Inspection on 13/07/06 for Crowborough Lodge

This inspection was carried out on 13th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Crowborough Lodge 07/06/07

Crowborough Lodge 19/12/05

Crowborough Lodge 18/05/05

Crowborough Lodge 05/10/04

Crowborough Lodge 01/06/04

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

CARE HOMES FOR OLDER PEOPLE Crowborough Lodge 2 Crowborough Road Saltdean East Sussex BN2 8EA Lead Inspector Merle Blakeley Key Unannounced Inspection 13th July 2006 09:30 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 Crowborough Lodge DS0000037605.V296956.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. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crowborough Lodge Address 2 Crowborough Road Saltdean East Sussex BN2 8EA 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) 01273 302614 Evans Care Ltd Mrs Bernadette Mary Weller Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated is twentythree (23) Residents must be older people aged sixty-five (65) years or over on admission One named resident with vascular dementia to be accommodated Date of last inspection 19th December 2005 Brief Description of the Service: Crowborough Lodge provides care and accommodation for up to twenty-three older people who generally do not have a high level of need. The home is a large detached residence with sea views and is situated in a quiet residential area off the A259 main south coast road in Saltdean. Local transport, shops and other amenities are located close by. Accommodation is provided on three floors and there are currently fifteen single rooms and four shared rooms. Communal areas consist of a large and small lounge, dining area, sunroom and a small garden area to the rear of the building. There are current plans to expand the service, as Evans Care Ltd has purchased the adjoining property. The current fees range from £337.00 to £403.00. Additional charges are made for hairdressing, chiropody and newspapers. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out over a period of seven hours on 13th July 2006. As well as this site visit information was also gained from a pre-inspection questionnaire, feedback survey forms from residents, informal talks with seven residents, four staff, the manager and the proprietor. The site visit consisted of a tour of the premises, looking at the particular needs of five residents, document reading, and observing staff interactions with residents throughout the day. There are presently twenty residents residing at Crowborough Lodge. What the service does well: What has improved since the last inspection? What they could do better: Some staff need to be reminded that they should not administer medications to residents using their hands, as this is not hygienic. Some staff also need Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 6 reminding that they must knock on a residents door before entering. A handrail needs to be installed along the corridor to assist residents with walking from the lounge/dining room area to their bedrooms. It is also recommended that staff attend a training course in dementia awareness. 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. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 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 the following standard(s): 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home carries out assessments on all prospective residents. EVIDENCE: Before a prospective resident moves into the home an assessment is received from their placing authority. The home will then carry out its own assessment, which is quite thorough and covers all areas of health and social care. When this assessment is completed it will indicate as to whether the home can meet the prospective residents needs. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 9 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 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are informative and regularly reviewed. The current healthcare needs of residents are being met. Medication is being appropriately stored. Tablets and other medications must be administered to residents in the correct manner. On the day residents were seen to be treated with respect by staff. EVIDENCE: Five care plans were viewed during this visit and they were found to be informative and up-to-date. Residents changing needs are being well documented and reviews on all residents had been carried out in the past month. Resident’s healthcare needs appear to be well met by the home. All residents have access to their own GP, opticians and chiropodist who visit, CPN’s and district nurses as and when required. One resident now requires to be hoisted at night and staff have received specific training to carry out this procedure in a safe manner. Risk assessments are also carried out and reviewed regularly. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 10 Medication records were checked and two minor errors were found. Medication is securely stored within the home. Risk assessments are carried out on all residents who self medicate. The home is currently producing a homely remedies policy and procedure. Some of the staff have attended medication training. One resident did state that some staff members administer tablets from their hands and this should not be occurring. All staff will need reminding of the homes medication policy and procedure. Staff were seen to treat residents with dignity and respect. Residents are called by their preferred name and it was stated that their personal beliefs, religion and cultural needs are also respected. A comment was made that a particular staff member is not knocking on resident’s doors before entering. Staff will need to be reminded about the importance of providing residents with privacy. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 11 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a number of weekly activities. Visitors are made welcome in the home. Residents are able to exercise choice and control over their lives. Residents state that they enjoy the meals that are offered. EVIDENCE: The residents are offered a number of activities during the week, which include quizzes, sing songs, films, short walks and visits to a local pub. The home has also organised a local excursion this summer. Residents were asked if they felt there were enough activities offered and most stated that there were. Residents are able to come and go as they wish and the daily routine is reasonably flexible to suit individual needs. All the residents who were spoken to said they were very happy with their lifestyles at Crowborough Lodge. Residents are encouraged and supported to maintain family links. Visitors are welcome in the home at most times of the day and a lot of the residents have regular visitors. Some residents go out with family members and friends. Residents felt that within reason they could exercise control and choice over their lives. Although mealtimes are reasonably fixed there is flexibility and Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 12 residents needs and choices are always taken into account. They can get up and go to bed when they wish and make choices about certain aspects of their lives. Residents can choose who carries out their personal care; they can attend their own religious services and they have access to advocates if required. There are two areas where residents are able to smoke. All the residents that were spoken to stated that they enjoyed the meals that were offered and that there were always menu options available. Most of the residents eat together in the dining room. The inspector was able to have a brief chat with the cook and a short tour of the kitchen facilities. The home employs two experienced part-time cooks and afternoon kitchen helpers. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has produced an effective complaints policy and procedure. The home has compiled an adult protection policy and procedure. EVIDENCE: The home has a complaints policy and procedure. One pending complaint was discussed with the manager and it appears that the proprietor, manager and the resident have now resolved this. There were no other issues. The home has an adult protection policy and procedure and there are no adult protection issues within the home. The vast majority of staff have attended training in the protection of vulnerable adults. All staff undergo a CRB clearance check before they commence employment in the home, however two could not be viewed during this visit. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 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 the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe and generally well maintained. The home is kept clean and tidy and free from any offensive odours. EVIDENCE: The environment is comfortable and homely and overall the home is maintained to a good standard. Several areas are now requiring some refurbishment and two bedrooms are being re-carpeted. A storeroom on the ground floor has been converted into a small office area. The corridor requires a handrail along the side to assist some residents in mobilising safely from the lounge/dining area to their bedrooms. The home is kept clean and tidy and there are no offensive odours. A cleaner is employed four hours a day, seven days a week. Crowborough Lodge DS0000037605.V296956.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): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home employs a stable staff team. Currently one staff member has obtained an NVQ qualification. Recruitment files do not all contain the required information. Adequate training is being provided. EVIDENCE: The home employs a team of twelve care staff who work on a full time and part-time basis. This team remains stable and they are providing a good level of care to residents. Residents who were spoken to felt that staff were caring and friendly. Staff who were spoken to during the day stated that they were happy working at Crowborough Lodge and generally felt well supported by the manager and proprietor. The home currently has some language students who come in to interact with residents for a few hours each week. All the students are nurses and have undergone CRB checks prior to them coming into the home. At the moment only one staff member has obtained the NVQ Level 2 qualification, however there is one staff member who is due to complete this qualification in October 2006 and one who is due to complete NVQ Level 3 in September 2006. Two other staff members have commenced NVQ Level 3 training and one other has commenced NVQ Level 2. Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 16 Several staff recruitment files were viewed and there are still some staff who do not have current photos on file. This was highlighted during the last inspection in December 2005. Not all CRB copies were available to be seen on the day. The home has been continuing with its annual training programme and all staff attended first aid training in July 2006. Staff have also attended manual handling and adult protection training. Future training needs include medication and food hygiene training. It is also recommended that staff try to attend Dementia Awareness training. Crowborough Lodge DS0000037605.V296956.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has successfully completed the Registered Manager Award (RMA). The home is run in a caring and supportive manner. The home has a quality assurance programme. Resident’s finances are appropriately maintained. The home tries to ensure that the health & safety needs of residents and staff are met. EVIDENCE: The registered manager successfully completed the Registered Managers Award in July this year. The home is run and managed in a relaxed and friendly manner and both residents and staff felt they could approach the manager if they had any issues or concerns. Recently the manager has been able to reorganise a lot of the homes files and this has helped to make record keeping less time consuming. The proprietor is in the home on most days and it was stated that he supportive and helpful and will always try to Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 18 accommodate resident’s wishes where possible. It is envisaged that building work on the new extension will possibly commence later in the year. The home has a quality assurance programme and earlier this year a relatives survey was carried out. The home received a good response from family members and friends with some constructive feedback. Several families have suggested the home produce a newsletter. Residents meetings are carried out with the last one being held in May 2006. Annual development plans are produced each March. The home appears to have developed a good working relationship with resident’s family members and friends. The home needs to ensure that staff supervision sessions are carried out more regularly. Apart from the home needing to supply a handrail for the corridor there were no other health and safety issues. A Food Hygiene Inspection was carried out in May this year and the home received a ‘Good Standard’. Water temperatures are checked regularly and the last fire drill was carried out in April 2006. Crowborough Lodge DS0000037605.V296956.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 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP29 Regulation Schedule 2 Requirement That all staff recruitment files contain current photographs of staff. Previous Requirement 2. 3. 4. OP9 OP10 OP19 13(2) 12(4)(a) 23(2)(b) (n) That staff use the correct procedure when administering medicines to service users. That all staff respect service users privacy at all times. That a handrail is provided for the corridor. 31/07/06 13/07/06 31/10/06 Timescale for action 31/08/06 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 OP30 Good Practice Recommendations That staff attend training in Dementia Awareness Crowborough Lodge DS0000037605.V296956.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Crowborough Lodge DS0000037605.V296956.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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