Inspection on 19/04/07 for Crossways Community

This inspection was carried out on 19th 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 Community 17/04/09

Crossways Community 30/01/06

Crossways Community 11/05/05

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 Crossways Community 8 Culverden Park Road Tunbridge Wells Kent TN4 9QX Lead Inspector Lisbeth Scoones Key Unannounced Inspection 20th April 2007 10:00 Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 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 Community DS0000023917.V335714.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 Adults 18-65. 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 Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crossways Community Address Crossways Community 8 Culverden Park Road Tunbridge Wells Kent TN4 9QX 01892 529321 01892 540843 martin@crosswayscommunity.org.uk www.crosswayscommunity.org.uk Crossways Community 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) Mr Martin Granger Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: First registered in 1971, Crossways Community is a Christian Charitable Trust. It provides a high standard of care, support and accommodation for 16 adults aged between 18-65 who have or are recovering from a mental health problem. Based on Christian values and community spirit, it provides a progressive service that is evolving and developing to meet the current and future needs of the residents. Crossways Community is a detached property with gardens and 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 town amenities a few minutes walk away. Accommodation is over three-storeys. There is no shaft lift. The home has sixteen single rooms, all with en-suite or designated facilities and television points. Crossways senior staff team comprises the registered manager, Home manager, care coordinator, training and development manager and administration manager. The home employs staff, working a roster, which gives 24-hour cover. Residents 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. The inspection report is available to residents. Weekly fees range between £303.25 to £738 with additional charges for a contribution to some holidays, personal TV licence and use of tumble dryer. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on Friday 20th of April between 10.00 and 17.00. The visit comprised discussions with the registered manager, care coordinator, administration manager and other staff. Conversations took place with the majority of the residents, both individually and in a small group. A tour of the communal areas and garden was undertaken. A pre-inspection questionnaire and comment cards, completed by the manager and 11 residents respectively, further informed the visit. A comment card completed by a GP read:” Crossways is an excellent organisation. If only there were more like it!” Two comment cards were received from care managers. One said: “They care for some very ill people very well”. The other: “The care home supports the individual and encourages them in their recovery. They liaise well with other agencies.” A Senior practitioner, contacted after the visit, said:” I am impressed with their standard of care.” Residents’ comments are incorporated in the report. At the time of the visit, occupancy was 14 residents. What the service does well: Residents spoken with said that Crossways is a good place to live. A resident said, “I always have the freedom to choose what I do”. Another, “ I like Crossways”. Residents receive an individual service aimed at supporting them to attain their full potential and/or maintain stability in where they are in life. Such support is extended to ex residents now living in the community. The Trust also runs a hostel and flats. Residents are encouraged to take part in a range of meaningful activities, both in-house and in the community. The home provides a comfortable, spacious and homely environment and has a calm welcoming atmosphere. Residents benefit from a clear management structure identifying staffs’ roles and responsibilities. Good systems are in place for monitoring and reviewing the service from an organisational operational perspective. This includes the views of interested parties or representatives. The registered manager is committed to find the best way of obtaining the views of the residents and this issue was discussed during the visit. The visit evidenced that Crossways is open to suggestions to further improve the service provided. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are provided with comprehensive information to make an informed choice about living at Crossways. The needs and aspirations of the prospective resident are assessed before a place at home is offered. Prospective residents have an opportunity to get a feel of the place prior to a decision of becoming a permanent resident is made. EVIDENCE: The home has produced an excellent service users guide (introduction to Crossways) which is available on-line at www.crosswayscommunity.org.uk In conversation with a resident, it was ascertained that a comprehensive assessment was undertaken before the offer of a place was made. The resident responded to the question what do you like about the living here, with: “ It’s the peak”. He elaborated by saying this was because of the staff, the environment and the freedom. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 9 The care coordinator explained the admission process and it is evident that prospective residents are only admitted following a thorough multidisciplinary assessment. Residents visit the home and stay initially for 5 days. During this time they meet with other residents and staff and get a feel of the place. At the previous inspection, a discussion took place about the benefit of a review of the then current procedure for obtaining information relating to any cultural or religious wishes. The registered manager said this has been acted upon. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs and personal goals are reflected in their individual plan but could be further improved. Residents are supported to make decisions about their lives. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: Residents spoken with said they were aware of their care plan. A resident said, “I meet up with my key worker to talk about things I want to do. Then it is put in my care plan. Most of it stays the same.” A sample of care plans was perused and in general provided good information about residents’ needs and aspirations. There was evidence of review but not of an evaluation, which should be part of the process. A resident had spoken of an aspiration but this had not been recorded in the care plan. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 11 Care plans are informed by risk assessments. However, for one resident, the care plan had been updated but the linked risk assessment had not. It is evident from speaking with residents that staff encourage and enable them to make decisions and choices about their lives. Residents manage their own financial affairs as explained by the residents and the home’s administration manager. A resident mentioned going into town to withdraw money and spend it! Residents are encouraged to take part in staff and residents meetings, which are minuted. Twice yearly, residents’ views and opinions are asked via a questionnaire. In conversation with the manager, various other ways of obtaining residents’ views were discussed. See also standard 39. