Inspection on 19/07/06 for Crossways Residential Care Home

This inspection was carried out on 19th July 2006.

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 Residential Care Home 12/10/05

Crossways Residential Care Home 17/05/05

Crossways Residential Care Home 10/11/04

Crossways Residential Care Home 05/05/04

Crossways Residential Care Home 26/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Crossways Residential Care Home 306 Yorktown Road Sandhurst Berkshire GU47 0PZ Lead Inspector Kerry Kingston Unannounced Inspection 19th July 2006 10:30 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 Residential Care Home DS0000011116.V295193.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 Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crossways Residential Care Home Address 306 Yorktown Road Sandhurst Berkshire GU47 0PZ 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) 01276 34691 Mr Tom Neehaul Mrs Naz Neehaul Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2005 Brief Description of the Service: Crossways is a residential care home providing 24-hour care to 10 older people over the age of 65. The home is an extended domestic dwelling over two floors with a passenger lift in situ. The home is within close proximity to local amenities and is well served by public transport and is close to the M3 and M4 motorways. The average fees are £440.00 per week. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced site visit which took place between the hours of 10.30 am and 3.30 pm on the 19th July 2006, to collect additional information to inform the report for the key inspection. Information was collected form a pre-inspection questionnaire, completed by the proprietor, C.S.C.I questionnaires sent to service users (eight of the nine service users returned them, most had been completed with the help of families), a discussion with one staff member, three service users, the manager/ proprietors. A tour of the home, service user and other records were also used to collect information, on the day of the visit. The home has met the two requirements made on the last inspection report. There are, currently, nine service users resident in the ten bedded home, some are able to clearly express their opinions verbally although others are not as clearly able to communicate with people they do not have a relationship with. What the service does well: 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. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 6 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 Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 7 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 the following standard(s): 3 The quality in this outcome area is good. The home is well able to meet the needs of the service users that it admits. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The assessments of the newest service user was seen, she has a full assessment completed by the Local Authority.The assessment includes all the needs of service users.One of the important considerations for admission was the ability of the service user to continue the activities that she participated in, whilst still in the community. The care plan is developed by the home, from the assessments and includes all the aspects of care needed to ensure that the service users needs are met. The family are involved in the admission process, as far as is appropriate and visit regularly. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 8 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 the following standard(s): 7,8,9 and 10 The quality in this outcome area is good. The home is able to meet the health and personal care needs of the service users, offering individual tailored care. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The content of four care plans seen were detailed and informative. They included personal care, health needs, mobilisation, dependency levels, psychological profiles and all personal and healthcare needs. The elements of the care plans are understood by care staff and translated to daily care practice. Service users have good health records, including visits to and by the primary healthcare team and specialist referrals. The home keep weight records and record discussions with the G.P about the appropriate care to give to any service users with any health issues. One service user suffers from a condition that she felt was not entirely understood by staff but the manager described the issues created by the condition and how to help the service user to deal with her difficulties and frustrations is noted on the care plan. The G.P visits Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 9 weekly and referrals are made quickly, as necessary. The G.P and primary health team is very supportive. Medication administration records are accurate. Care practice seen was sensitive and respectful, this was confirmed by three service users who said that ‘ staff very are respectful they knock on doors and talk to you like an adult. They are very kind and helpful. You can always talk to them.’ One staff member described how she ensures privacy and dignity and three others were observed carrying out daily care preserving service users dignity and privacy. All eight of service users returned Questionnaires noted that they always receive the care and support needed. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 10 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 the following standard(s): 12,13,14 and 15 The quality in this outcome area is good. The home ensures Service users have positive daily life experiences by providing activities and appropriate food. Service users are able to make decisions for themselves although this is informal and not formally recorded. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Service users likes/preferences for activities are noted in care plans and activities completed are recorded on daily notes. One service user attends a day centre for three days per week.One service user who said she was not provided with activities said that she prefers to amuse herself, she loves quiz shows,reading and watching the television.’ The proprietor was observed ensuring she was able to pursue her chosen activity. Social outings are generally provided by service users’ families and one service user who doesnt have family is taken out by staff. Service users were observed being given a choice of a variety of activities including puzzles/converstaion/knitting (one lady showed me a scarf she was knitting). Service users confirmed that they felt they had plenty to do ,if they wanted to. