Inspection on 07/07/05 for Crossways

This inspection was carried out on 7th July 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 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 19/01/06

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 CW9 7PN Lead Inspector BRONWYN KELLY Announced 07 JULY 2005 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 F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Crossways Address Station Road Lostock Gralam Northwich CW9 7PN 01606 45559 01606 46059 crossways@clsgroup.org CLS Care Services Limited 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) Mrs Annette Needham Care Home 39 Category(ies) of OP Old Age (38) registration, with number PD Physical Disability (1) of places DE Dementia (1) CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Nil on present certificate, but a variation will be required to remove the two categories of registration that are no longer required - 1 DE and 1PD. Both of these were for named service users who now no longer reside in the home. Date of last inspection 18th November 2004 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 spacious and comfortable and many contain a lot of the residents own personal belongings and items of furniture. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over seven hours on one day. A tour of the building took place, and with the permission of the residents, a number of bedrooms were seen. Six residents were spoken with privately and each was happy to share their views of living in the home. In addition, ten residents chose to complete a ‘comment card’ with assistance from the care staff. Group discussions with residents also took place in the lounges. Three visiting relatives and a community nurse were spoken with during the inspection. The views of three care staff, one care team leader and the manager were also listened to. Four relatives/visitors comment cards and one General Practitioners comment card were received in the post following the inspection. What the service does well: The residents who live in Crossways enjoy living there and they consistently said there is a good staff group who are very caring. All residents spoken with said the food was good and they have a choice at each meal. The staff group were seen to be kind and caring in their work with the residents. Relatives and families were also keen to stress that good relationships exist between them and the staff group. The staff team is well trained and able to meet the needs of the residents. The standard of care is good. The home has a friendly, informal atmosphere where visitors are welcome at any time. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Assessment and care planning must improve so that staff are able to know what to do for each resident. The provision of activities for the residents must be improved. The complaints procedure displayed must be clear so that people also have information about how and when to contact the CSCI. Whilst redecoration and improvements to the home have taken place, further work must be done to make sure the residents are living in a comfortable, homely environment. Some attention is needed in the ground floor dining room – chairs, sideboard and carpet - to make it more comfortable and homely for the people who live there. The first floor dining room is also short of suitable chairs. A lounge area that residents have access to is being used as a storage area in the home. Outside garden facilities for residents could be improved upon. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 7 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 F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 8 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 F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 9 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 and 5 Residents and their families receive clear information to enable them to make a choice about whether or not they wish to live at the home. Procedures for the assessment of residents admitted in an emergency and subsequent care planning are not being followed. Without an assessment, there is no assurance that care needs will be met. EVIDENCE: A new service user guide entitled ‘Your Guide to Living at Crossways’ has been recently produced. 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. Residents spoken with also confirmed that they had the opportunity to visit the home with their relatives before making a decision to move in. One resident was admitted in an emergency over two weeks before the inspection, but there was no evidence of any assessment of their care needs having taken place or a care plan in the residents file. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 10 Some care plans do not provide staff with sufficient information they need to satisfactorily meet residents’ needs. Personal support is provided in such a way as to promote residents’ privacy, dignity and independence. EVIDENCE: Five resident’s individual plans of care were seen. There were some inconsistencies in the quality of record keeping. Two were well written and up to date with evidence of resident involvement. Three care plans had no moving and handling assessment and no evidence of having been reviewed on a regular basis. One of these three residents required the help of two staff members for mobilisation, but there were no instructions for staff on how to carry this out. As mentioned in the previous section, one file contained very little information about the resident or their level of need. In spite of the poor standard of record keeping, the residents’ view of their care is very positive. Some comments received during discussions are: • “Staff are all courteous and nice to the residents” • “The staff will do anything