Inspection on 19/01/06 for Crossways

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Crossways 29/08/07

Crossways 23/06/06

Crossways 07/07/05

Crossways 18/11/04

Crossways 15/07/04

Crossways 24/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Crossways Station Road Lostock Gralam Northwich Cheshire CW9 7PN Lead Inspector Bronwyn Kelly Unannounced Inspection 19th 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 Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crossways Address Station Road Lostock Gralam Northwich Cheshire CW9 7PN 01606 45559 01606 46059 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) www.clsgroup.org.uk CLS Care Services Limited Mrs Annette Needham Care Home 39 Category(ies) of Old Age not falling within any other category registration, with number (39) of places Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This home is registered for a maximum of 39 service users in the category of OP (older people not falling within any other category). The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 7 July 2005 Date of last inspection Brief Description of the Service: Crossways is a registered care home, providing accommodation for 39 older people. It is managed by CLS Care Services, a not for profit organisation which manages a number of homes in the northwest of England. The home was purpose built in the 1980s, providing single bed roomed accommodation on the ground and first floors. Two of the bedrooms are large enough to be used as doubles if required. The home is located in a wellestablished residential area. It has a small courtyard for residents use. Local community amenities such as shops and bus stop are within a short walking distance. There are good links with the local community and relatives of service users. Service users have access to all areas of the building and there is a passenger lift to the first floor. There is a variety of sitting and dining areas including a smoking lounge. Services users bedrooms are comfortable, well furnished and many contain a lot of the residents own personal belongings and items of furniture. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over six hours on one day. A tour of the building took place, and a majority of the bedrooms were seen. A variety of records were examined as part of the inspection. Part of the process of the inspection is to listen to the views of the residents that live in the home and listen to the views of their relatives and visitors. On this occasion, four residents were spoken with privately and group discussions took place in lounge and dining areas with a number of other residents. Two visiting relatives were happy to give their views of the home during the inspection. The views of two care staff, activities co-ordinator, care team leader, domestic staff, manager and the home service manager were also listened to. Relatives completed one comment card during the visit and three residents were each assisted to complete a questionnaire. The CSCI pharmacist inspector has made two visits to the home in the past six months to check on areas of concern regarding the medication system at the home. Following these visits, requirements have been made. The pharmacist will be visiting again within the near future to check that these requirements have been actioned. What the service does well: The residents living at Crossways enjoy living there and are pleased with the care they receive from the staff group. Good feedback was received during the inspection about the quality of the care provided. One resident said “I recommended this home to a friend who has now moved in”. She went on to say that Crossways has “very nice staff”. Another resident wished to be quoted as saying she receives “good all round care”. Although the standard in relation to menus and food was not inspected on this occasion, many residents were complimentary about the food. One resident said, “no faulting the food”. Another said, “I enjoy the food and the fact that I don’t have to cook it”. Residents were pleased with the range of activities and outings that are arranged in the home with them. The staff team is well trained and able to meet the needs of the residents. The standard of care is good. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 6 The home has a friendly, informal atmosphere where visitors are welcome at any time. 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. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 and 3. Standard 6 does not apply, as intermediate treatment is not provided. Good information is available for service users to help them make a decision about moving into the home. Residents’ needs are assessed before they move in to ensure they can be met EVIDENCE: A new service user guide entitled ‘Your Guide to Living at Crossways’ has been recently produced last year. A copy of this is given to all prospective and new residents so that they are able to make an informed choice about whether or not the home is suitable and able to meet their individual needs. There are plans to place a copy in the bedroom of each resident for information. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 9 The manager or a member of the senior staff visit each prospective resident in their own home or hospital and carry out an assessment, to ensure their needs can be met at the home. These assessments were seen on a number of care plans. Social work or medical assessments may also be used as part of this process. When the resident moves into the home, this information is used to develop a plan of care. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 and 8. The pharmacist will be inspecting standard 9 at a later date. The residents’ care plans do not always provide staff with up to date information they require in order to meet the needs of the residents and could be improved. Arrangements are in place to ensure the health care needs of residents are identified and met. EVIDENCE: The care plans of five residents were read. There has been improvement since the last inspection and all contained risk assessments and moving and handling information, providing safeguards for residents. However, each of the plans seen had not been reviewed since various dates between July and October 2005. Two residents, one of whom moved into the home in July 2005, had no photograph of them on their medication sheet or care plan. The plans were also lacking in details about the residents’ social interests and past life. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 11 Residents confirmed that their health needs are taken care of and the GP is called when they are unwell. The care plans showed that residents have chiropody, dental and optical treatments when required. A GP intervention record sheet is included in each care plan, and showed visits by the residents’ GP Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 and 14 Social activities provided in the home and various contacts within the community are well organised and provide stimulation and interest for the residents. Routines at the home are flexible, enabling residents to have choice and control over how they spend their time. EVIDENCE: Since the last inspection, there has been considerable improvement in the provision of social and leisure activities available for residents. A new activities co-ordinator had been appointed, and he has encouraged the residents to be involved in all aspects of planning their daily lives in the home. Joint family and resident meetings are being arranged to help in this process. Following a weekly Friday meeting with the residents, an activities programme for the following week is well displayed in various places around the home, and read to those who have difficulty reading. Links are being established with local churches and schools, and a group of primary school children visited recently to talk with the residents about their wartime memories. Visits to other CLS homes for lunch are also being arranged. