Inspection on 22/08/05 for Crossways Care Nursing Home

This inspection was carried out on 22nd August 2005.

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 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 Care Nursing Home 30/10/07

Crossways Care Nursing Home 09/11/06

Crossways Care Nursing Home 04/11/05

Crossways Care Nursing Home 26/10/04

Crossways Care Nursing Home 04/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Crossways Care Nursing Home 17 Overton Road Sutton Surrey SM2 6RH Lead Inspector Deborah Yapicioz Unannounced 22 August 2005 10:30 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 Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Crossways Care Nursing Home Address 17 Overton Road, Sutton, Surrey SM2 6RH 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) 020 8642 0955 Hopelit UK Limited Mrs Alison Churchill Care home 33 Category(ies) of Old age, Dementia - over 65 registration, with number of places Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Intermediate care may be provided for up to five service users. Date of last inspection 26 October 2004 Brief Description of the Service: Crossways Nursing home is owned by Dr and Mrs Koa Hung Yu and is registered with the Commission for Social Care Inspection to provide nursing care for up to thirty-three older people with numerous conditions associated with old age and dementia. Since Dr and Mrs Yu took over ownership of the home on 31st January 2003 a great deal of work has been put into the renewal of the fabric of the building to bring it in line with the National Minimum Standards. The registered providers have planning permission to extend the home and work is due to begin on the new extension in October. The Crossways is a large Edwardian three-storey house with a twelve bed roomed annexe which was added in 1998. The home has surrounding gardens and is situated in a quiet residential street close to the centre of Sutton. There is a spacious dining room on the ground floor and two lounges. The kitchen and laundry areas are clean and well equipped. There is ample space for parking vehicles at the front of the property. The home is also close to rail and bus links Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected under the National Minimum Standards Care Homes for Older People. The inspector would like to thank Alison Churchill, the service users and staff, for their time and willingness to facilitate the inspection process. Methods of inspection included observation of contact between staff and service users and a discussion with the registered manager. Records examined included the service users plans, complaints, staffing records, training records, Medicine Administration Record Sheets and Criminal Records Bureau Checks. The home is about to begin a major building project to improve and add to the facilities available at the home. The management team have arranged regular meetings with the builder to help minimise the impact and inconvenience the service users may suffer as a result of the building works. What the service does well: What has improved since the last inspection? A requirement was made at the last inspection that all staff have Criminal Records Check on their files as part of the recruitment process. This has been completed and Criminal Records Check checks are received before new staff take up their posts Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 6 The home has recently completed a customer Care Survey and is in the process of compiling the results. The home has also introduced new wound care charts for service users with pressure sores. The home manager has also completed a course in manual handling and risk assessments, which will enable her to train other staff in this area. 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 Care Nursing Home G53-G53 S36868 Crossways V204073 220805 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 Care Nursing Home G53-G53 S36868 Crossways V204073 220805 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) 1,2,3,4 The home provides good information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. A needs assessment is always completed to ensure that service users needs can be met. Each of the service users is issued with an individual contract setting out the terms and conditions of the placement, which safeguards the interests of both parties. Service users referred for intermediate care are provided with an occupational therapy programme, which enables them to maximise their independence. EVIDENCE: A statement of purpose and service users guide is available to interested parties, which outline the service and facilities available to prospective residents. A needs assessment is requested from the referring care manager and the home manager always completes the in-house assessment to ensure that the home is suitable and the service users needs can be met. The service users files looked at during the inspection all contained assessments completed before the service users moved into the home. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 9 The service user and their family (if it is appropriate) are involved and consulted in each stage of the admission. Service users and their families are encouraged to visit the home before a decision to move is made. A meeting takes place soon after moving into the home and the manager said that there is always a member of the management team around to deal with any teething problems or misunderstandings. The home has a contract in place, which includes rooms to be occupied, who is liable for breech of contract, fees, complaints and the trial period. The home provides intermediate Care to a small group of service users. These service users are provided with a rehabilitation programme and assessment and assessment by an Occupational Therapist. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 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) 7,8,9,10,11 The service users have individual care plans, which include consultation with service users and their families. Care plans are regularly updated to ensure the service users changing needs are met. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ medication is well managed to ensure good health. Service users have been consulted on their personal and cultural preferences in relation to illness, death and dying, thus ensuring their individual wishes are respected. EVIDENCE: The service user plans carry on from the original plan drawn up by the care manager and other involved professionals. The plans include risk assessments and any medical appointments or visits from other professionals. Service users and their families are also involved in drawing up the plan. Some service users prefer to be known by a shortened version of their name and those details are recorded in their personal file. The home has a key worker system. Case files looked at where updated regularly. The home manager stated that issues of respect and how to treat service users with dignity and offer choices is incorporated into the induction training of new staff. Service users spoken to during the inspection felt that the staff team Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 11 are nice to them and treated them well. The home has a policy and procedure on Death and Dying. Service user files looked at as part of the inspection showed that the service users are asked about issues around death and dying before admission to the home, this includes any cultural or religious wishes. The qualified nursing staff at the home are the only people that give out medication at the home. Records examined showed that all medicines administered are recorded on Medicine Administration Record Sheets, which were up to date at the time of the unannounced inspection. