Inspection on 11/05/05 for Crossways Community

This inspection was carried out on 11th May 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 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 Community 17/04/09

Crossways Community 19/04/07

Crossways Community 30/01/06

Crossways Community 28/09/04

Crossways Community 27/04/04

Crossways Community 04/11/03

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Belle Vue Country House

The Laurels

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

CARE HOME ADULTS 18-65 Crossways Community 8 Culvenden Park Road Tunbridge Wells Kent TN4 9QX Lead Inspector Helen Martin Unannounced 11 May 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Crossways Community Address 8 Culvenden Park Road Tunbridge Wells Kent TN4 9QX 01892 529321 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) Crossways Community Mr Martin Granger CRH Care Home 16 Category(ies) of MD Mental Disorder (16) registration, with number of places Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 September 2004 Brief Description of the Service: Crossways Community provides care, support and accommodation for 16 adults aged between 18-65 who have or are recovering from a mental health problem. Crossways was first registered on 12th February 1971. It consists of a detached property and gardens with car parking facilities to the side of the building. The home is located in a residential area of Tunbridge Wells, close to shops and public transport with other usual town amenities being a few minutes walk away. Accommodation is over three-storeys. There is no shaft lift. The home has sixteen single rooms, all having en-suite or designated facilities and television points. Crossways’ senior staffing team comprises of the registered manager, two deputy managers and an administrator. The home employs staff, working a roster, which gives 24-hour cover. Service users and staff share the domestic duties as part of their programme towards more independent living. The staff who work at Crossways are Christians and their faith forms the basis of the philosophy of care offered within the home. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Helen Martin and Harbinder Ghir, Regulatory Inspectors for the CSCI, undertook this unannounced inspection on 11th May 2005 at 10.30. The visit included talking with residents, staff, the deputy managers and the manager. Some judgements about quality of life within the home were taken from direct conversation with residents and the deputy managers. In addition a tour of parts of the premises was undertaken and some records were looked at. What the service does well: What has improved since the last inspection? The home has taken advice from the Pharmacy Inspector for the CSCI and has a safe and organised system in place for the administration of medication, improving the protection of residents. Additional choice has been offered by the home to residents and their representatives regarding alternatives to appointeeship held by the home. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 6 The risk assessment format is more clear and easy to follow, which allows comprehensive and detailed information, providing guidance for staff on the actions to be taken to meet the health and welfare needs of residents. The method and recording of induction training has improved, enabling residents needs to be better met. 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 Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This was not inspected on this occasion. EVIDENCE: Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10 There is a clear and consistent care planning system in place, which provided staff with the information they needed to meet the needs of residents. Residents are supported to make active choices and decisions throughout their daily living. EVIDENCE: Care plans inspected were divided into sub sections, which were easy to read and follow. The file was divided into sections including risk assessments, mental health, physical health, finances, independent living, medication, reviews, evaluations, additional information and consent forms. The information was very detailed and comprehensive. Care plans identified risk in great detail, which also focused on the management of risk. Documentation seen included risk assessments associated with violence, verbal aggression, self-care, medication and smoking. Care plans were up to date, reviewed regularly by the home and by multi-disciplinary professionals. Residents are supported to make independent decisions and choices. Residents spoken to informed how they have been supported to complete academic courses and attend social activities. All residents at the home handle their own Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 10 finances and if required are supported. Residents participate in regular resident meetings and discussion groups. They have the choice to be involved in the daily running of the as far as their abilities allow. Copies of policies and procedures were readily available in the main dining room. Individual records examined were accurate, secure and confidential and staff were aware of how to handle confidential information. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 16, 17 Residents are provided with the support to maintain their independence and in areas of personal development according to their needs and wishes. Residents are engaged in community life; enjoy a range of leisure activities and a varied and nutritional diet. EVIDENCE: Care plans showed that the development of personal, social and emotional skills are fundamental to the service provided. Staff support residents to develop practical life skills for example by supporting them with managing their finances. The home is based on Christian ethos and therefore residents have the opportunity to be involved with spirituality and attend weekly chapel meetings if they choose. Residents are offered opportunities to develop educational skills and seek employment opportunities. Some residents are in the process of completing adult education courses and others participate in voluntary work. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 12 The home has a weekly activity programme where residents are offered opportunities to participate in a range of leisure activities both within the home and in the local community. Staffs enable residents as far as possible to integrate into community life by providing information and access to community facilities and events. Group trips and outings are available for those who share the same interests. Residents are also supported and encouraged to pursue their own interests and hobbies. One resident spoken to stated how he enjoys going out for meals, socialising with his friends and goes to the gym on a regular basis. He stated that he does his own shopping and prepares his own meals. All residents are provided with the option of a holiday outside the home, which they choose and plan. The home menu records showed that residents are supported in preparing their own meals or have the option to have their meals provided by the home, which are varied and healthy. A daily log of nutritional intake for individual residents is kept. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Personal, physical and emotional healthcare is provided that meets resident’s needs and wishes. Residents are protected by clear and comprehensive arrangements for the administration of medication, although further guidance is being sought regarding the avoidance of secondary dispensing. EVIDENCE: All residents have a detailed plan of their daily routine including what support is needed in relation to personal hygiene. Personal support takes account of individual preferences and resident’s choice of dress and appearance is respected. All residents have a designated key worker. Residents are supported to attend appointments with treatment. Care records showed that resident’s health is monitored and prompt referrals are made. Personal support takes account of individual preferences and is provided in private. Medication is managed well by the home. The home has an appropriate medication policy and procedure in place, which protects all service users and ensure the safety of those self-medicating by using risk assessments where necessary. The home has sought guidance from the Pharmacy Inspector with Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 14 the CSCI and continues to seek further guidance from health care professionals to avoid any secondary dispensing. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home provides a satisfactory complaints system and residents feel that their views are listened to and acted upon. EVIDENCE: The home has a comprehensive complaints policy and procedure. The home’s complaints logbook was seen which had the facility to record minor niggles in addition to formal complaints. The logbook indicated residents feeling comfortable highlighting their concerns as niggles. Staff responded promptly and actioned appropriately. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 30 Residents’ benefited from living in a safe, well-maintained and clean environment. Décor, furnishings and fittings that are of a good standard and provide a homely and pleasant living environment enhance their comfort. EVIDENCE: The premises were comfortable, bright, airy, clean and free from offensive odours. Furnishings and fittings in communal areas were of good quality, domestic and unobtrusive. The home provided a large lounge, a smoking room, chapel room, seating area in large inner hallway, a dining room and a smaller dining area leading from the kitchen area. One communal bathroom and additional toilets were provided on the ground floor. The grounds around the home were well maintained and were equipped with suitable furniture. There is also a separate visitors room. A resident’s room was seen during the inspection, which was comfortable with adequate furnishings and was also personalised with the resident’s own furnishings. The resident stated that he liked his room and was happy at the home. All rooms were lockable and required the resident’s agreement to enter. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 17 All rooms with the exception of two had adequate en-suite facilities. The remaining two had their own designated bathrooms. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35 The procedures for the recruitment of staff are comprehensive, robust and, ensure the protection of residents, although this would be enhanced by minor amendment to the staff application form. The staff group receive adequate training to meet the needs of residents, although clear records for fire drills would reflect this better. EVIDENCE: The home has a comprehensive recruitment procedure. One staff file was viewed during the inspection. The file was complete with all relevant checks made required by the regulations. The file included a comprehensive completed application form, three good references, medical check, copies of ID, and a photograph of the applicant. The home employs a successful applicant once a Criminal Bureau and POVA check has been completed and received by the home. It was advised the home amends its application form to include a full employment history instead of a history backdating to the last 6 years. A comprehensive and detailed staff-training matrix was viewed during the inspection. Training is organised for all staff on a yearly basis. It was advised that a log is kept of all staff attending fire drills and training, as this could not Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 19 be clearly identified in the records viewed. All newly recruited staff complete an organised 6-week induction programme and are supervised closely. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 41 Residents benefit an experienced manager who recognises their needs and manages the home well. The manager has a clear vision for the home, which he has effectively communicated to residents, relatives and staff. EVIDENCE: The manager has many years experience of working with this service user group and has completed a management qualification. The registered manager communicates a clear sense of direction, leadership and an openness that encourages innovation, creativity, development and change. Staff said they felt well supported and the manager was approachable. Lines of accountability within the home and with external management are clearly understood. During the inspection all residents care plans were kept in a secured place when not in use. Documentation seen was completed appropriately. Residents could access their records if they wished. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 21 Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 4 4 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crossways Community Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 x x H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 23 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 Regulation None 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. 3. Refer to Standard OP20 OP34 OP35 Good Practice Recommendations It was recommended that the home continue to seek further advise from health care professionals to avoid any secondary dispensing of medication. It was recommended that the staff application for employment form be amended to include a fuller employment history. It was recommended that a clear record is kept of all fire drills and training for staff and residents. Crossways Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane, Maidstone Kent ME16 9NT 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 Community H56 S23917 Crossways Community V220096 110505 Stage 4.doc Version 1.30 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. 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