Inspection on 05/10/05 for Crows Nest

This inspection was carried out on 5th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 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 11/05/06

Crows Nest 08/06/05

Crows Nest 11/03/05

Crows Nest 11/06/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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 Unannounced Inspection 10:00 5th & 11 October 2005 th Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 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.V249421.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 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.V249421.R01.S.doc Version 5.0 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.V249421.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 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. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was being made as a result of the number and type of requirements made at the previous two inspections. This was the Crow’s Nest’s third unannounced inspection since April 2005, and took place over 2 days. Care plans for four residents were inspected and several residents took an active part in the inspection. Parts of the building were inspected, including people’s bedrooms with their permission. Matters concerning the general running of the home, including staff recruitment, and health and safety were inspected and discussed with the Manager. 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 contacting your local CSCI office. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 6 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.V249421.R01.S.doc Version 5.0 Page 7 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): 2 People have their individual needs assessed. EVIDENCE: Each person’s file included a Social Worker or Care Management assessment. The Manager explained that getting Care Managers involved again once people had been initially assessed was difficult. Reassessment would ensure people are having their needs met at this home, and could be carried out by the Manager. The difficulty in accessing Social Work and Care Management support will be brought up with the placing Local Authorities. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 8 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): 9 Systems to review people taking risks as part of an independent lifestyle need to be run better, to ensure that there are no unnecessary restrictions on people’s choices and activities. EVIDENCE: People were able to outline what kind of things that they enjoyed doing. Risk assessments have been carried for various activities, these should be reviewed every six months, in line with the home’s own instructions; the last reviews in three of the files inspected were dated February 2005. The home has a missing person’s procedure but no photographs of individual people to support it. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 9 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, 14, There is an appropriate range of activities for people to take part in. People are supported to have appropriate personal and family relationships. EVIDENCE: Each person was able to describe the kind of opportunities they have to take part in activities that they enjoyed; these were recorded in care plans and new members of staff were aware of people’s preferences. People have been able to take up jobs in supported employment, as well as take part in educational courses. People have access to leisure activities both inside and outside of the home. Each person is able to go on holiday to a place of their choosing. There are also opportunities to go out in a group or on a one to one basis with staff. Staff support people to keep in touch with the others, such as relatives and friends, who are important to them. People have opportunities to mix with Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 10 people who do not have disabilities, through the use of what the local community has to offer. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 11 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): 19 People’s physical health needs are being met. EVIDENCE: Each person’s file provided evidence that the right kind of healthcare services are being accessed at the time that people need them. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 12 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): 23 Systems are in place to protect people from abuse. EVIDENCE: The home has Protection Of Vulnerable Adults policy and procedure; this procedure should be amended to take account of the Local Authority procedure. There should also be a statement that any person making a disclosure must be offered immediate protection from potential harm or abuse. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 13 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, 27, 30 Some bedrooms were not homely. Improvement could be made to the main bathroom. Parts of the home were not clean and hygienic. EVIDENCE: Of the three bedrooms inspected, two were not satisfactory; one had a slight odour and no light bulb in the ceiling light fitting. Another bedroom had a significant odour. The quality of some of the bedding was not satisfactory, several beds did not have valance sheets, and some of the bedding looked faded. There are plans to replace beds. There were a few window frames that were dusty. Grouting in the main bathroom on the first floor looked dirty and should be replaced. A carpet cleaner was being stored in one of the ground floor toilets – this should be removed. In the kitchen there was an old and dirty deep fat fryer that should either be thoroughly cleaned or thrown out. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 14 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): 34, 35 People are not properly protected by the home’s recruitment procedures. EVIDENCE: Two new members of staff were on duty during this inspection; both had received basic induction that included First Aid, The protection of Vulnerable Adults and Fire Safety. It was not clear whether this training was the equivalent of the TOPSS Induction Foundation course: evidence should be provided that this training is in line with the expected standards. The Manager also stated that the home would only take on staff that were already known to her or her family: this does not reduce the need for following proper recruitment procedures. Recruitment records were not satisfactory: each recent recruit had only one reference, there was no record of the interview and the manager revealed that interviews had been carried out by her alone. Two written references must be obtained before confirming staff appointments, and interviews should be recorded and carried out by at least two members of staff: photographs of members of staff must be included in files. It would also be good practice to actively involve people in interviewing staff who are going to support them. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 15 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): 38, 42 The management of this home needs to improve to protect people’s welfare. Some matters regarding Health and Safety do not promote people’s health, safety and welfare. EVIDENCE: There was some hostility displayed by the manager at the beginning of this inspection, who questioned why this was the third inspection since the beginning of April. This inspection was being made as a result of the number and type of requirements made at the previous two inspections, several of which refer to the health, safety and protection of the people who live here. The Manager felt that the Commission was asking too much of the home. There will be further unannounced inspections until the Commission is satisfied that the Health and safety outcomes for the people living here have improved. There was food in the freezer that was not labelled or dated. Some cooked meats and other food in the fridge was not covered properly. There was some out of date food found in the store cupboard – this was removed during this inspection. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 16 The Fire Log was inspected: there has not been a fire drill since 25/2/05 – fire drills must be carried out at least every 6 months, in line with the local Fire Authority requirements. Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 2 X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 1 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crows Nest Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X 2 X X X 1 X DS0000000632.V249421.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 2 3 4 5 Standard YA6 YA9 YA30 YA30 YA34 Regulation 17 – schedule 3 13 – (4) (b) 16 – (2) (k) 16 – (2) (j) 19 – schedule 2 13 – (40) (a) 13 – (4) (c) 23 – (4) (e) Requirement Photographs of service users must be kept in their files Risk assessments must be reviewed at the agreed times Steps must be taken to get rid of odours in the home All parts of the home must be kept clean – outstanding requirement Two written references must be sought for new staff and staff files must include the member of staff’s photograph. The carpet cleaner must not be stored in a toilet Food must be labelled and dated, and food must be thrown out when it is out of date Fire drills must be carried out in line with Fire Authority regulations – this is the third requirement regarding fire safety. Timescale for action 11/11/05 11/11/05 11/10/05 11/10/05 30/11/05 6 7 8 YA42 YA42 YA42 11/10/05 11/10/05 11/10/05 Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 19 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 YA23 YA26 YA27 YA34 YA34 YA34 YA35 Good Practice Recommendations Amend Adult Protection inline with the Local Authority procedures Continue the programme of replacing beds and bedding Grouting in the main bathroom should be replaced Keep a record of interviews of new staff Two people should carry out staff interviews Involve service users in staff interviews Provide evidence that induction training is line with TOPSS induction standards Crows Nest DS0000000632.V249421.R01.S.doc Version 5.0 Page 20 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. 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