Inspection on 10/04/07 for Crossways Care Home

This inspection was carried out on 10th April 2007.

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 Care Home 22/04/09

Crossways Care Home 06/01/06

Crossways Care Home 30/08/05

Crossways Care Home 14/09/04

Crossways Care Home 26/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Crossways Care Home 2 Sunte Avenue Lindfield Haywards Heath West Sussex RH16 2AA Lead Inspector Mrs M McCourt Unannounced Inspection 10th April 2007 09:00 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 Care Home DS0000046532.V332602.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 Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crossways Care Home Address 2 Sunte Avenue Lindfield Haywards Heath West Sussex RH16 2AA 01444 416841 01444 453830 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) Crossways Healthcare Limited Mrs Deepwantee Mannick Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th January 2006 Brief Description of the Service: Crossways is a care home registered to accommodate up to twenty-five people aged sixty-five or over. The registered provider is Crossways Healthcare Limited and Mrs D Mannick is the registered manager. The property is a large detached house, with accommodation provided over three floors. There are nineteen single and three double bedrooms, eighteen of which have en-suite facilities. Communal areas include a lounge, dining room, quiet lounge and a garden area at the rear of the house. The home is located in the village of Lindfield, near Haywards Heath, close to local shops and amenities, with easy access to local rail and bus stations. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken by one Inspector on Tuesday 10th April 2007 and lasted a total of seven hours. Pre-inspection planning took approximately three days, consisting of the review of previous inspection reports, reading of the pre-inspection questionnaire, in addition to all preinspection documents requested, information received from other relevant professional bodies and regulatory information received by the Commission for Social Care Inspection (CSCI). A full tour of the building took place and included the observation of health and safety matters, hygiene issues, decorative order and a general overview of the atmosphere created within the home. Policies and procedures were also examined during the site visit. Six support staff, administration staff and the registered manager were spoken to at the time of inspection. Case tracking was carried out by examination of relevant records and information held on the staff and residents. The Inspector also spoke with five Service Users accommodated at the home. The current scale of monthly charges ranges from £345 to £700 per week. This information was obtained from the pre-inspection questionnaire. Additional charges are made for personal items, such as; clothing, magazines, hairdressing, chiropody and so on. The Commission has received no complaints in respect of the service. What the service does well: The home has implemented a comprehensive assessment process, which includes a pre-assessment of need, carried out prior to admission, followed by a further assessment on admission. Once settled, service users are reassessed after four or so weeks, ensuring their needs and requirements are closely monitored in the initial weeks of living at the home. The home undertakes to provide palliative care to service users, should they need it. There are relevant policies in place, and training is offered to those Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 6 staff who are interested in learning about the skills required to provide this level of support. In addition, relatives and family are able to stay at the home in a self-contained flat on the third floor. The inspector spoke with residents and was able to determine that the home is thought highly of from those accommodated in it. Comments were complimentary of the services and staff. One resident said that they liked their room, particularly the view, and that “this is as good as it gets, I can’t praise the staff enough, they are very good to me”. Another resident said “top marks to them, I love it so much I don’t want to leave”. The inspector was pleased to note that service users are able to choose from at least two meals at all main meal times. In addition to this, all produce is fresh, with meat delivered twice a week and organic vegetables also delivered twice a week from a local Lindfield grocers. Roast dinners are cooked twice a week because the residents enjoy it so much. The home is decorated to a high standard generally, and on the day of inspection there was an Easter display near the entrance door, which was bright and cheerful. The manager of the home is organised and particularly efficient in her duties. Staff and service users spoken with were complimentary of the managers skills and abilities. The inspector was told that Mrs Mannick is “very supportive” and “a good manager”. What has improved since the last inspection? What they could do better: The inspector considered this service to be of a high standard, and as such, little to improve on. However, two recommendations have been made regarding regular, one-to-one supervision for all staff and to up-date staff knowledge on infection control issues. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a thorough and comprehensive assessment process in place, with all care needs carefully considered prior to admission. Contracts are in place and all signed and dated by both the service user and the home. EVIDENCE: Terms of agreement/contracts were in place for four files sampled. Two were private arrangements and two were funded by West Sussex County Council. All four had been signed by the service user and the registered manager of the home. