0000003318.V304045.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that any complaints they have will be listened to and acted upon and that they will be safeguarded from harm. EVIDENCE: The homes complaints procedure is included in the homes statement of purpose and the main reception area. Residents spoken with during the course of the inspection said they would talk to the staff if they were not happy about anything. The home has not received any complaints and prides itself on having good relations with not only the residents, but their families too. One resident said “there is nothing to complain about at all” whilst another said “the staff are always so helpful”. The home has policies and procedures in place to ensure that the residents are safeguarded from any form of abuse. Staff have attended adult abuse awareness training delivered by the South Gloucestershire Council. A copy of the homes policy about the protection of vulnerable adults (POVA) is kept with all other policies and procedures and the day- to- day paperwork. Staff spoken with during the inspection demonstrated a good awareness of adult abuse issues and of their responsibility in reporting any bad practice. Crossley House DS0000003318.V304045.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 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is safe, comfortable and warm, and equipped to meet their needs. EVIDENCE: Crossley house is a listed Georgian building, set in its own grounds, and located just a short walk from the centre of the village of Winterbourne. The home is approached via a gravel driveway and there is level access into the home. The gardens to both the front and rear of the property are well-kept and accessible to residents. There are areas of shade and residents can sit out on the patio on the comfortable garden furniture. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 16 The communal areas are all located on the ground floor, along with six of the bedrooms and one of the assisted bathrooms. There are two lounges, one considered to be a “quiet room”. The dining room is a conservatory to one side of the house, located next to the open-plan kitchen. The dining room has air conditioning units installed, to keep the room cool in the summer and warm in the winter. The wide staircase complete with stair lift leads from the hallway to the first floor. A second staircase from first to second floor also has a stair lift. The furniture and fittings throughout Crossley House 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. There are a further two bathrooms, one on each of the upper floors. One toilet is located opposite the lounges. The home has one stand aid and various handrails in bathrooms and toilets. One bedroom has a door guard installed as the resident likes to have their door open at all times. A call bell system is sited in all rooms, bathrooms and communal rooms. All bedrooms are for single occupation and have ensuite facilities of at least a toilet and wash hand basin. A number of rooms also have a shower. Residents are encouraged to personalise their own rooms and to bring in any items of furniture they wish. One resident said “ I have a wonderful room”. Each bedroom is fitted with a door lock and the resident can have a key if they wish. The bedroom furniture is varied throughout the home and two replacement beds have just been purchased to meet resident’s specific needs. Each bedroom has a window and the degree of opening has been limited on each, to safe guard residents. All radiators throughout the home are guarded with boxed radiator covers. Since the last inspection the home has devised a system for staff to follow should they need to inform management of any ‘health and safety issues’ such as repairs, maintenance or equipment that requires attention. The home was clean, tidy and well maintained and there were no odours throughout. Crossley House DS0000003318.V304045.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are cared for by skilled staff who are trained and competent to meet their care needs, but safe vetting and recruitment procedures must be used to ensure that residents are not looked after by unsuitable workers. EVIDENCE: The home employs a team of care staff, plus domestic and catering staff, led by the manager. There has been no use of agency staff and this means that residents will be cared for by staff who are familiar with their needs, and are known to them. On the day of inspection there was one care assistant, the cook and a domestic plus the manager on duty. This level of staff is appropriate to meet the needs of residents. There has only been one staff change since the last inspection meaning that residents are cared for by a stable staff team. The home currently has only five members of staff who are trained to at least an NVQ level 2 (33 ), and two others are working towards achieving the award (46 ). The home should continue to commit to the NVQ training programme to ensure they meet the 50 target. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 18 There have been two new members of care staff employed since the last inspection. An examination of their personnel file evidenced that the home does not completely follow safe vetting and recruitment procedures – the home had only obtained one written reference for one worker and did not have information on file of one workers work permit arrangements. The recruitment procedures for new staff must be tightened up, to comply with current legislation. All new staff will complete an induction training programme at the start of their employment, to ensure that they are aware of the homes procedures and are competent in the areas of their work. The documentation for two workers were examined. Certificates of training courses each staff member has attended, evidence that the staff group have received training in a wide range of relevant subjects. Examples include Manual Handling, Safe Medication Procedures, Wound and Skin Care, and Food Hygiene. Most staff have attended Dementia care training, and protection of vulnerable adult (POVA) training. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 19 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, 35, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe and run in the best interests of the residents. EVIDENCE: The Registered Manager for the home is Jacqui Woodman. She has worked for Ablecare Homes for many years and has been the home manager at Crossley House for three years. She has already achieved the Registered Managers Award and an NVQ Level 4 in Care qualification, and has undertaken other relevant training relating to the care of older people and those with a dementia. Mrs Woodman cooperated in the inspection process, and was able to located all necessary information and documents easily. This evidences that the home has good systems in place and is well run. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 20 The manager has a very “hands-on” approach and is very involved with the day-to-day care of the residents and working alongside the staff team. Staff meetings and residents meetings are held on a regular basis and there was evidence that everyone is encouraged to make suggestions about how the run is run and what happens. The home completed an annual service satisfaction survey in April and the results showed that in general the residents were happy with the service received. The survey covered meals, choice of activities arranged, home arrangements, involvement in care planning and ability to express any concerns or complaints. The home has good systems in place to manage any monies they hold on behalf of the residents. A number of the accounts were checked against the records held and they tallied. Staff receive formal supervision with the manager on a regular basis and the records kept, and discussion with some staff, evidenced the important role this plays in the smooth running of the home. All the homes records were well maintained and were securely stored. Staff were able to verify that they knew the location of those files they needed to use. All the necessary environmental checks were completed. There was evidence that new staff had been instructed in the homes fire safety procedures and the fire alarm system. All the health and safety testing of electrical equipment, stair lifts and hoisting equipment were up to date. The fire log showed that regular fire drills have been performed at various times of the day, and that all the staff have been included at some time or another. The home was well maintained throughout by the Ablecare Homes maintenance team. The house has listed building status. Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 21 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 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 22 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 OP29 Regulation 19 Requirement Two written references that verify previous experience and qualities, must be obtained for all staff. Information regarding work permit arrangements must be available for inspection. Timescale for action 01/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Crossley House DS0000003318.V304045.R01.S.doc Version 5.2 Page 23 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.V304045.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!