Inspection on 02/09/05 for Crossways

This inspection was carried out on 2nd September 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Crossways 24/10/06

Crossways 13/02/06

Crossways 03/02/05

Crossways 24/11/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Crossways 1 The Boulevard Sheringham Norfolk NR26 8LH Lead Inspector Marilyn Fellingham Announced 2 September 2005 9.30am 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 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 I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Crossways Address 1 The Boulevard Sheringham Norfolk NR26 8LH 01263 823164 01263 826185 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr S Booth Mrs Dawn Clark Mr S Booth Care Home 24 Category(ies) of Old age (24) registration, with number of places Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3 February 2005 Brief Description of the Service: Crossways is registered as a private care home providing accommodation and personal care for up to twenty-three older people. It is sited within walking distance of all amenities close to the centre of the small seaside town of Sheringham and was originally two large, period houses dating from the turn of the century and has been restored, adapted and decorated to a high standard whilst retaining some of the original features and made into one property. There is a shaft lift to facilitate access to all floors and it has bedrooms situated on the ground, first and second floors. All bedrooms are single with a toilet and washbasin en-suite and four bedrooms also have en-suite bathing facilities. The design of some bedrooms gives service users additional living and sitting space and there is communal use of an adapted bathroom on each floor, a lounge, conservatory and large, dining room where all service users have their own dining table. The grounds, although not extensive, are kept tidy and provide small, safe areas to the side and rear of the property where service users can sit and parking to the side of the front of the property with space for a number of vehicles. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over six hours. Opportunity was taken to tour the premises, look at care and staff records and policies. Opportunity was also taken to communicate with a number of service users and staff that were on duty during the course of the inspection process. The manager/provider was present for the inspection as was his deputy. What the service does well: What has improved since the last inspection? There have been vast improvements made since the last inspection mainly in relation to ensuring that the appropriate paperwork is in place and that the requirements made from previous inspections have been met. New garden furniture has been obtained; the kitchen has been re vamped. New policies and procedures are in place. An induction and foundation course has been commenced and existing staff have also participated in these. Staff meetings are now on a regular footing. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 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. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 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 standard(s) 1,3,5 Service users are provided with sufficient relevant information to make an informed choice prior to admission. The admission procedure is adequate, providing the prospective residents with the opportunity to visit the home before admission; there is however room for improvement in the record keeping for this procedure. EVIDENCE: The home has an admission procedure for admission to the home, however the Inspector was unable to see a completed record and it is recommended that records be kept of the assessment carried out prior to admission. It is also recommended that this information be then used to formulate the care plans. A service user confirmed with the Inspector that he had been the opportunity to visit the home before moving in and he also indicated that he had been given enough information to enable him to make a choice about admission to the home. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 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 standard(s) 7,9,10,11 The care planning system has much improved although attention needs to be paid to ensuring the care is more detailed on the care plan and less subjective. The care plans also lack continued reviews and evaluation of the prescribed care. It is recommended that all staff receive more training in relation to care planning skills. EVIDENCE: Examination of the care plans revealed that the prescribed care was not in enough detail to ensure that the carers were aware of what care needed to be given. It was also evident that the care plans contained subjective material that could upset the service users particularly in relation to their emotional behaviour and attitudes. One resident brought this to the attention of the Inspector because he felt the information about him was hurtful and not objective. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 10 Policies and procedures are now in place for care of the dying; these were It was noted by the Inspector that the system for handling and the administration of medication has greatly improved; policies and procedures were seen for this. After discussion with staff and one resident it is recommended that consideration is given to facilitating more training in giving medication for the staff. Discussion with some of the residents and observations made during the inspection showed that staff have an understanding of how to promote the resident’s dignity and privacy. Communication between staff and residents was seen to be appropriate to the individual needs of the residents. On inspection of a care plan for a resident who is dying it was found to be lacking in some detail of required care; however on discussion with residents and staff the Inspector felt that the care being given was being performed in a dignified manner and met the needs of the resident. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12,14 On the whole service users find the lifestyle that is on offer in the home matches their preferences, although the home does not have a dedicated activities plan. Service users make choices about their daily activities. EVIDENCE: Although it is the manager’s/providers wish to provide more activities for the residents it was evident to the Inspector after discussion with them that they do not always wish to join in programmed activities and very much prefer to be independent and do their “own thing”. The Inspector noted that one resident was seen to go out three times into the town and preferred to do this rather than an organised activity. However it was confirmed by the residents that the Inspector spoke with that activities are organised and that they had enjoyed two Bar-B-Qs and had held a coffee morning at the home. It appeared that the residents are very independent and enjoy choosing what they wish to do. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 12 One resident who is blind pointed out that she would join in activities and outings, but was not always aware of what was happening as the events were posted on the notice board; the manger agreed that this was not suitable and said he would ensure that this resident would always be informed of forthcoming events. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16,18 Complaints are dealt with in a satisfactory way. Service users are protected from abuse. EVIDENCE: Those residents spoken with indicated that they would speak with the manager or their carers if they had a complaint or concern; they also indicated that they felt they would be listened to. Information about how to make a complaint is given to every resident and they made it very clear to the Inspector that they would feel very comfortable in airing their views. The complaints procedure was also posted on the main notice board. No complaints have been received by the Commission or the home, small issues are dealt with on a day-to-day basis. One resident informed the Inspector that the manager always addressed their concerns in a satisfactory way, that he was very kind and had no complaints. Staff spoken with confirmed that they had received training in abuse issues and they were familiar with the policies and procedures in place relating to abuse. They also stated that they found the session interesting and informative and now had a much better understanding of abuse issues. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19,20,24,26 Service users live in a safe and very well maintained environment. EVIDENCE: The home appears safe, it is very well maintained and suitable to meet the needs of the service users. The manager/provider works extremely hard to ensure that the home is always in a good state of repair and this was found to be so on the day of inspection. It was noted that appropriate fire and health and safety practices were in place and being observed. The recent fire inspection report was seen. The residents have access to a range of indoor and outdoor communal areas, it was noted and also commented upon by one of the residents that new garden furniture had been purchased and a few residents were seen to be taking advantage of this: it is sited in a very pleasant part of the garden with numerous plants in pots. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 15 Those rooms that the Inspector viewed were found to be very homely well maintained and many of the rooms contained the resident’s own possessions. The home appeared clean and hygienic throughout. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Staff are deployed in the home in sufficient numbers to meet the needs of the service users. Staff training has improved. EVIDENCE: Induction course and a foundation course is now up and running and the staff confirmed that although if they had been at the home a number of years they too had done the induction and foundation courses. Records were also available to substantiate this. Policies were seen for moving and handling and it is recommended that although most of the residents are very mobile the staff have training in moving and handling to ensure best safe practice. As mentioned before it is also recommended that the staff receive more training in the administration of medication; one resident felt that they should know more about the medication they were giving her and this was noted by the Inspector and records checked to see what training had already taken place. It was also evident in discussion with staff members that they needed a little more information about the medication they were required to administer to the service users. More staff are allocated at various times of the day during the week so that the home can ensure that the residents needs are met. It is also so that the residents can be taken out if they choose on a one to one basis, this was seen to correspond with the numbers of staff rostered on the duty rotas. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 The service users benefit from the home being run by the present owner/manager; they also benefit from his leadership skills and approach to running the home. The home does not monitor quality of care very well and a requirement is made. Staff are not appropriately supervised and a requirement is made. The interests, safety and welfare of the service users are protected by he home’s policy and practice. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 18 EVIDENCE: Discussion with staff and service users, observations made during the inspection process and examination of records leads the Inspector to assume that this is a very well run home. Many of the residents commented on how helpful the manager/provider is and also how kind he is to them and that nothing is too much trouble. Discussion with the manager/provider confirmed that as yet there was no system in place for monitoring the quality of care; he is very keen to establish this and realises the importance of such a system: a requirement is made. It was also established that the staff have not received any supervision sessions and a requirement is made. Examination of records, discussion with both staff and the management confirmed that the health, safety and the welfare of service users is promoted and protected. Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION 3 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 1 x x 1 x 3 Crossways I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 20 Yes Are there any outstanding requirements from the last inspection? 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 33 Regulation 24 Requirement The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care. The registered person shall ensure that persons working at the care home are appropriately supervised The registered person shall prepare a written plan as to how the service users needs in respect of his health and welfare are to be met and keep it under review Timescale for action Immediate and on going Immediate and on going Immediate and on going 2. 36 18 3. 7 14 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. Refer to Standard 3 7 Good Practice Recommendations It is recommended that acurate record are maintained for assessment and admission purposes. It is recommneded that the care plans contain more detail and that the records made on the plans of care are less subjective. I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 21 Crossways Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 I55 S27294 Crossways V241682 020905 Stage 4.doc Version 1.40 Page 22 - 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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