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have a choice of appropriate activities. Residents are part of the local community. Residents are encouraged to have appropriate relationships. Resident’s rights are respected and responsibilities in their daily lives recognised. Residents are offered and included in the preparation of healthy and enjoyable meals. EVIDENCE: Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 13 Residents have a structured day with jobs in the community or in house. Day activities are planned with their key worker. Crossways employs designated life skills staff who support residents to be independent. Residents are encouraged to attend college courses, find work placements and other community based activities such as computer, literacy and numeracy skill courses. A resident said, “ I enjoy Math and English at college twice a week.” Residents’ artistic talents are encouraged. Some residents enjoy painting and produce other artwork. The chapel room has a piano. There is a TV, computer, DVD player and various games and sports equipment. Following risk assessment, residents are free to come and go as they please. They have their own key to access the front door and their room. Residents go out walking, to the gym or shopping, sometimes accompanied by a member of staff or as a group. On the day of the visit, a group of residents were going out for the afternoon. A resident said, “I like in-house holidays and annual holidays”. The extensive gardens have a number of allotments for residents’ use and a summerhouse. It has a water feature and private spaces. Visitors are made welcome and encouraged as part of the overall ethos of the home as a community. Residents said they enjoy the choice of food on offer. Healthy, nutritious and varied meals are provided as evidenced by the menus seen. Residents have their main meal in the evening. On the day of the visit it was vegetable curry and couscous. There is a staff and a residents’ kitchen where residents prepare their drinks and meals under supervision. A resident is particularly good at baking cakes and making crumbles, shared with the other residents. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive the personal support they ask for and need. Residents’ physical and emotional health care needs are met. Resident’s medication support and needs are supported thorough robust policies and procedures. EVIDENCE: It was observed that staff interact with residents in a respectful manner with regard for their privacy and dignity. A resident confirmed that residents are supported to access NHS facilities as e.g. CPN’s, diabetic nurses and chiropody. Residents receive additional support and advice as needed from outside professionals. This would include psychiatrists and counsellors. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 15 In conversation with the member of staff responsible for medication, it is ascertained that good medication procedures are in place. Following assessment, some residents self- medicate and spot checks are undertaken for compliance. Medication records were well maintained. However staff must be vigilant that all hand written entries are signed and countersigned by a second member of staff. A resident said: “ I put up with the injections as am aware of the benefits to feeling well.” Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel that their views are listened to but the procedure would benefit from review. Residents are protected from abuse, neglect and self-harm. EVIDENCE: The pre- inspection questionnaire states that since the previous inspection 4 complaints were made, responded to within 28 days and substantiated. At this visit a recorded complaint, though completed, had not adequately recorded the outcome for all parties involved. It was recommended that the procedure in this respect be reviewed. It is evident that the staff are pro active in seeking the views of the residents’ and appropriate others. They strive to take action before complaints arise. The staff receive adult protection training. There are policies and procedures in place to promote and protect residents. A training session in raising awareness of self-harming is booked for the near future. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, homely, comfortable, spacious and safe environment. EVIDENCE: It is evident that the home continues to make efforts to ensure that residents have a comfortable, well-maintained environment. All areas visited were well furnished and decorated, bright and spacious. There are two TV lounges, two dining rooms and a chapel/quiet room. The chapel room is used every afternoon by staff and residents (if they wish) for prayer, singing and reflection All residents said that the home was very clean and that this was important to them. A resident said, “It is lovely here”. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 18 Residents’ bedrooms were not visited on this occasion but all residents spoken with said they were happy with their room. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent and qualified staff. Residents are protected by the home’s recruitment practices. Staff receive the appropriate training to meet residents’ needs. EVIDENCE: It is evident from talking to the administration manager that new staff are carefully selected based on their caring and practical skills. A sample of files of recently appointed staff perused indicates that robust recruitment procedures are in place. Staff are provided with job descriptions and have designated roles and responsibilities. Staff spoken with said they support each other and work as a team. It was observed that staff interact well with the residents and each other and have a mutual respect and understanding of their duties and Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 20 responsibilities. There is a very low staff turnover with most staff having worked at Crossways for a considerable period of time. The staff rota would indicate that staffing levels are good. Staff are well trained as evidenced on the training matrix and in conversation with the care coordinator. A robust induction programme is in place. The home is committed to supporting staff with specialist training as identified through supervision and appraisals. Currently 35 of staff have attained the NVQ level 2 or above. As is stated in the Business Plan, “we will continue to have the majority of our care home staff trained to NVQ (111) or above.” Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a well run home. Good quality assurance systems are in place ensuring that residents’ views determine review and development of the home. Residents’ health, safety and welfare is promoted and protected. EVIDENCE: Crossways registered manager is highly experienced and has a management qualification. A good management structure is in place. The senior team Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 22 comprises a home manager, a care coordinator, a training and development manager and an administration manager. Crossways Community’s comprehensive Business Plan 2007-2010 was discussed and evidences its commitment to provide an ever-improving service. It operates according to a comprehensive quality assurance system. A representative of the Trust visits monthly. Policies and procedures are regularly reviewed and are available to residents. Regular meetings are held to seek the views of the residents. Residents’ surveys are carried out twice a year. See also standard 8. There is an annual development plan. The pre-inspection documentation lists dates and frequencies of maintenance visits and tests. This evidences that the home ensures that residents live in a safe environment. Staff and residents are provided with fire safety awareness, First Aid and Food Hygiene training. Regular fire safety checks are made. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 4 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 4 x x 3 x Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 24 NA 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 YA6 YA22 Good Practice Recommendations That care plan reviews and risk assessments are evaluated That, following a complaint investigation, the home can evidence that all parties are satisfied with the outcome. Crossways Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Community DS0000023917.V335714.R01.S.doc Version 5.2 Page 26 - 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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