Inspection on 10/11/05 for Crown House

This inspection was carried out on 10th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Crown House 05/09/06

Crown House 02/06/05

Crown House 11/01/05

Crown House 18/08/04

Crown House 24/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Crown House Crown Walk High Street Oakham Rutland LE15 6BZ Lead Inspector Paula Dutton Unannounced Inspection 10th November 2005 10:00 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 Crown House DS0000006459.V263479.R01.S.doc Version 5.0 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. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crown House Address Crown Walk High Street Oakham Rutland LE15 6BZ 01572 770301 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 Michael Waycot Mrs M Waycot Mrs Margaret Jackson Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 06/05 Brief Description of the Service: Crown House is a residential care home providing registered to accommodate up to twenty-two older people. The home was originally a hotel and is situated in the centre of Oakham close to all the shops and other amenities. The home retains many of the original features of this period building including the Grade 2 listed main staircase. The home is on the first floor, which can be accessed by the passenger lift or the stairs. The home is located on the first floor, above a small mall of shops and cafes. There are twenty single rooms and one double room. All the bedrooms have ensuite facilities. The home has a spacious dining room, located at the front of the building and a bar where residents may smoke. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 10:30am until 01:00pm. The registered manager was available during this time. A tour of the premises took place. Different aspects of the care services provided to four residents were viewed. Two residents spoke to the inspector about their experiences and opinions of care services delivered by the home. A visiting District Nurse and a Student Nurse expressed their views of the ability of the home to meet residents’ health care needs. Seven other residents were observed in communal areas. Discussion took place with the manager and the chef. One resident’s bedroom was viewed. Four main files were viewed including needs assessments, care plans, risk assessments and administration of medication record charts. The accident record was viewed. This method of gathering information is known as ‘case tracking’ and measures all contributing factors to the overall outcomes for residents. This report should be read in conjunction with the previous inspection report from June 2005. What the service does well: This service is operated to a very high standard. There are a range of areas to be identified as a strength within the service: • • • • • • • • • • Management leadership A caring professional team Close involvement of the owners A prompt and responsive service to residents’ choices High standards in the appearance of the environment High standards in the levels of cleanliness High standards in hospitality High standards in catering High standards in risk assessment The location of the home in relation to the immediate community. Some residents made the following comments: • • • • • ‘It’s very nice here. Staff are lovely. I can’t fault them. They are very kind and nice’ ‘I settled from the first day’ ‘I was happy from the first. It’s a happy and relaxed place’ ‘The food is wonderful’ ‘They check on you every two hours at night’ Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 6 • • • • • • • • ‘if family take you out for a meal it doesn’t live up to the standards in the home’ ‘I do my own medication. I feel free and able to do it’ ‘Staff take a pride in what they do’ ‘If you make a suggestion they respond very quickly’ ‘They’re excellent. Staff are brilliant’ ‘Sally (owner) and Margaret (Manager) are a really good team’ ‘Margaret is tremendous. Any problems she can solve them’ ‘Sally is a lovely person. It’s such a happy place that I can spend the rest of my life here’ Some comments were made by health professionals: • • • • • • • ‘The level of care is excellent’ ‘Staff are very particular about the level of care’ ‘Residents are very well cared for’ ‘The strength in the home lies in Margaret and the team. Margaret is excellent and very caring’ ‘There are very high standards of cleanliness’ ‘Meals are excellently presented’ ‘Staff understand health care instructions and contact the nurse or doctor appropriately and promptly’ 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. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 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 Crown House DS0000006459.V263479.R01.S.doc Version 5.0 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): 1, 3 Information is exchanged between residents and the home prior to admission so that an informed decision can be reached about whether the home can meet the individual’s needs. EVIDENCE: The home’s Statement of Purpose and Service Users’ Guide is currently being reviewed. Information provided to potential residents was available. This information included the home’s aims and values. The manager stated the next Statement of Purpose and Service users’ Guide will include photographs of the home as a visual guide to services. This is good practice. A discussion took place about making information available on audio or video tape. The manager stated the home would accommodate requests for information to be provided in another way to the written word. The manager stated all new admission are assessed prior to admission. Discussion with the manager showed consideration is given to those residents already living at the home. Discussion took place about the home’s registration details. Evidence showed assessments are undertaken prior to admission by the manager. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 9 Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 10 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 Residents’ health, safety and welfare needs are met. EVIDENCE: A visiting District Nurse expressed her total satisfaction with the way in which residents’ health care needs are met. It was her opinion that the standards of care provided by the home are excellent. Care plans identified the assistance to be offered by staff to residents to ensure their health, safety and welfare needs are met. Evidence showed specific instruction to ensure high risk activities were addressed through a system of risk assessment. Evidence was seen of risk assessment for movement within bedrooms and movement over longer distances through the home. Evidence showed staff observed and evaluated the level of risk on a regular basis. Care plans featured specific issues relating to a person’s care in which they wished to remain independent. Evidence showed residents are offered the opportunity to construct their care plans. One resident had kept his care plan Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 11 for a few days whilst he considered exactly what it should contain. Care plans contained information about personal care needs and social care needs. Medication was securely stored and records were accurately maintained. Evidence of risk assessments were viewed for those residents who choose to self medicate. These demonstrated a close monitoring and consultation takes place with the resident. This is good practice. Observation found staff were very well presented, respectful and professional in their approach to residents and visitors. Two residents confirmed staff consistently maintained their privacy and dignity. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 12 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): 13, 15 Residents are able to participate in the local activities. Residents choose from a nutritious range of meals. EVIDENCE: The location of this home is unusual. The home occupies the original site of the Crown Hotel and has not lost the appearance or character associated with a hotel. Residents stated they can go to the shops and services such as the dentist which are literally below the home in the high street immediately under the home. Three residents expressed their pleasure in the location of the home and in the view of the high street below the main lounge and snug. The evidence relating to the provision of a nutritional and varied menu indicated the exceptionally high standard of service. Observation found the dining area was very well presented with tables beautifully set ready for silver service meals. A resident explained the meals service to the inspector. This started with a cup of tea at 6am and another at 7am if needed. Breakfast was taken at 08:30 which offered a range of cereals, fresh fruit, toasts and breads. At mid morning tea and biscuits were served. Dinner takes place from 12:30 to 14:00 starting with a choice of starter, a main course with a glass of wine, a sweet, cheese and biscuits and coffee. Mid afternoon brings tea and cakes followed by a meal Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 13 at tea time. Warm drinks are offered at bedtime or later at request (please see comments from residents listed in the Summary pages). A resident explained that everyone gathers in the main lounge before a bell sounds to announce lunch. Everyone then goes through to be seated in the dining room. Two residents stated they did not want to got out to dinner because nowhere could match the excellent standard achieved by the home. The chef discussed the planning and preparation of menus. There is no fixed budget for the provision of foods. Fresh vegetables are bought each week from the market. There is no set menu as the residents can express preferences and ingredients are then bought. The chef has worked at the home for 6 years. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 14 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): 18 Residents’ rights are upheld and their safety is protected. EVIDENCE: Discussion with the manager demonstrated a strong commitment to upholding residents’ rights to choose how to live their daily lives. Evidence from residents confirmed the service offers a responsive and flexible approach to choices made by residents. The home had copies of the Department of Health’s guidance document entitled ‘NO SECRETS: Mistreatment of Vulnerable Adults’. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 15 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, 20, 21, 22, 23, 24, 25, 26 Residents live in a safe and very comfortable environment. EVIDENCE: A tour of the premises found all areas were maintained to an exceptionally high standard. Carpets, curtains and soft furnishings were homely in appearance, good quality and very clean. All areas of the home had received careful attention to detail to ensure a tasteful and homely atmosphere throughout. Evidence showed there is a programme of renewal. A resident’s bedroom had been decorated and a new carpet fitted before moving in. A resident had a particular preference for a shower facility so a shower was fitted to the ensuite bathroom. All areas are equipped with a call ball system. Two residents confirmed they could use the call bell system if needed and staff were prompt in their response. Radiators were guarded to prevent any injury through scalding. All areas were accessible to those people with mobility impairments. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 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, 30 The number and skills of the staff team provided ensure residents’ needs are met. EVIDENCE: A rota records the staff working at the home. A discussion took place with the manage about recruitment checks in particular Criminal Record Bureau checks. Advice was given about contacting the commission where a new member of staff was identified as suitable to start working at the home subject to a risk assessment prior to a full police check being returned. The manager confirmed all appropriate checks are completed prior to employees starting work. Evidence was seen of a programme of training provided for staff including training on moving and handling, food hygiene, infection control, dementia care, catheter care and general health and safety training. Three staff have started their National Vocational Training Qualification level two in Care and the manager is about to complete her National Vocational Training Qualification in Care Level Four. It is the manager’s intention to complete the Registered Manager’s Award over the next year. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 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, 32, Strong management leadership and a robust system of risk management ensures residents maintain their independence safely. EVIDENCE: The manager demonstrated a very strong commitment to achieving positive outcomes for residents. Evidence from two residents showed each person had very positive experiences of care provided by the staff team. Evidence indicated there is an effective leadership between the manager and the owners. One resident stated the management and ownership demonstrated they truly cared about people living at the home. Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 18 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 4 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 X X X X X X Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 19 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. Refer to Standard Good Practice Recommendations Crown House DS0000006459.V263479.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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. 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