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 13 Discussions are taking place with some residents regarding planning a holiday together. There is a monthly ‘mystery trip’ and shopping outings arranged as well as various activities in the home such as quizzes, games and concert trips to theatres. Residents spoken with were very pleased with the range and type of activities on offer. They also said there was no pressure to join in if they did not wish to. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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): 18 Through training, polices and procedures, staff have a good knowledge and understanding of adult protection issues which protect residents from abuse as far as possible. Policies and procedures regarding the handling of residents’ finances provide security for residents. EVIDENCE: Staff receive training in adult protection during their induction to the home and as part of their NVQ training. This is updated by in-house training and staff have all recently attended a course. During discussion, staff demonstrated an awareness of the issues surrounding adult protection and the actions to be taken if abuse was suspected. Policies and procedures are in place as required. Systems are in place to help residents with their financial affairs, which are in line with CSCI recommendations. Residents who are unable to look after their own affairs may keep their money centrally in a CLS residents’ savings bank account and accrue interest. Details can be accessed for each resident at any time on the home’s computer. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 and 26 There has been considerable improvement in the décor and furnishings of the home over the last year, creating a better environment for residents to live in. EVIDENCE: Since the last inspection, there has continued to be further improvement to the environment for the residents. This has included: • One lounge has been completely refurbished with new decoration, carpets and furniture. • New dining tables and chairs have been purchased for throughout the home. • The corridors downstairs have been re-decorated and the upstairs corridor is in the process of re-decoration. • All bathrooms have now been refurbished and toilets repainted. • 20 bedrooms have been redecorated and new bedcovers purchased. • A lawn at the front of the home has been fenced for security, new garden chairs and tables purchased and a new patio area with raised flowerbeds is planned. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 16 The manager has plans to continue with the refurbishment, particularly some of the lounge areas. The work completed so far has provided a more comfortable and homely environment for the residents. One bedroom, identified during the inspection, has considerable odours, and staff are trying a number of different methods to alleviate this. The Environmental Health Officer last inspected the kitchens in October 2005, and wrote in the visitor’s book “Excellent standard of hygiene and cleanliness”. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 and 29 Staff at the home are well trained and employed in sufficient numbers to meet the needs of the residents. The procedures for the recruitment of staff are robust, providing safeguards to people living in the home. EVIDENCE: Since the last inspection, some staff vacancies have been filled, with the result that less agency staff are used in the home. This had provided better continuity of care for the residents. The care staff group are continuing with their training, and hope to reach the government’s December 2005 target of 50 trained care staff early this year. To date, 7 of the 22 care staff hold an NVQ qualification (33 ) and 7 are working towards it, with four due to complete in the near future which will bring the total to 50 . Many of the general staff have commenced NVQ training in housekeeping. CLS have a good commitment to NVQ training. The staff spoken with said they had good opportunities to attend training courses relevant to their jobs. They were pleased that the home does not have to rely so much on agency staff. Staff said they enjoyed working in the home, and they had built up good relationships with the residents. The staff files of the two latest members of the care team to be employed were checked. Both contained two references and evidence of an interview. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 18 Evidence was seen to show that all staff working in the home have had a Criminal Records Bureau check completed. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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, 35 and 36 The manager is experienced and supported by a staff team who are working to improve the quality of life for residents in the home. Policies and procedures for safeguarding residents’ money provide security. EVIDENCE: The manager has almost completed her training for the registered managers award and hopes to hold this qualification within the next few weeks. As discussed in standard 18, systems and safeguards are in place to assist residents who do not wish or are unable to care for their own money. Small amounts of money are sometimes left for safe keeping by relatives. The accounts and receipts for this were seen to be in good order. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 20 Formal staff supervision has commenced, although behind schedule at present. The second staff fire safety training session that should have been held in 2005 is also behind schedule, but has been planned for February 2006. This must be in addition to this years training. The manager should ensure that all aspects of running the home are up to date to ensure the safety and welfare of the residents. Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 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 x 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x 3 2 x x Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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 2 Standard OP7 OP7 Regulation 15(2)(b) 17(1)(a) Timescale for action Residents’ care plans must be 31/03/06 kept under review. A photograph of each service 31/03/06 user must be kept in the home. Requirement 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 OP31 Good Practice Recommendations The manager should consider ways of ensuring that various aspects of the running of the home are up to date and in good order, such as care plan reviews, staff fire training and staff supervision. Supervision arrangements should be in place for all staff. 2 OP36 Crossways DS0000006508.V274537.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Crossways DS0000006508.V274537.R01.S.doc Version 5.1 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. 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