Inspection on 20/05/08 for Crows Nest

This inspection was carried out on 20th May 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 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 02/05/07

Crows Nest 11/05/06

Crows Nest 05/10/05

Crows Nest 08/06/05

Crows Nest 11/03/05

Crows Nest 11/06/04

Similar services:

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Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Crows Nest Prospect Place Newbiggin By The Sea Northumberland NE64 6DN Lead Inspector Allan Helmrich Key Unannounced Inspection 20th May 2008 10:15 Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 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.V364760.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 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.V364760.R01.S.doc Version 5.2 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.V364760.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning disability - Code LD, maximum number of places: 12 The maximum number of service users who can be accommodated is: 12 2nd May 2007 Date of last inspection Brief Description of the Service: The Crows Nest is a stone built, end terrace house, set in a residential area of Newbiggin by the Sea. It overlooks the golf course and sea front. The owners work as part of the staff team. There is a mix of single and double bedrooms at ground and first floor levels. People who live in the home can make use of the shared space that includes a sitting room, dining- room and kitchen on the ground floor. At the front of the house there is a conservatory that looks over the large, walled garden. The home is not 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 people who live in the home go to day services in nearby towns and use local leisure and social amenities in the evenings and at weekends. There is a bus service that runs from the end of the road. The fee is £370.00 a week. Information about the home can be found in the home’s statement of purpose and service user guide. Copies of the Commission for Social Care Inspection (CSCI) inspection reports are available in the home. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. An unannounced visit was made on the 20 May 2007, and lasted for 5 ½ hours. Both proprietors were present for most of the inspection. Before the visit we looked at: Information we have received since the last visit on 2 May 2007; How the service dealt with any complaints and concerns since the last visit; Any changes to how the home is run; The provider’s view of how well they care for people; The views of people who use the service, their relatives, staff and other professionals who visit the service. Questionnaires were distributed by the home and were returned by; 7 residents, 3 relatives and a professional visitor. During the visit we: Talked with five people who use the service, one staff, and both proprietors. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building/parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. What the service does well: The system of introducing new residents into the home involves existing residents as well as appropriate professional people to ensures a homely friendly environment is maintained. Each resident is consulted regularly to ensure they are supported to live the life they choose. They are encouraged to go out and about on their own and to be independent in daily activities such as laundry and shopping. Everyone who lives in the home is given the chance to look after their own medication and finances if they wish. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 6 Staff promote privacy and make sure that they ask permission to enter someone’s bedroom. Residents are listened to and any concerns are taken seriously. The staff team are well trained to ensure appropriate standards of care and support are provided. Relatives commented the staff team have been very supportive of residents and their families through recent family illnesses and bereavement. Residents commented in questionnaires; I do the things I want to only. The staff are canny. I like living here everyone is friendly. I do everything I want to do. I like the staff. I like to talk to them, we get on well and have a laugh. 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. The summary of this inspection report can be made available in other formats on request. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 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.V364760.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience good quality outcomes in this area. Prospective users of the service are given good information about the home and have their needs assessed to limit the possibility of moving into a home that cannot meet their needs. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Admissions to the home are rare. However someone who was admitted within the last two years stated they had settled in well and enjoy living in the home. This person’s case record showed that sufficient information was collected; including professional assessments, to ensure the placement was appropriate. After this a plan of support was developed with the service user to promote independence and instruct staff in the amount of support needed. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience good quality outcomes in this area. People are involved in planning their care, making choices and decisions about what they want to do, and are helped to be independent in their personal care and daily life. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Three case records were reviewed and these demonstrated that each person in the home lives a lifestyle of their choice. To support these lifestyles each member of the household signs up to ‘the house rules’. Regular meetings are held between the service user and their key worker and details of decisions made in these meetings are recorded and signed by both parties. In each of the files there was a recent care management review and when necessary, a record of ‘follow up’ conversations between the manager and service user to ensure there is full awareness of the substance of the review. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 10 The files identified three different lifestyles with their support requirements and levels of independence described. Residents spoken to enjoy living in the home and were seen during the day being involved in the maintenance of the house. One resident was painting the house gates on the morning of the inspection and others were seen helping a proprietor assemble drawers and cabinets recently purchased to provide additional storage in some bedrooms. Should a risk be identified, details of that risk are recorded with any actions appropriate to ensure levels of harm are measured against any loss of independence. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. Management and staff in the home encourage lifestyle choices and personal development. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Four people spoken to during the inspection all stated they choose what to do and where to go. Everyone who lives and works in the home has strong links with the local community and enjoys getting out and about. One person spoke about going to college where they do maths, English, IT, cookery and sports. Another resident chooses not to go out alone but does enjoy the theatre and shopping. One resident was very proud of his links with the community lifeboat and new centre currently in development in the town. People use the local shops independently, the public library, go to local pubs, Women’s Institute, Church and Lifeboat events. They take part in the Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 12 Newbiggin in Bloom group and use the sport and leisure facilities at the Heritage Centre. One resident who helps several people in the village regularly uses a bike to get around. The manager spoke knowledgeably about each resident and how staff support each person as an individual to ensure personal goals and choices are encouraged. The manager is working with one resident whose care manager feels, due to reduced mobility, may need to move to different accommodation in the future. The manager has enabled this person to speak up for them self and determine their own future. People are helped to keep in touch with their family. Relationships with staff were seen to be warm and friendly. Everyone sits down at the weekend to choose the meals for the week ahead. Store cupboards and freezers were well stocked. People who live in the home are able to help with food preparation if they wish. Everyone who commented said they enjoy the meals provided. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience adequate quality outcomes in this area. People living in the home are mainly independent with personal care routines and see health care professionals as their needs dictate. The medication records do not clearly identify a safe system for supporting people in the home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Most people are independent with personal care. Where help is needed routines are detailed to ensure independence is encouraged. People living in the home can see a range of healthcare professionals as and when they need. Records showed that people had been to the dentist, optician, GP and had attended specialist clinics to monitor conditions such as asthma. The manager and a member of staff talked to the inspector about the routine for ordering, receiving and recording medication into the home. Medication Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 14 audits are not done and record sheets showed prescribed and non-prescribed medicines recorded together. There was no record of the persons GP being contacted to ensure homely medicines given were appropriate. Staff dispensing medicines are trained and a risk assessment is done for anyone wanting to self medicate to ensure this is appropriate. All medication is kept safely. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. The views of people who live in the home are listened to. They are protected from harm through policies, procedures and staff training. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The files for three people who live in the home were seen and each contained a copy of the complaints procedure. Each month the key worker meets with the resident and any areas of dissatisfaction are recorded and addressed. Notes of house meetings showed that people were not afraid to talk about things they were unhappy about, or would like to see changed in the home. No complaints had been received by the home or CSCI. Staff training in adult protection is up to date. The manager has recently reviewed the procedures dealing with the recognition of abuse. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience good quality outcomes in this area. The home is clean and tidy and currently meets the needs of all users of the service. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home was clean and reasonably well maintained. Other than the dining room that was being used by staff and residents to build bedroom cabinets, the home was tidy. Residents’ bedrooms seen were personalised. Everyone spoken to stated they like living in this home. Small improvements are being made to the home and more are planned. There is some dampness to a wall that is being attended to. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 17 The kitchen is a good size and some residents use it to prepare snacks and assist staff with meals. Some residents also use the laundry that contained appropriate washing machines and other equipment. The home has systems to ensure that a reasonable standard of hygiene is maintained. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People who use the service experience adequate quality outcomes in this area. People living in the home are protected and supported by a well-trained staff team. However some systems are not in place to ensure new recruits can achieve the same standards. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The same staff team have worked together for over three years. Staff records are in place containing appropriate employment information. But an audit system is not used to ensure any future recruitment follows best practice guidance. Each member of staff has achieved at least a National Vocational Qualification (NVQ) level 2 and a training plan is in place to residents needs are met. Recent staff training has included; person centred planning to ensure care is individualised, palliative care and bereavement and food hygiene. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 19 An induction package that meets the standards of Skills for Care is not in place should the home employ anyone in the future without a care background. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use the service experience adequate quality outcomes in this area. The home is well run which benefits the people who live there. They are consulted about what goes on in the home. Both people living in the home and staff are protected through health and safety procedures, systems and training. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home manager is experienced in the care a people with a learning disability and demonstrated throughout the day knowledge and commitment to the provision of appropriate care. The home is managed and run in a way that involves and suits the people who live there. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 21 Residents clearly make choices about what they want to do and where they want to go. Most are able to do this independently. People talked freely about things that they had done, enjoyed doing and always took part in. The home’s registration certificates were displayed. Gas servicing certificates are in place and portable appliance testing (PAT) has been updated. Accident and fire records were up to date. A certificate to show the home’s internal wiring is satisfactory was not available. Everyone who spoke to the inspector was confident that their views were taken into account and they were listened to. House meeting and staff meetings are held regularly and any issues identified were appropriately addressed. Although no formal system to monitor quality of care provided is in place, residents and their families are active in the home and are regularly consulted about the care provided. All of the questionnaires returned by residents, visitors and professional people contained positive comments. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 22 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 x 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 3 23 3 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 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 23 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 YA20 Regulation 13(2) Requirement The manager must review the medication process to ensure that an audit is done monthly and that homely remedies are authorised by a GP and recorded separately to prescribed medicines. The manager must ensure the home’s internal wiring is checked by an approved person and an IEE 15th Edition certificate of quality is available on the premises for inspection. Timescale for action 30/06/08 2. YA42 23 30/06/08 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 YA32 YA34 Good Practice Recommendations Ensure a skills induction package is available in the home should anyone without a care background be employed. Produce an audit sheet for future recruitment to record that thorough recruitment procedures are followed. Crows Nest DS0000000632.V364760.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V364760.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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