Inspection on 20/10/05 for Crown Rest Home

This inspection was carried out on 20th October 2005.

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

Crown Rest Home 09/04/10

Crown Rest Home 24/04/07

Crown Rest Home 01/06/05

Crown Rest Home 11/01/05

Crown Rest Home 30/06/04

Crown Rest Home 21/10/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Crown Rest Home Station Road Little Dunham Kings Lynn Norfolk PE32 2DJ Lead Inspector Ruth Hannent Announced Inspection 20/10/05 09:30 am 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 Rest Home DS0000027514.V249268.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 Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crown Rest Home Address Station Road Little Dunham Kings Lynn Norfolk PE32 2DJ 01760 722039 NO FAX # lindsey.wood2konline.co.uk 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 Christopher Wood Mrs Lindsey Wood Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Crown Rest Home provides residential care for twelve older people. Although a range of needs is catered for there is no ‘specialised’ service. The home comprises of the original building (which was a public house) plus some more recent extensions. Care has been taken to make access as easy as possible throughout the property. The home is situated a short distance out of the village, and there is a better than average (four times daily) bus service. Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place with Mr. and Mrs. Wood over a period of six hours. Some records and care plans were inspected. Staff and family members were spoken to. Ten residents were spoken to in detail. A meal was taken with the residents. A tour of the building took place. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 6 contacting your local CSCI office. Crown Rest Home DS0000027514.V249268.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 Rest Home DS0000027514.V249268.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, 4, and 5 Residents were clearly able to make the choice about where they wished to live with the information offered to them. No one moves to the Home without a thorough assessment of care needs completed. This Home has a reputation to keep up and is working hard to ensure all needs can be met on a resident’s admission. Families and friends are encouraged to visit and assess the Home to the suitability for their relative/friend. EVIDENCE: This Home has a waiting list of people who are on the phone regularly hoping for a place. A brochure about the Home is available along with terms and conditions. Many people, prior to moving in, have been to visit and many have been recommended by word of mouth. On discussing with residents how they came to choose The Crown Rest Home as their Home they all were very clear Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 9 about the reputation heard, the family visits involved and the meeting and discussing of care needs with Mrs. Wood. The visitor’s book left in the entrance was noted to have clear positive comments written by people visiting the Home, although dates were a little spread. This book should be completed more often to support evidence of visitor’s comments. (Recommendation). The needs of the potential resident is assessed by Mrs. Wood to ensure the service offered can meet the needs with a person centred approach. This manager also is a registered nurse and although The Crown in not a nursing home, Mrs. Wood is able to ascertain the health needs of the potential resident and know if the community nurse team can support that need. One visitor spoken to told of her hunt for the correct Home for her mother and how welcome she felt when being shown around and how she is now actively involved in the Home life. Crown Rest Home DS0000027514.V249268.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): 8, 9,and 11 The Home provides the health care needs of each resident fully. Medication procedures are in place and administration is carried out safely. Residents who wish to self medicate are encouraged to do so once a risk assessment has been completed and it is established that the person is safe with administration. The evidence seen and heard is assurance that at the time of death residents and their families are treated with sensitivity and respect. EVIDENCE: With the Home having a registered nurse as one of the Managers the records seen and the support offered was noted to be thorough and clear. The community nurse and the G.P. visited during the inspection and it was evident that the relationship and team work was suitable and appropriate to ensure the healthcare needs were met for the individual residents. Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 11 The overseeing of the medication administration at lunchtime was not carried out with the normal Home’s procedure and after discussion with the staff and Manager it was clear that this was not normal practice and a full detailed explanation was relayed to ensure all procedures of medication administration were safe and followed. The Inspector was then satisfied that the medication is administered correctly. One resident manages her own medication, which is supported by a risk assessment and the medication is in her bedroom within a locked drawer. On talking with this resident she prefers to manage her own pills and is able to do so safely. On the day of the inspection one resident had sadly passed away that morning. The sensitivity witnessed and the conversations heard were appropriate. The family had stayed with their mother on a bed in the room offered by the Home. The manager had given time and compassion to the family. A full care plan of need to support this person in their final hours was seen with all the correct equipment for pressure relief, controlled drugs for pain relief, mouth care, fluid intake and personal care in situ. Crown Rest Home DS0000027514.V249268.