Inspection on 05/09/06 for Crown House

This inspection was carried out on 5th September 2006.

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 10/11/05

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 Linda Clarke Unannounced Inspection 5th September 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 Crown House DS0000006459.V310488.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. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crown House Address Crown Walk High Street Oakham Rutland LE15 6BZ 01572 770301 01572 770250 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.V310488.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 10th November 2005 Brief Description of the Service: Crown House is a care home providing personal care and accommodation for up to twenty-two older persons. The accommodation is sited on the first floor having originally been a hotel; access to the first floor is via a stairwell or passenger lift. There are twenty single rooms and one shared room all having full en-suite facilities. Crown House benefits from two roof gardens providing seating. Information as to the facilities and services offered is available to prospective service users upon request; alternatively these are located in the reception area along with copies of the Commission of Social Care Inspections, Inspection Reports. The maximum weekly fee is £450.00, which was provided on the day of the site visit, and is detailed within the homes documentation. Additional costs for individual expenditure such a Chiropody, and hairdressing services are payable, the amount being dependent upon the services received. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that the inspector looked at the care provided to two service users living at the home and by talking with the service users themselves; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. What the service does well: Crown House is a friendly home situated in the heart of the market town of Oakham in Rutland. The staff on duty were caring and appeared to have good relationships with the service users. All service users spoken with made very positive comments about the care they received. • • • • • • “Very happy, I’ve been here since January and I can’t fault it, I’m looked after remarkably well and in a dignified manner.” “The care here is marvellous, they’ve been kindness its self.” “Care staff are excellent, without fussing.” “Everyone is efficient, helpful and kind.” “In my estimation it couldn’t be any better.” “If I am unwell, then the staff are very efficient and I have quick access to a Doctor.” Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 6 Crown House actively encourages all service users to participate in the care, which includes the reviewing of their care plans. The philosophy of Crown House is to promote and support service users to maintain their independence. Crown House has strong leadership from both the Registered Person (owner) and the Registered Manager, this directly affects the health, welfare and quality of life of service users through strong consultation processes with service users, a comfortable and homely environment, the provision of high quality meals using locally acquired produce, good access to health care provision. Service users access local services independently or with staff support due to the central location of Crown House to shops and services. 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.V310488.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 Crown House DS0000006459.V310488.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): 1, 3 and 5. 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. People’s needs are fully assessed prior to admission so the individual and the care home can be sure the placement is appropriate. EVIDENCE: Information regarding the services and facilities, which Crown House provides is incorporated within the Statement of Purpose and Service User Guide these detail the initial assessment and trial period, information as to the aims and objectives of the Home, information on staffing, advice on raising concerns along with environmental information. Copies of these documents are given to prospective service users and can also be found on the table in the reception area, along with previous Commission for Social Care Inspection Reports. The records of one service user that recently moved into Crown House were viewed; the records contained an initial assessment of their care needs, which were undertaken by the Registered Manager. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 9 The service user following one week of her four-week trial period had decided to make the arrangement permanent. The service user spoke with the Inspector saying, “we didn’t know places like this existed when my family and I came for a visit”. A relative of two service users spoken with informed the Inspector of the number of homes she had visited, and as to how she and her relatives had decided upon Crown House. “’When I spoke to the owner I initially thought it sounded too good to be true, but I visited along with my relatives.” “We all chose Crown House, due to the friendliness of everyone and the homely atmosphere and the welcome we received”. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 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 and 11. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to maintain their independence and are actively involved in all care decisions. EVIDENCE: The care plans of two service users were viewed. The plans detailed elements of care supported by risk assessments, which outline the promotion of service user health and welfare whilst supporting their independence. The philosophy of Crown House is the assumption of service users abilities and the care plans then focus on areas of support required by the individual. There was clear evidence of regular consultation and reviewing of care plans, and the views of service users were recorded. Consultation with service users further evidenced that they are actively involved in all care decisions including the completing of risk assessments. Access to health care was recorded, with some service users making appointments and attending health care practitioners independently. The Registered Manager had recently, at the invitation of local General Practitioners, attended a meeting to look at palliative care and the attainment Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 11 of the Gold Standards Framework, which would support service users in their decision making process during illness, in order that their wishes were respected and their dignity maintained. Medication records of two individuals were viewed, it was noted that both service users (one in part) administered their own medication; this was supported by risk assessments which were completed by the service user themselves on a monthly basis. The records kept in relation to controlled drugs were viewed and found to be in good order. Service users when asked as to their views on the care they received made the following comments. “Very happy, I’ve been here since January and I can’t fault it, I’m looked after remarkably well and in a dignified manner.” “Care staff are excellent, without fussing.” “The care here is marvellous, they’ve been kindness its self.” “Everyone is efficient, helpful and kind.” “In my estimation it couldn’t be any better.” “If I am unwell, then the staff are very efficient and I have quick access to a Doctor.” A relative advised that she is actively involved in the care of her relatives and informed of any health issues. Individual service users have chosen as to whether they wish to have a private telephone line installed in their room, and a significant number of service users choose to correspond by letter with friends and family. One service user spoke of the location of the home being conveniently sited within Oakham, enabling her to access the bank to manage her finances. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 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): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A range of activities within the home and community mean the service users have a range of opportunities to participate in stimulating and motivating activities. Meals and mealtimes are relaxed and enjoyed by service users. EVIDENCE: Crown House offers a range activities, which includes a monthly exercise class provided by a Physiotherapist, in addition there are regular musical events including singing and instrumental sessions, and individual entertainers. The local school plays an active part in service users lives in that pupils visit to play cards and read to service users, and also undertake shopping for them in Oakham. There is a monthly Church service, and visiting Church representatives cater for Quaker, Church of England and Roman Catholic religions, which reflect the religious make up of the current service user group. Service users are supported to take part in external trips, including trips to Rutland Water and boat trips, a significant number of service users go out independently visiting local cafes and shops. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 13 One service user when asked as to her views of activities advised said, “the biggest benefit to me is accessing to the two roof gardens.” Whilst another lady said, “I enjoy writing to my school friends.” One gentleman said, “I join in the musical events, but I enjoy listening to stories, supplied by the local institute for the blind. Crown House provides a very high standard of meals, with service users being consulted as to their choice from the menu. The main meal of the day offers three courses; the ingredients for all meals are fresh and provided by local producers. Meals are presented to a high standard, reflective of hotel standards. At an additional cost wine is served as an accompaniment. Service users are encouraged to eat in the dining room for the lunchtime meal, care plans detail the wishes of service users in relation to breakfast, tea and snacks. Service users were asked as to their views on the meals provided. • • “The food is superb the quality is of a four star hotel.” “The food is very good and is nourishing.” A relative visiting confirmed that she herself had ate on a couple of occasions with her relatives and found the meals to be very appetising and served to a high standard. Service users and their relatives can choose to sit independently at a dining table at an alternative location in Crown House for privacy if they so choose. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints system is effective; service users feel safe and listened to. EVIDENCE: The Commission for Social Care Inspection has not received any concerns since the last Inspection. Crown House has not received any concerns since the last Inspection. The policy and procedure for expressing concerns is available, and information is initially provided in the homes brochures, which are given to service users when visiting, and on admission. Two members of staff were spoken with who were able to confirm their awareness and role in the safeguarding of adult protocols, and confirmed that they had received training as part of their induction. Service users spoken with said they were very much involved in the running of the home, and they were confident that should they have any concerns they would be dealt with, however no one spoken with had any issues and were more than satisfied with the care they received. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 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, 24 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Crown House is decorated to a high standard and is well maintained providing a homely environment for service users in which too reside. EVIDENCE: Crown House is located on the first floor, above a shopping parade, and was clean and tidy. The accommodation comprises of a lounge, snug and dining room as well as individual bedrooms incorporating built in wardrobes, draws and desk space and all having en-suite facilities. The communal areas are decorated to a high standard, including occasional furniture and furnishings providing service users with a stimulating and relaxing environment. Planned improvements have been scheduled to take place over the next two months, which includes the painting to the exterior of the home, and the decorating and furnishing of the lounge. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 16 Crown House provides two roof-terraced gardens with ample seating and protection from the sun; in addition there are hanging baskets and tubs offering a colourful display of flowers. Discussions with service users evidenced that they felt very much that Crown House was their home, and did not view it as a care home. Service users chose as to where they wished to spend their day, some choosing to sit in the lounge to read newspapers, whilst others sat in their rooms watching television or reading. Individuals liked their bedrooms, and were happy with the facilities offered, and said that they personalised their rooms, by bringing with them personal items including furniture. One service user took the opportunity to sit on one of the roof gardens to enjoying the sunshine. One lady said, “the biggest benefit to me is accessing to the two roof gardens.” Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff employed to meet the needs of service users and to safeguard their welfare. EVIDENCE: Crown House employs fifteen members of care staff, of which three have attained a National Vocational Qualification. There are three members of staff who are anticipated to complete their qualification in the next three to four months, with three members of staff having recently commenced their training. There are sufficient members of staff on duty to meet the needs of service users, enabling staff to spend quality time with service users. Crown House has not employed any staff since the most recent inspection, the records of two members of existing care staff were therefore viewed, the documentation evidenced that all pre-employment checks had been made, including the taking up of references and a Criminal Record Bureau check. Staff records reflected that staff receive training in health and safety, first aid, moving and handling, infection control, food hygiene and medication administration, this was confirmed by the two members of staff spoken with. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 18 The Registered Manager for the most recently appointed members of care staff, was using the common induction standards, a member of staff spoke with said that he was currently working through these, and that he was being supported by the Registered Manager. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Registered Manager offers a clear sense of leadership, which reflect on the day-to-day delivery of care practice of residents and running of the home. EVIDENCE: The Registered Manager has attained level 4 National Vocational Qualification in Care and the Registered Managers Award, and has worked in her current capacity for fourteen years. The owners (Registered Persons) and the Registered Manager are respected by the service users, visitors and staff as confirmed by those spoken with on the day of the site visit. One member of staff stating, “there is good communication systems in place between the Registered Person and Manager.” Whilst a visitor said that “they are both very friendly, and speak with service users in a non-patronising manner.” Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 20 A quality assurance system has been established which comprises of questionnaires which are distributed to service users and regular service user meetings, the frequency of which are dictated by the service users themselves. Comments recorded on the questionnaires included “I couldn’t be cared for better.” “The staff are delightful and treat me very well.” “I feel safe here in caring hands.” Letters from relatives were also viewed, which praised the care offered to their relatives by the management team and the care staff. The records of one service user viewed, detailed that the lady manages her own finances, this was confirmed by the service user herself, who accesses the bank on a regular basis. One gentleman said that his son has Power of Attorney and manages his finances on his behalf. Records viewed evidenced that the home is regularly maintained; areas included within this were maintenance of fire equipment and systems, electrical equipment and gas supply. Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 21 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 X X 4 X 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 Crown House DS0000006459.V310488.R01.S.doc Version 5.2 Page 22 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.V310488.R01.S.doc Version 5.2 Page 23 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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