Inspection on 11/05/06 for Crows Nest

This inspection was carried out on 11th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Crows Nest 22/04/09

Crows Nest 20/05/08

Crows Nest 02/05/07

Crows Nest 05/10/05

Crows Nest 08/06/05

Crows Nest 11/03/05

Crows Nest 11/06/04

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

CARE HOME ADULTS 18-65 Crows Nest Prospect Place Newbiggin By The Sea Northumberland NE64 6DN Lead Inspector Bill Middlemist & Carole McKay Key Unannounced Inspection 11th May 2006 1:30 Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 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 Crows Nest DS0000000632.V289263.R02.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 Adults 18-65. 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. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crows Nest Address Prospect Place Newbiggin By The Sea Northumberland NE64 6DN 01670-817696 01670 817696 jyball@btinternet.com 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 John Ball Miss J Ball Miss J Ball Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11 October 2005 Brief Description of the Service: Originally the family home of the owners, Crows Nest is an end terrace stone built property overlooking the golf course and sea front. The home is in a residential area, with a private walled yard, and a garden to the rear. The owners no longer live in the house, though they, and some of their relatives, make up the staff team. Family pets also live at the home, therefore there is a strong family theme. The residents rooms are on the ground and first floor, with sitting, dining and kitchen areas on the ground floor. Half of the places are in shared rooms and most of the bedrooms are on the first floor. The home has not been adapted for people with mobility problems. The service is suited to people who do not have high care needs or mobility problems and can cope with living in a large group. Most of the residents go to day services in nearby towns and use local leisure and social amenities in the evenings and at weekends. Transport links to local towns are available by bus from the end of the road. The basic fee for this home is £370.45 a week. Any prospective service users can contact the home for its’ Statement of Purpose, Service user Guide and previous inspection reports. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that was carried out by two inspectors. The site visit lasted for four and a half hours. Each person who lives at this home made contributions to the inspection and said what it was like to live at The Crow’s Nest. Each person also took time to fill in the “Have your say about…” questionnaire. Three members of staff were involved in the inspection and were helpful in providing information. The inspection focused on outcomes in people’s choices, rights, inclusion and independence, and covered care planning, risk assessment, activities, meals, complaints, protection, the environment, quality assurance, and health and safety. Each inspector gained evidence for the outcomes by talking with people and staff, examining a range of documents, observing the relationships between people and staff, and making a tour of parts of the building. It was not possible to assess the key standards that deal with staffing as records were not accessible. What the service does well: What has improved since the last inspection? Several improvements have taken place in key areas since the previous inspection, and there was a positive atmosphere in the home. Care planning is more focused on what is important to people, and risk assessments are being reviewed regularly. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 6 Repairs have been made to parts of the building and there is a programme of redecoration. Staff training is on going and there is further training planned for the future. There has been a real improvement in promoting the health and safety for people who live here. 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. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Crow’s Nest has a statement of purpose and service user guide. Each person has had their needs assessed. EVIDENCE: The statement of purpose states the kind of service the home sets out to provide. All the people spoken with were unsure about the written information the home has published for them, including the service user guide. Staff have not recently been through the service user guide with the people living here, to remind and promote the rights of each person and how the service will support them. Each person has an assessment of their needs that has been carried out in partnership with suitably qualified professionals. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are apparent in all these areas, and further work will raise standards further. EVIDENCE: Care planning has improved and there is a greater focus on choices, rights and inclusion. Each person’s skills are being maintained through the way staff are working in line with the care plans. Each person is aware of their care plans and they are involved in creating them. There is not enough emphasis on how staff will promote independence, in line with the home’s statement of purpose. Risk assessments and risk management plans are supporting people’s personal support needs, and are promoting rights, choice and inclusion, to a certain extent. These have not been expanded to promote greater independence. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 10 One person said, “ I make my own decisions and if I am not sure I will talk to the staff”. Another said, “I usually make decisions about what I do each day”. One person said that they are keen to have a greater say in the running of the home, and this could be developed in line with promoting independence. Each person has a copy the house rules. These are not used as fully as they could be to offer people individual responsibilities. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16, 17 Quality in this outcome area is good: This judgement has been made using available evidence including a visit to this service. Each person is part of the local community, they have a good range of activities that suit them. Each person enjoys appropriate relationships and further work could develop this. EVIDENCE: Each person spoke about their activities and how these are suitable. Good use is made of the local and wider community. Several people were preparing to go on holiday to Spain and described the support they had in choosing holiday clothes. Each person provided verbal evidence on how they are supported to be part of the local community. Collectively, the people living at The Crow’s Nest have a strong group identity. They support, consider and accept each other, to the point of tolerating some behaviours that are used to communicate needs and preferences. It would be Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 12 good practice to address those behaviours, perhaps in group work, that are routinely tolerated, in order to assist developing individual communication skills within the home. Daily records support the view that some behaviours are routinely tolerated. Everyone is involved in planning menus each week. The menus are repetitive and plain. These could be developed and staff could encourage a wider choice. One member of staff described how some changes to the menu did not suit some people, but acknowledged that menus could be more imaginative. Staff will prepare alternative meals on request. Advice was given on fortifying meals and drinks in response to discussing special diet requirements. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person is gets the personal support they need and have good access to healthcare services. EVIDENCE: Personal support needs are well documented and give clear instructions to staff on how to support people in tasks such as shaving, showering and other aspects of personal grooming. This area could be developed as there did not appear to be much of an emphasis on femininity within the females of the group, for instance, in hairstyle, make up or dress. Each person continues to have access to a full range of healthcare services and the home continues to support people well in this area. One member of staff has been trained to provide footcare. Medication is properly recorded and those medicine records inspected provided a clear and accountable audit trail. Some medications were not stored correctly Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 14 and advice was offered on the storage of internal and external medicines, and on recording consent to medication. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People said that their views are listened to but they did not have a copy of the complaints procedure. Staff need a greater understanding of protecting vulnerable adults. EVIDENCE: Each person said that they are listened to, but did not have a copy of the complaints procedure. Most people said it is easy to voice their opinions on what they like and dislike. Staff are aware of the Protection of Vulnerable Adults issues but were not familiar with local procedures or background law. Training will be provided in this subject when it is available. There was a basic understanding of challenging behaviours, but the staff knowledge base needs to be developed to view challenging behaviours as a means of communication. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are constant efforts being made to improve the environment. EVIDENCE: A number of key improvements to this home are noted. There is a programme of redecoration and improvements to bedrooms and bathrooms. Some rooms are being redecorated while people are on holiday. One person was unsure if they had chosen how their room was going to be decorated. Real efforts have been made to improve hygiene in one of the bedrooms. The kitchen and bathrooms were clean to a good standard, and there has been a recent promotion of hygiene procedures based on good hygiene practice. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards will be assessed at the home’s next key inspection as staffing records could be accessed. EVIDENCE: Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each person is benefiting from the home’s quality assurance systems. Good efforts are being made to promote health, safety and welfare. EVIDENCE: Good efforts are being made to improve the service provided and there is capacity for continual improvement. All previous requirements regarding health and safety have been implemented. Documents detailing water temperatures, water supply, food temperatures, and fire safety are all up to date. Electrical equipment has not been PAT tested: this must be carried to protect the people living here. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 19 Quality Assurance systems are being used to gain the views of people living here, resulting in outcomes such as staff training to improve communication. Crows Nest DS0000000632.V289263.R02.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 Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 X X 2 X Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 21 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 YA42 Regulation 13 (4) Requirement All electrical equipment must be PAT tested. Timescale for action 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 Refer to Standard YA1 YA6 YA7 YA17 YA22 YA23 YA23 Good Practice Recommendations Remind service users of the service user’s guide. Expand care planning and risk assessments to focus on promoting independence and diversity. Review how people are involved in the running of the home. Review menus and promote greater choice and variety. Ensure that each person has a copy of the complaints procedure. Take up Safeguarding Adults training when it is available. Develop staff understanding of challenging behaviours. Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Crows Nest DS0000000632.V289263.R02.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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