Inspection on 24/10/06 for Crossways

This inspection was carried out on 24th October 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

Crossways 13/02/06

Crossways 02/09/05

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 Mrs Marilyn Fellingham Unannounced Inspection 24th October 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 DS0000027294.V317631.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. Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crossways Address 1 The Boulevard Sheringham Norfolk NR26 8LH 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) 01263 823164 01263 826185 Mr S Booth Mrs Dawn Clark Mr S Booth Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2006 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 DS0000027294.V317631.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and lasted for five and a half hours. During the inspection a sample of records were checked, nine service users were spoken to along with staff members and the management. The Inspector attended part of the morning quiz session where two of the carers were interacting with the service users. What the service does well: What has improved since the last inspection? Record keeping has improved and there are better training records in place. Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 6 Care planning has greatly improved and the home must be commended for this. The home is making good progress to achieving 50 of its care staff being qualified to NVQ 2 or above. The home has started to implement a system for monitoring the quality of care given in the home. 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. The summary of this inspection report can be made available in other formats on request. Crossways DS0000027294.V317631.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 Crossways DS0000027294.V317631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector examined three case notes of recently admitted service users; these were found to be adequate. The Manager had visited prospective service users prior to their admission to ensure that their needs could be met. A recommendation is made to encourage the assessor to make more formal notes for this activity and to send confirmation to the service users that their needs can be met. The Inspector noted that a more thorough assessment was then carried out once the service user had settled into the home. All three service users stated that they felt that they had been given sufficient information prior to their admission. Contracts were seen for these service users, the paper work has just been revised to meet the criteria of this outcome group. There is a service user Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 9 guide and statement of purpose that is given to all service users. Although the process for making a complaint is sited in the entrance hall it is recommended that a copy be put in the service users guide. Crossways DS0000027294.V317631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector examined three care plans, these indicated that the assessment process was used to formulate the plans of care. The care plans were informative with evidence of service user involvement. There was clear evaluation and care altered to meet the changing needs of the service users. Nutritional and skin integrity assessments had been recorded; assessments were also in place for determining those at risk in relation to manual handling and falls. It was noted that there was service user and relative involvement in the care planning system. There were excellent daily notes in place, these were most informative and it could be seen that this information was used to change care on the care plans. Service users spoken to felt that their privacy was respected and that the staff were kind, considerate and very caring; they also felt that they were Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 11 encouraged to make choices and pleased themselves as to what they did on a daily basis. Staff have an overall understanding of the care needs of the residents. The home has updated its medication policies and this was being put into practice. A random check was made of the medication and case tracking confirmed that there was good practice in place. It is required that changes in the doses of insulin be recorded on the MAR charts and not just on the care plans. Although difficult to assess the care of the dying is handled well, care plans of a deceased resident were examined and these were found to contain detailed information for care, especially related to dying. Letters of appreciation from relatives were seen that supported the theory that the dying were well cared for. Crossways DS0000027294.V317631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At previous inspections, relatives and friends were noted as visiting throughout the inspection process; residents confirm this. Records also show that people receive regular visits from family and friends. Service user records show that there is flexibility of routines for them. It was noted that people are able to bring in belongings from home so that their rooms are homely and contain familiar objects. Records indicated that residents had been given the opportunity to make outside visits, it was noted that these records indicated lots of one to one contact for the residents; the duty rosters are so arranged to allow for this activity. Those residents spoken to certainly enjoyed this personal involvement. Residents meetings have taken place and it is established at these meetings what activities the residents would like to do. A talk on bee keeping had been given as one resident is interested in this subject and a monthly programme was seen of all other activities that had taken place. One hour is given over Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 13 every day at 11am for service users to join in activities such as exercise and mind stimulation games. The Inspector observed this taking place and one service user commented that it was fun and caused much laughter. It was also noted that choose what they want to do and one service user plays the organ which is enjoyed by the other service users. A newsletter is generated on a monthly basis and it highlights the events that will be taking place. The residents have always spoken highly of the food they are offered, one resident however felt that some meals were not good: a check of records of meals served showed that they were nutritious and appetising: the service users continue to state that the food is acceptable and that they are given choices. Crossways DS0000027294.V317631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure was available to all service users and their relatives, this could also be found on the notice board. Those service users spoken to were aware of the procedure for making a complaint but the general consensus was that they did not have anything to complain about. Residents meetings are held where residents can raise any issues if they wish to. Service users state that the manager/provider and his partner are very easy to talk to and that they constantly ask them if they have any concerns. The home does not handle any of the service users monies, small purchases made on service users behalves are recorded and receipts given. Those staff spoken with confirmed that they were familiar with all aspects of the protection of vulnerable adults and that they had received training in this; records also confirmed this. Crossways DS0000027294.V317631.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector found the home to be extremely clean and tidy; service users and visitors felt that the cleanliness of the home was always maintained to a good standard. All rooms as they become vacant are re decorated and carpeted, one room and its en suite was being decorated at the time of inspection. The top floor corridors have been re decorated and the staircases. All the rooms are very pleasant and homely. Crossways DS0000027294.V317631.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Those service users spoken to felt that they were well supported by the staff and that they were well cared for; one service user said that if she gets stuck, one of the girls will help you. Another service user stated that she felt the staff knew what they were doing and that she was well looked after. There is recorded evidence of staff induction; newly appointed staff confirmed this. Since the last inspection staff have attended a number of training sessions that have had particular relevance to their work, this was recorded on their training files. NVQ training is continuing and one senior carer is doing NVQ level 4. Records for recruitment confirm that there is a robust system in place for recruitment and the staff records for newly appointed staff contain all the required evidence of Criminal Records Bureau disclosures and POVA first checks. Two references were in place for all new recruits and the files were also seen to contain appropriate proof of staff identity. New members of staff have had an induction and this has been recorded. The home is in the process of up dating its interview note taking and it is recommended that more constructive notes be kept for this purpose. Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 17 The staff commented that they felt that the management were committed to improving training. Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Those people spoken to, staff, service users and visitors felt that the home was managed well; it was evident after these discussions that there was effective leadership in place. All service users spoken to said that they spoke with the provider/manager every day and that his partner who also had managerial responsibilities was very easy to talk to and always listened to them and treated them with enormous respect. Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 19 Records were seen to evidence that formal supervision has taken place and the staff spoken to said that they felt these sessions were of value and very helpful and also useful in encouraging communication amongst the caring team. The home has started to initiate a quality monitoring system and the documents were seen for this. The home has carried out audits for activities and given quality questionnaires to residents, family and professional bodies. They audit an area every two months and then collate the results; quality issues in relation to the environment, food hygiene and staff have already been covered. The home has made great improvements in these areas. Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 20 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 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 x x x x 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action 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 OP3 Good Practice Recommendations It is recommended that more formal notes are kept for assessment purposes. It is also recommended that a letter of confirmation be sent to service users that their needs can be met. It is recommended that a more formal approach is used for the interview process with more detailed notes. 2. OP29 Crossways DS0000027294.V317631.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000027294.V317631.R01.S.doc Version 5.2 Page 23 - 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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