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 10 A pre-assessment of need is carried out prior to admission by the registered manager or the deputy. Following this a further assessment is completed on admission (to take account of any changes since the pre-assessment process). This is then reviewed after about four weeks and updated or changed as necessary. The home does not offer intermediate care or take in emergencies, however, it does offer respite care. The inspector was told details of a planned respite stay, which included prior visits to the home. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans are in place and reflect identified needs. Health needs are met by the home with the home liaising closely with relevant health professionals for additional support. Medication is stored and administered appropriately. Service users are treated with dignity and respect. EVIDENCE: The assessment process is comprehensive and thorough. Care plans are written up on a standex note system, detailing any care needs identified by the assessment process. The care plans looked at did reflect needs previously identified. Two out of four care plans were up-to-date with the other two Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 12 being slightly overdue reviews. Risk assessments are also carried out on all residents and recorded on personal care plan files. Written notes from visiting professionals are detailed in personal files. Residents keep their own GP surgeries and the home liaises with GP’s for any specialist assessments required, such as; community nurse visits. A visiting professional was present on the day of the site visit and briefly spoke with the inspector. The inspector looked at the medication storage and records. All medicines are stored within a metal trolley cabinet that is stored in a locked cupboard. All stock was seen to be stored neatly. Controlled drugs are held and records demonstrated that these are appropriately kept, with written documentation being correct and up-to-date. MAR sheets were also kept in good order, with only 2 small discrepancies where medication given had not been signed for. The inspector observed that the home should keep a running total of loose medication items, such as; paracetamol and Risedronate, etc. Palliative care is provided with relevant policies in place. Training is offered to those staff who are interested in palliative care. Turn charts are used for people who are receiving bed care. Relatives and family are able to stay at the home in a self-contained flat on the third floor. The inspector spoke with residents and was able to determine that the home is thought highly of from those accommodated in it. Comments were complimentary of the services and staff. One resident said that they liked their room, particularly the view, and that “this is as good as it gets, I can’t praise the staff enough, they are very good to me”. Another resident said “top marks to them, I love it so much I don’t want to leave”. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to exercise choice over their lives and have access to a good range activities provided by the home. Meals are wholesome, nutritious and varied, with the home ensuring meals are cooked using the very best quality ingredients. EVIDENCE: Residents have access to various activities within the home. There is a painting class every Wednesday and the inspector saw many fine examples as a result. A pianist/singer visits the home on a monthly basis and there is also a reminiscence programme, also run monthly. The registered manager said she takes some of the residents to garden centres (depending on the weather), usually this takes place in the summer. In the afternoons some people like to play scrabble and other board games. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 14 The home holds a summer BBQ to which family and friends are invited and a Christmas party is also held each year. Service users confirmed that they could receive visitors in private and relatives can arrive without prior notice. One resident told the inspector that their relatives visit sometimes and they will take her to local restaurants for a meal. The home does not control any of the service users’ finances. They do keep a small amount of personal monies for some, for which the home provides a cash-flow balance sheet, detailing what the amounts were spent on, and this is sent to families each month. Menus were received with the pre-inspection questionnaire. They looked wholesome, varied and nutritious. There is a choice of two meals given at all main meal times. The inspector spoke to the cook, who said that orders for meals are taken the day before. If a resident does not want the choices offered, they will be made something else (usually an omelette). All produce is fresh, with meat delivered twice a week and vegetables delivered twice a week from a local Lindfield grocers, which is also organic. Roast dinners are cooked twice a week because the residents enjoy it so much. Today there was smoked haddock, new potatoes, green beans and carrots on the main lunchtime menu, with Spaghetti Bolognaise as the second choice. The inspector sampled the haddock, which was well presented, tasty and wholesome. The home also keeps a record of meals eaten. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 15 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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good, up-to-date complaints policies and procedures in place. Service users are protected from harm by the home’s adult abuse policies and the appropriate training of staff. EVIDENCE: Complaints policies and procedures are in place, with a 28 day limit to concluding all complaints. Their policy was up-to-date with CSCI’s Southampton address. Adult abuse policies are in place and include; restraint, use of bedrails, violence/aggression, harassment and so on. The abuse policy refers to the West Sussex County Council’s procedures which are also available to staff. Staff spoken with confirmed that they had received training in adult abuse and their knowledge and understanding was good. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 16 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): 19, 20, 21, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable and well-maintained environment. The home is hygienically clean with no unpleasant odours detectable. The manager should up-date her knowledge on infection control. EVIDENCE: The property is a large detached building, located in the village of Lindfield. Accommodation is provided over three floors, with the office, self-contained flat and spare room located on the top floor, bedrooms on the first and second floors and in addition, a basement that houses the laundry equipment. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 17 Residents have access to a good level of communal space, including a large lounge, dining room/lounge and a small quiet lounge on the first floor, used for hairdressing every Tuesday and for receiving visitors and relatives, if service users wish. The entrance hallway was clean, bright, and welcoming, with an Easter display near the door. All rooms are very nicely decorated in pastel colours with matching soft furnishings. Bedrooms are redecorated when residents move out. The home also employs a handyman who works as and when needed. A list is made of all maintenance issues that are entered by staff into a book. The handyman will then spend a day fixing and will initial the entries when completed. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by appropriate numbers of staff. Staff are competent and well trained in their roles. The home has a good level of commitment to recruitment procedures, ensuring the safety and protection of service users. EVIDENCE: The home employs nineteen staff. Four staff work the morning shift, with each designated a section/wing of the house and responsibility for those particular residents. In addition there are two cleaners employed seven days per week, a cook and a chef, also covering seven days per week. Three staff work on late shifts and there are two waking night staff employed for night duty. Three staff have achieved NVQ and three are currently training for their NVQ. All documents required for safe recruitment were in place, with the manager obtaining CRB and/or POVA checks prior to employment. On commencement Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 19 of work, staff undertake an induction programme until they are familiar with procedures. Staff receive training on various subjects throughout the year, details of which were sent to the inspector with the pre-inspection material. Staff spoken with confirmed that they do receive regular and appropriate training on all aspects of care. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 20 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): 31, 32, 33, 34, 35, 36 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a well run home that is managed to suit their best interests. Service users financial interests are safeguarded by the home’s own procedures. The health, safety and welfare of service users and staff are promoted and protected by relevant policies and procedures. EVIDENCE: Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 21 The registered manager, Mrs Deepwantee Mannick, has managed and owned the home since 2003. Mrs Mannick is RMN qualified and is currently completing her RMA. In addition she has completed a City & Guild in health and safety and is due to do the palliative care course. Staff spoken with were complimentary of the managers skills and abilities. The inspector was told that Mrs Mannick is “very supportive” and “a good manager”. In order to ensure quality assurance is in place, the home sends questionnaires to all residents, relatives and professionals (multi-disciplinary team) every six months. Results are then put into a displayed as a graph, which informs the providers what areas they are weak/strong in, and therefore which areas then need to improve on. Resident meetings are not held as yet, but the manager said she would be prepared to implement them. The home does not control any resident finances. Only a small amount of personal monies is kept for sundry items. The registered manager said that supervisions are due to commence on 20th May 2007, starting with night staff group supervision sessions. 1 to 1 sessions for day staff are due to start later this month (April 2007) and she told the inspector that the aim is for supervision to be held for individuals every other month. Health and safety checks are routinely carried out by the home and fire training has been scheduled for March and September this year. The home also carries out planned evacuations during the night-time. Inspection of the kitchen found it to be functional and clean, however thought should be given to labelling jar food, especially mayonnaise, salad creams, tartar sauces and so on. The home uses a red-bag system for washing soiled laundry. There was some discussion regarding the appropriate temperature required to kill bacteria, with staff believing that if clothes are put on a ‘medical’ wash cycle, this would suffice. The inspector advised that this be checked. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 22 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 X 4 X X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 4 3 x 3 Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 23 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. 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. 2. Refer to Standard OP36 OP38 Good Practice Recommendations Staff should receive formal, regular one to one supervision. All staff should be aware of appropriate infection control procedures. Crossways Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Care Home DS0000046532.V332602.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!