Inspection on 20/04/06 for Crowmoor House

This inspection was carried out on 20th April 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

Crowmoor House 18/09/07

Crowmoor House 23/01/06

Crowmoor House 23/08/05

Crowmoor House 05/01/05

Crowmoor House 30/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Crowmoor House Frith Close Monkmoor Shrewsbury Shropshire SY2 5XW Lead Inspector Mr Ian Harris Unannounced Inspection 20th April 2006 08:00 20/04/06 08:00 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 Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 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. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crowmoor House Address Frith Close Monkmoor Shrewsbury Shropshire SY2 5XW 01743 235835 01743 340804 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) Shropshire County Council Mrs Catherine Ann Wallington Care Home 58 Category(ies) of Old age, not falling within any other category registration, with number (58) of places Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may admit from time to time two (2) service users between the ages of 60 to 65 years for the purpose of rehabilitation. 23rd January 2006 Date of last inspection Brief Description of the Service: Crowmoor House is a large Care Home situated in the Monkmoor area of Shrewsbury and owned by Shropshire County Council. Built about twenty years ago it is single storey and comprises six individual units, five of which provide long-term accommodation, the sixth offering respite care with a maximum of two places allocated for rehabilitation. This latter service is managed in partnership with the local Primary Care Trust. The Inspector was informed this Unit would not offer ‘Respite’ only with effect from April 2006. The Registered Manager is Mrs. Catherine Wallington under the auspices of Shropshire Social Services. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection and took place over 5.5 hours. The fullest, co-operation was given to the inspection officer by the Acting Care Manager, staff and residents. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 5 members of staff and 6 residents were spoken to. On the day of inspection the atmosphere within the home was found to be warm, friendly and comfortable with contented residents. All the residents spoken to expressed their satisfaction with the care they received and there were comments as follows “ you will not find a better home in Britain” “The staff are very helpful “ I’m very settled this is a very nice home.” What the service does well: What has improved since the last inspection? There have been considerable improvements made to the home’s environment since the last inspection. All of the bathrooms and toilets have been refurbished. A new shower room has been installed and all the corridors have Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 6 been redecorated. Extensive work has taken place to produce new policies and procedures regarding the safe handling, storage, and administration of medication. 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. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 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 Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 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 and 6 All the residents undergo a full multi-disciplinary assessment prior to admission. Residents that are in the rehab unit have a good programme that maximises and encourages independence. EVIDENCE: All the residents undergo full multi-disciplinary assessment prior to admission. Copies of the assessment, Care Plan and Reviews are on the residents’ files. Each resident is provided with a detailed service users guide and statement of terms and conditions when they move into the home. This statement contains all the required information. The statement is clear on what the fees do and do not cover. All the residents in the rehab unit have a detailed care plan, which is designed to help they regain and develop their independence. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 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, and 10 Each resident has a comprehensive individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P.s, local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration and recording of medication are good with clear and comprehensive arrangements being in place to ensure resident’s medication needs are met. However medication has not been delivered in a safe and efficient way. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a monthly basis. The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 10 G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures, these services are provided by local practitioners. The records indicate that resident’s medical needs are being met. Medication is administered by means of a Boots monitored dosage system. The system is breaking down and mistakes are being made. This is mainly due to lack of staff. The staff who are administrating medication are often called away and distracted by residents in need of attention. This highlights the low staffing levels. The home receives good support from the local pharmacist who does a three monthly audit of the homes medication. There are plans to introduce a new system administration of medication in June when new lockable cabinets are provided and the staff trained in the new procedures. All residents have single rooms. No personal care interventions take place in communal areas. Observed practice on the day of inspection was appropriate and showed respect for the residents. Consultation with health care and social care professionals is carried out within the resident’s bedrooms. Visitors are able to meet residents in their bedrooms or in one of the lounges. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 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 and 15 The home provides a stimulating experience for the residents where they are encouraged to maintain their independence as much as possible The home provides a range of very good of social activities within the home designed to the capabilities of the residents The meals in the home are good, offering both choice and variety and also catering for special dietary needs EVIDENCE: The Acting Care Manager stated that the residents are consulted regarding the day-to-day running of the home through residents’ meetings reviews, questionnaires and by feedback from their Care Staff. This was confirmed by a number of residents who said that they enjoyed the activities and outings that are arranged. The routines and activities within the home are flexible and are built around the needs of the residents. The home has Staff members designated to organise social and leisure activities and identify interests that the residents wish to pursue. This has proved very successful in promoting and encouraging participation in the programme of activities. All residents at the home have access to the clubroom, which offers a wide and varied range of activities. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 12 The observations made, examination of menus and the comments received from the residents confirmed that particular attention is given to the residents’ individual preferences. Most of the comments made by residents regarding the quality, quantity and variety of food provided are complimentary. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 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 and 18 The home has a good complaints procedure with some evidence that residents’ views are listened to and acted upon. The home has good policies and procedures regarding protection from abuse, which includes a whistle blowing policy. EVIDENCE: The home has a comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence and the service users guide that is placed in every bedroom. The home has a complaints book in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in an in house training programme and the N.V.Q. training, which the Staff is undergoing. There have been no incidents that have needed to be recorded or reported. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 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 and 26 The standard of the environment within the home and the garden is good providing the residents with attractive, comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. EVIDENCE: The home has been established for many years and was purpose built in order to provide appropriate accommodation for older people. The home is maintained to a high level, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. There is a programme to remove vanity units from bedrooms in order to give Residents more usable space 4 units have been completed with completion of the 2 other units expected within 12 months. It was noted that all the bathrooms and toilets have been refurbished and a shower room provided. Also all the corridors have been redecorated. The home was found to be clean tidy and free from odour. The home has good policies and procedures regarding infection control and the staff have received Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 15 training in food hygiene and Infection Control. conscious of the dangers of cross infection. All staff appeared to be Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, and 30 The home is not always staffed to a level that ensures that service users’ needs are met at all times. The home has good policies and procedures regarding the recruitment of staff, which includes all the appropriate staff checks and references. There is a very good training programme in place that ensures that the staff are competent to do their job. EVIDENCE: Inspection of staff rotas and discussions with staff indicated that the home is understaffed at times and does not always meet the needs of the residents. The rota indicates that there are only 8 care staff on duty to cover 6 units which means that 4 units has only 1 member of staff covering it. This is a particular concern given the high dependency of a number of residents and the responsibility to use 2 staff members to administer medication. This creates a situation when units are left uncovered by care staff. Mistakes have been made in the administration of medication when staff giving out medication, are called away to meet residents’ urgent needs. The staffing should be increased to ensure a minimum of 2 care staff to each unit and I floating member of staff to concentrate on the administration of medication. It was also noted that the care staff have to deal with the residents laundry, which takes them away from providing personal care of the residents. In a home of this size an ancillary worker should be provided to cover these duties. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 17 The home operates an efficient recruitment procedure and the Local Authority has registered with the Criminal Records Bureau in order to complete the appropriate checks on staff. There was evidence within the home that all the checks are being carried out. Staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has a very good programme of N.V.Q. training and has now exceeded the minimum standard all care staff has completed or are undergoing N.V.Q. level 2 in Care. Care staff, have attended courses on Safe handling of medication, Risk assessment, and Moving and lifting, First Aid, Infection Control and Fire Prevention. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 and 38 The home is well managed by the Acting Care Manager There are clear lines of accountability within the Home. The home has good policies and procedures regarding Health and safety and the Acting Care Manager and staff demonstrated that they are aware of their responsibilities to promote health and safety. EVIDENCE: The Acting Care Manager has considerable experience in managing services for older people and has obtained the Registered Managers Award. There are clear lines of accountability within the Home. The Care Manager has regular supervision meetings with his line manage. From observations made and discussions with residents and staff indicated that the Acting Care Manager is very approachable and operates an open door policy. The staff and residents stated that they are happy to approach the Care Manager with any problems they might have. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 19 All the records and administrative procedures within the home that were inspected were found to be well ordered and maintained. However it was noted that the monthly regulation 26 visits to the home are not being carried out and reports of the visits are not being sent to the commission The home has a good heath and safety policy and staff are aware of their responsibilities regarding these issues and a number of staff have received training. Fire fighting equipment is well maintained the systems are regularly checked and staff have received Fire Prevention Training. In regards to any accidents that take place, they are all recorded in an appropriate record book. Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 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 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 21 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 OP9 Regulation 13.-(2) Requirement The policy and procedures document for the safe handling of medicines within the Home must be amended and up-dated to include the comments made by the Pharmacist Inspector. The remaining vanity units in bedrooms must be removed. The levels and skill-mix of staffing covering shifts throughout 24 hours, and the model used to manage the six units, must be reviewed and issues arising resolved. The registered person must ensure that the care staff hours are increased in order to provide a minimum of 2 care staff on duty in each unit throughout the working day and in addition 1 floating care staff throughout the day to assist in the unit as required The registered person must provide additional member of staff to cover work in the DS0000032792.V288519.R01.S.doc Timescale for action 28/06/06 2. 3. OP24 OP27 12.18.(1)(9)(a) 31/03/07 01/07/06 4 OP27 18 (1) a 01/07/06 5 OP27 18 (1) a 01/07/06 Crowmoor House Version 5.1 Page 22 6 OP31 26 laundry. The Registered person must ensure that the Home has an effective system of Quality Assurance. This should include regulation 26 visit undertaken monthly 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE 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 Crowmoor House DS0000032792.V288519.R01.S.doc Version 5.1 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!