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 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) 13,14, The daily routines and house rules promote residents’ rights and encourage independence. The home has an open visitors policy to ensure family links are maintained. EVIDENCE: There is an open visitors policy and families are welcome to visit at any time, although the service users can choose who they wish to see. The visitor’s policy is included in the service user guide. There are no restrictions with regard visiting times, providing there arrive at ‘reasonable’ times of the day (e.g. not late at night etc…). Visitors can be seen in any part of the home including bedrooms. The home invites relatives and families to any social events. Information about how to contact local advocacy groups is available in the lobby entrance. The vast majority of service users families are able to represent them and offer advice as required. Service users are on the electoral register and have postal votes. Personal items including furniture can be brought into the home if service users wishes and the item is suitable for the purpose. Any items brought into the home would be recorded on the service users file. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 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 There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: Crossways have a complaints procedure, which outlines how a complaint is dealt with and timescales for action. The complaints procedure is included in the service uses guide. The home keeps a record of any comments or complaints made about the service. The home has an Abuse policy and any concerns would be referred in line with the Vulnerable Adults Procedure. The home has a copy of the local authority Adult Protection Policy on site. The majority of staff at the home has had training on abuse issues with the exception of newer staff. The home manager is in the process of arranging training for new staff. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 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) 19,20,23,24,26, The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. Service user’s bedrooms provide privacy and reflect individual interests and preferences. EVIDENCE: The home is located in a quiet residential area and the layout and design appeared suitable to meet the needs of older people. The home was clean and generally odour free on the day of the inspection. The home has undergone a planned programme of improvement since the current owners took over responsibility for the home. The management team are now planning to extend and improve the current facilities. Work is due to begin on the extension within the next few months and should be completed in 2006. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 15 There is ample communal space through out the home. The communal areas appeared comfortable, bright and furnished appropriately with areas for service users and their visitors to meet in private. There are sufficient numbers of bathrooms and toilet facilities situated throughout the home. Service users bedrooms are pleasant and they have all been personalised by their occupants. The home has recently put nameplates on service users bedroom doors. The baths and showers are within close proximity to the communal areas and service users bedrooms. The home has appropriate laundry facilities separate from the kitchen and the preparation of food. The laundry has suitable flooring. There is a locked cupboard for the Control of Substances Hazardous to Health products. The home has policies and procedures on the disposal of clinical waste. Various specialist equipment and adaptations were evident throughout the home, with a designated area to store wheelchairs. There is a lift to service all floors and a record of maintenance kept. There are “Grab rails” a call bell system, mobile hoists, and other adaptations capable of meeting the assessed needs of the majority of the service users were in evidence through out the house. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 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) 27,29,30 The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home, ongoing training to build on staff skills is provided. The staff team have all had Criminal Records Check, as a safeguard to offer protection to the homes service users EVIDENCE: The home arranges for at least six staff to be on duty during an early shift and five staff for a late shift. At night there are two staff on duty. The home also employs kitchen and domestic staff. The home management team will review staffing levels as appropriate when the home extension is complete. The home has recently recruited three new members of staff from China through an agency. Although the new members of staff are qualified nurses in their own country they will work as carers until they are able to do the “conversion” course. The new staff are currently completing their induction training, this includes health and safety issues. Evidence of training was seen on the sample of personnel files viewed and included Fire Safety, Risk assessment and Manual Handling. The home has recently organised training in wound care and basic food hygiene. The home manager has recently completed a four-day course to become a “Manual Handling and Risk assessment” trainer. She is planning to run a refresher course in Manual handling before Christmas. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 17 A requirement was made at the last inspection that all staff have Criminal Records Check on their files as part of the recruitment process. This has now been completed and Criminal Records Check checks are received before new staff take up their posts. Criminal Records Checks were seen for the recently recruited staff. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 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) 31,32,33,38 The management style is open and the home appears to be well run. There are clear lines of accountability, which is aimed at ensuring the interests of the service users, are safeguarded and their safety and welfare are protected. EVIDENCE: Alison Churchill is the manager of Crossways. Ms Churchill has been in post two years and is a Registered General Nurse and has substantial experience in a care setting. She is in the process of completing the National Vocational Qualification level four. Barbara Grant has recently been promoted to the post of deputy manager. There has been an improvement in the frequency of staff supervisions at the home although they are still not happening as frequently as they should. Overall, the manager continues to demonstrate a good awareness of health and safety issues. Environmental risk assessments have been completed and all policies and procedures have been updated. Records indicate that fire alarms are tested on a weekly basis and fire drills are undertaken quarterly, in line with good fire safety guidance. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 19 The home has undertaken a customer care survey. The comments received from the service users were generally good As mentioned before the home is due to be extended. The builder has been asked to supply a “method statement” which will include arrangements for access. Regular meetings are planned between the manager and builder during the building process, which should help to minimise the disruption to the home. Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 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 3 3 x x 2 x 3 Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 21 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 36 Regulation 18(1) Requirement The home manager must ensure that all members of the staff team receive regular supervision. Timescale for action 15/09/05 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 Good Practice Recommendations Crossways Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Croydon, Kingston & Sutton Office 8th Floor, Grosvenor House 125 High Street Croydon CR0 9XP 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 Care Nursing Home G53-G53 S36868 Crossways V204073 220805 Stage 4.doc Version 1.40 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. 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