for you” • “Very good staff” CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 11 Residents confirmed that their health needs are taken care of and the GP is called when they are unwell. A visiting community nurse was spoken with, and she said the patients she visits always look well cared for. The care plans showed that residents have chiropody, dental and optical treatments when required. Observation of the staff at Crossways and a group discussion with three care staff showed that they have a good awareness of how to protect residents’ privacy and dignity. Residents confirmed that staff knock on bedroom doors and wait for an answer before entering. Visiting relatives said they had always seen staff treating residents with respect and dignity. The day of the inspection coincided with the unfortunate London bombings, and a number of residents were visibly upset at the television coverage. Some excellent examples of a caring staff group were observed in the way they supported residents who were upset. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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 standard(s) 12 and 15 The activities available over the past few months do not meet the individual needs and choices of all the residents. The dietary needs of residents are well catered for, providing residents with a good choice and quality of food. EVIDENCE: Since the previous inspection, there has been evidence of more discussion with residents regarding their choices of social activities. Coach trips, theatre trips and canal journeys have all been recently arranged and a July summer fete is being organised. The residents have been provided with a computer and some staff are exploring ways of enabling residents to benefit this. As there is no one in the post of activities co-ordinator at present, the care staff have continued with an hour of in-house activity each afternoon. Some residents feel it was not enough to keep them occupied. One resident said “Sometimes not enough activities” One relative also commented on the lack of stimulation at present. Another relative wrote on the comment card “In the past six weeks the social/leisure facilities have become virtually non-existent. Otherwise everything else is very satisfactory”. In response to the question in the comment card “Do you like the food”, eight residents responded ‘yes’ including one who wrote ‘extremely good’ and two responded ‘sometimes’. Some comments received during a group discussion in the lounge were: • “The food is good” CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 13 • • “Good food – I have put on a stone since I have been here” “The food is wonderful. I am diabetic but they feed me well and supply diabetic foods”. The cook confirmed that she has flexibility within the menu choices and is able to meet the individual needs of residents. There are two dining areas in the home and food is served from a hot trolley. The food served for lunch looked appetising and well cooked, with plenty available for second helpings for those who wanted some more. Some of the furniture in the dining rooms was old and ‘mis-matched’ which did not create a homely and comfortable feel. Six old bathroom chairs and an office chair were in use as there were not enough dining chairs. Part of the dining room has a desk and is used by staff for their paperwork. Residents spoken with did not express any negative opinions about this. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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 standard(s) 16 There is a satisfactory internal complaints procedure displayed and a ‘comment card’ system that enables people to express their views and concerns to the organisation. The complaints procedure on display does not enable people to get in touch with the CSCI easily. EVIDENCE: The complaints procedure in the Service User guide does not include the telephone number of the CSCI. The procedure displayed in the entrance hall is only the internal procedure and does not even mention the CSCI. Therefore, some relatives and visitors may not be fully informed of their right to contact the CSCI Records are kept of any internal complaints, and these have been dealt with according to procedures. Residents spoken with said they knew who to talk to if they had any concerns. One visitor spoken with said the staff were quick to attend to any queries they had about their mother’s care. The CSCI has not received any complaints about Crossways during the last twelve months. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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 standard(s) 19 and 26 The standard of the environment continues to improve, but a number of areas of the home still need attention in order to provide a comfortable, homely place in which to live. EVIDENCE: Since the last inspection, there has been considerable improvement to the environment for the residents. This has included: • Redecoration and new carpeting to two corridors. • A number of bedrooms and two lounges have been decorated and had new carpets. • A new en-suite bedroom has been created from an unused lounge area. • Two bathrooms have been renovated. • A large chimney structure has been removed from the entrance area of the home. • Ten new lounge chairs are currently on order for the home. Residents are pleased with the work that has been carried out. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 16 There is a refurbishment plan in place to continue with the improvement to the residents’ facilities in the home. Some additional areas for improvement were also noted during the inspection: • The ground floor dining room carpet is badly stained and requires attention. • There is a shortage of dining chairs resulting in six brown plastic covered bathroom chairs with white metal legs being used. Also, a red office type chair was in use. This does not create a homely atmosphere in the dining rooms. • The ground floor dining room sideboard is very worn and requires attention. • Part of one of the residents’ lounges is used for the storage of old TV sets, wheelchairs and the carpet cleaner. • There is a badly stained ceiling in the ‘bungalow’ bathroom. • No lampshade in one identified bedroom. At present, the residents have use of a small enclosed courtyard area in which to sit outside. There are large grounds around the home, but these are not enclosed and do not have any seating, brollies etc. The manager spoke of future plans to develop this area to provide better outdoor facilities for residents. The external entrance area to the home has improved with the removal of an old ‘flue’, but the area still looks uncared for, with tubs of dead plants and a pile of soil outside the front door. The home is clean and during a tour of the building, no odours were detected. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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 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 and 30 Recent appointments of permanent staff should ensure that the residents are cared for consistently. The numbers of staff on each shift are sufficient to care for the residents. Training is continuing to ensure that staff are competent to do their jobs. EVIDENCE: In the two months prior to the inspection, eighty three shifts at the home have been covered by agency or ‘bank’ staff due to staff vacancies and staff sickness. During a group discussion with the residents, some commented on the high number of different staff working in the home. This situation should be resolved very soon as three new permanent staff have been recruited and will be starting work when all their references and checks are complete. Staff training is continuing and to date, seven of the care staff have completed NVQ level 2 with a further six working towards it. Some senior staff are working towards either level 3 or 4 NVQ. The staff group have also taken part in training relevant to their jobs such as fire training, first aid, infection control, moving and handling and food hygiene. This training, plus future training that is planned, will support the staff in providing for the varied needs of the residents. Residents who were spoken with gave a consistent message that the staff at Crossways are very caring. One relative wrote on the comment card “I am more than happy with the care my father receives from all the staff at Crossways”. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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 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) 33, 36 and 38 An internal quality assurance scheme has commenced to ensure that the residents’ views of the home are taken account in relation to the way in which the home is run. Regular staff training in health and safety matters ensures the safety and welfare of residents and staff although staff supervision is still under development. EVIDENCE: Residents and their relatives have recently completed customer satisfaction survey questionnaires. The results of these have not yet been published, but there are plans to have them available in the Service User guide outlining how the home intends to deal with any areas of concern. Two care assistants spoken with have not yet had any supervision yet from senior staff. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 19 The pre inspection questionnaire provided information to confirm that equipment and installations at the home are serviced on a regular basis. The home employs a handyman who attends to maintenance issues such as checking fire equipment, water temperatures and other health and safety matters. The fire record book indicated that staff are trained in fire precautions and drills. Various health and safety policies and procedures are in place in the home. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x 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 2 x x x x 3 x x 2 x 3 CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 21 no 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 3 Regulation 14 Requirement Each resident admitted to the home must have as assessment of their needs completed that is revised when there are any changes. Care plans must be up to date and provide clear guidance to staff on the action to be taken to meet their health and welfare needs. The complaints procedure must include the name, address and telephone number of the CSCI. Suitable and sufficient dining furniture must be provided for the residents. Suitable provision must be made for storage in the home. All parts of the home must be kept clean and reasonably decorated. (Dining room carpet and bathroom ceiling) Timescale for action 4/8/2005 2. 7 15 1/9/2005 3. 4. 5. 6. 16 19 19 19 22 16 23 23 1/9/2005 30/11/200 5 30/11/200 5 30/11/200 5 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 Good Practice Recommendations F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 22 CROSSWAYS 1. 2. 3. Standard 12 19 36 Arrangements for the provision of activities should be reviewed as soon as possible to ensure residents needs are met. The provision of the outside space provided for residents should be reviewed so to provide sufficient space that is safe and accessible. Supervision arrangements should be in place for all staff. CROSSWAYS F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire 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 F51 F01 S6508 Crossways V229881 070705 Stage 4.doc Version 1.30 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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