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): 12, 13, 14 and 15 Residents are very happy with their lifestyle which matches their expectations. Families and friends are actively encouraged to be involved and visit the Home. Service users are actively encouraged to exercise choice and control. Meals are well balanced with plenty of choice on offer for individual tastes and needs. EVIDENCE: Quite a lot of the inspection time was spent talking to the residents on the lifestyle they lead now they live in this Home. Comments such as “I can do what ever I like” or “I go out and visit the local town when I feel like it” was some of the conversations of the day. People were seen enjoying the daily papers, crosswords, conversations, a glass of sherry, exercises or quietly in their rooms, making wool blankets, watching T.V or listening to the radio. One person felt she could not find anywhere better to live and enjoy her later years. The residents also have meetings where they decide what and how they would like things to happen within the Home. Any donations that are offered to the Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 13 Home are recorded and are then spent in discussion with the residents. Minutes of meetings were seen with the next planned meeting advertised on the notice board. Visitors were seen coming and going freely throughout the day. One lady visits almost daily and talked of how she is made welcome and how she has now become more involved with activities such as planting pots with residents and attending events planned in the Home. (The next to be the annual firework party with a supper). The staff, were carrying out their duties throughout the day with all conversations offering choice overheard. One resident was asked where she would like to sit for her dinner. “Would you like white sauce on your dinner, how much do you like, what do you fancy for your pudding” etc. Although staff know the residents well they are reminded by the Managers not to get complacent and to always offer the choice. This was made evident with the following days menu being actively completed even when staff think they know residents likes and dislikes. The main meal of the day was shared with the residents, which was pork chop, greens and potatoes with white sauce. The alternative being a jacket potato with a choice of prawns, beans, cheese or chilli with salad. The residents all spoke highly of the food and the amount of choice they get. In the afternoon the residents are asked what they fancy for tea from soup, sandwiches, something on toast or jacket potatoes. One resident who is cared for in bed has the same food but liquidised. On talking to this person she made it understood that she enjoyed her food and ate well. Drinks are always available with residents encouraged to keep up their liquid intake. Crown Rest Home DS0000027514.V249268.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): 16 With the evidence seen the handling and recording of complaints is taken seriously and action taken that is appropriate. EVIDENCE: One complaint had been received that had been treated actively and in a positive way. The recording and action taken was seen with an outcome that pleased all parties involved. This complaint was not directly linked to the service provided but was handled and dealt with in a manner that involved staff, resident, resident’s family and Management. Theses records were seen and discussed in full with the Managers. Crown Rest Home DS0000027514.V249268.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, 24 and 26 Residents do live in a safe and well maintained environment. Residents do have comfortable bedrooms with their own personal items around them. The Home is kept clean with no unpleasant odours. EVIDENCE: On walking the Home it was noted how clean, neat and tidy it was. The communal areas are well furnished with plenty of chairs. Occasional tables and kitchen style tables and chairs for dining at. The majority of the bedrooms are light and bright. (Only one bedroom seen had a small window, which meant the electric light needed to be on). But on talking to the gentleman in this room he was very happy with it and would not wish to switch to another room. Two of the bedrooms were in need of a lick of paint and it was noted in some rooms, the curtains needed attention where some of the curtain hooks had Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 16 snapped or come unhooked. (Recommendation). These needs were recognised by the Managers and are to be rectified shortly. The Home has all records (seen) to comply with the fire regulations for the home which included alarm checks and dates, fire equipment checks, Fire training, when the fire officer visited and the outcome of that visit. All areas were recorded as no concerns. The bedrooms were furnished appropriately with resident’s own processions around the room. Each one has its own small en-suite with toilet and hand wash basin One gentleman was proud of his room and happily showed how he sometimes like to move the furniture around to have his cupboards in different positions. Family photographs and pictures were around the walls with some residents having their own furniture to add to their personalised room. Different types of beds were in place according to the needs of the resident. Some had electric controls to raise and lower the head or bottom of the bed by the person themselves. One room had a nursing type bed for the full care needs to be met for the resident in this room, with others having basic suitable beds appropriate to match the room. The laundry duties are carried out by the care staff in a suitable laundry area. The linen and clothes are washed in an industrial type machine with temperature available on the machine settings to ensure that infection control is in place. The linen seen was clean and stored neatly with personal washing placed appropriately and separately to prevent any mixing of residents clothing. Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 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 The residents do have their needs met and care is personalised by a competent staff team. The Home aims to ensure all residents are in safe hands by full training and induction. The Home does need to ensure it follows the minimum standards when recruiting new staff by having two written references in place for each staff member before they start their new job. The Home encourages and works hard to get staff trained and competent to do their job. EVIDENCE: The Home has recently recruited staff in to positions to ensure that at all times through the day at least two staff are on duty. The posts have now been filled and the new staff members have started their inductions. The majority of the staff have worked at the Home for a long time and are able to support the newly recruited staff in their role. One waking night staff member is on duty with a call system to the Manager who is within a few minutes drive if required urgently. The rota’s seen were accurate after a discussion on the rota’s was held with the Managers. Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 18 The Home at present has twelve staff. With two NVQ trained, two about to complete and one just started the Home is very nearly up to the 50 of staff required to be qualified. With a staff member now showing interest it looks like the figure will be reached next year. The Home also has a comprehensive induction pack that is completed by all new staff. The most recent one was seen with all areas covered signed and dated. A concern was shared with the Managers of taking on a new member of staff without the two written references. One was seen on the personnel file with a date recorded of a verbal one had been received by phone. A Pova check had been completed but the CRB was still outstanding. All new staff must have two written references before they can commence work (Requirement). The Home works hard in ensuring staff are up to date with their training. Records of each training attended is recorded and a system is in place to bring to the attention of the Manager when the date is due for re-training. On talking to a staff member about the support and training she receives it was evident that the Home encourages and offers all staff relevant and frequent training. Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 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, 32, 36 and 38 The Home is managed and run by a competent person who is of good character. The Manager offers a clear balance between working as a team, leading by example and being a leader to benefit the Home. The staff team now have regular supervision and are appropriately trained and supported to ensure good care delivery. The safety and welfare of service users and staff is evident in the records. A concentrated effort is required to ensure paperwork completed for statutory authorities arrives at its destination in the timescale required. EVIDENCE: Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 20 The manager has owned and run the Home for many years and has the recognised management qualification NVQ 5. She is also a qualified/registered nurse and works well with outside health agencies and staff to keep the care teams knowledge up to date on conditions and diseases associated with older people. Three care staff were in the building during the inspection with one other staff member designated to cook. The conversations held with the Manager and staff were heard as appropriate. The teamwork in action was seen, with information sharing in an appropriate manner witnessed. On talking to a staff member they were able to say how involved the Manager was and how the standards of care required were overseen by an active/involved Manager. Minutes of residents meetings were also seen which showed the involvement of the residents with an inclusive and an open positive attitude. The minutes showed how the residents were encouraged to make a decision on how to spend money in the resident’s funds with a building society account being opened to hold the fund just for residents. Staff, now have regular planned supervision sessions with an agenda and dates prior to the event. Records were seen of three staff members supervision with the annual appraisal format showing a more comprehensive form for information about the progress of the past year and plans for the next. Staff were able to talk about the support they receive and how it aids them within the workplace. The manager has an ongoing programme for staff development and training. The completed past twelve months training included first aid, manual handling, adult abuse, food hygiene, safe handling of medicines and strokes. The next twelve months starts with palliative care education, which was posted on the notice board and had already a number of names signed up to it. The Home has procedures in place to ensure that all equipment is serviced appropriately with items seen with current dates such as the servicing of fire extinguishers, records of water temperature checks, fire alarm checks with the rotation of zones, COSHH data sheets and environment risk assessments. The recording of accidents were noted but recently an incident highlighted the failing of recording to the correct authority on accidents that resulted in admission to hospital or a staff member injured at work and the correct timescale of reporting not adhered to. It is recommended that the Manager tracks the official form sent such as RIDDOR to ensure it has been received. (Recommendation) Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 x 11 3 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 x 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 3 x 2 Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No 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 19 Sch 2 Requirement It is a requirement that all staff employed at the Home have two satisfactory written references before commencing their employment. Timescale for action 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP4 OP24 Good Practice Recommendations It is recommended that the visitor’s book is used more proactively as ways of callers to the home gaining information. It is recommended that the Home checks the environment more frequently to bring the décor back up to standard which includes checking the curtain hooks are adequate and the walls are painted where they are looking a little scuffed. It is recommended that due to the delay in official forms arriving in statutory departments the tracking of the forms take place. 3 OP38 Crown Rest Home DS0000027514.V249268.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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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