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 11 Family members are welcomed to the home.Eight service users have regular contact with friends and family members. Service users confirmed that they are able to put forward their views about the care in the home, one lady said that she prefers her daughter to do it for her but she believes that she is listened to and staff act on her views, if they can. The home does not have a cook but staff produce good quality meals, Service users choose whatever they want, one service user said she was not keen on the food and this was noted in her care plan. Weight records are kept and there are no major nutritional issues evident in the home. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 16 and 18 The quality in this outcome area is good. Service users are comfortable expressing their views, they are listened to and the home protects them from abuse. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: No complaints have been received since the last inspection. Regulation 37 notifications are now being recieved by the C.S.C.I more frequently as when notifications need to be made has been clarified. Staff are trained in the Protection of Vulnerable Adults as soon as possible after commencing employment. One staff member spoken to outlined how she would deal with any Vulnerable adults situations and was also able to outline the complaints procedure. Service Users know who to talk to if they are not happy and all eight questionnaires noted that everyone, including family knew how to complain. The three service users spoken to felt that staff listened to them. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 19 and 26 The quality in this outcome area is good. The home is well maintained, comfortable clean and hygienic. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The home is fresh,clean and well maintained. Three bedrooms and a bathroom have been decorated/refurbished and service users were able to choose the colour of their rooms and linens to match the colour scheme. One Service User has been offered a ground floor room (now vacant) as it may suit her needs better. The downstairs bathroom is refurbished and all bathrooms and toilets are very clean, there are no odours and there are fresh flowers and ornaments on display.The garden is beautifully kept and service users are encouraged to use the outdoor space and participate in the gardening. Annual development plans include refurbishments and replacements. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 14 The environmental health officer visited recently, she made two requirements and two reccomendations, most of which have been complied with, the home has until 2007 to fully comply. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is good. Staff competence and skills are able to meet the needs of current service users with their present staffing ratios. Recruitment policies and practices are robust and keep Service users safe. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: There are a minimum of two staff per shift. The manager is usually supernumerary but in times of staff shortage she works on the care rota. Staff were seen supporting service users with all their needs during the course of the inspection visit. Service users appeared confident to call staff and ask for anything they required, their requests were responded to quickly. The staff member, spoken to and the manager felt there were enough staff to complete all the chores and meet all the needs of service users. The home has a part time gardener and cleaner but no cook. Three service users said that there were enough staff to assist them , as necessary but they were always busy. Recruitment records of the two newest staff showed that all necessary checks and references were in place.One reference was not convincing and advice was given that if there was any doubt a references validity should be checked. There are currently eight staff,four have NVQ 2 or above and two are currently undertaking N.V.Q.training. The manager of the home is an N.V.Q.assessor. The staff member,spoken to said that she has had good training opportunities and there is regular and positive supervision.She said that there had been real Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 16 improvements in communication, menus and activities with the current management team. One service user is currently, being reviewed to assess whether additional staff hours may be necessary to support her changing needs. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 The quality in this outcome area is good. The home is run in the best interests of the service users and their health, safety and welfare is protected. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The home is managed by the proprietors, one does the practical day-to-day management tasks and the other does the administrative tasks. Management tasks are re-arranged if there is a staff shortage to release one partner to focus more on the care shifts. A limited annual development plan is produced as a result of the quality assurance process but this focuses on practical issues to inform the annual budget. Advice was given that it would be good practice to extend the plan to Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 18 include practice issues and to evidence how service users views are collected and influence/ impact on it. Families deal with service users finance but the home keeps a small amount of personal allownace monies for them. All expenditure is receipted and entered into a financial record book to ensure it is all properly accounted for, records were seen to be accurate. Health and safety checks are up-to-date. The five year electrical check has highlighted some areas that need attention. The proprietor is adressing the areas identified by the electrical check and two areas identified by the fire officer.( Fire reccomendations to be complied with by January 07). There have been eleven recorded accidents/incidents since January 06. All have been dealt with appropriately and two incidents with the same service user resulted in a change to the individuals’ care plan and other safety measures. Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 19 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 X 3 X X N/A 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 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? NONE 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 OP29 OP33 Good Practice Recommendations To ensure all references are clear and valid. A formal method of gaining visiting professionals views about the running of the home needs to be developed. To record service users views and choices. 3 OP33 Crossways Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Residential Care Home DS0000011116.V295193.R01.S.doc Version 5.2 Page 22 - 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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