Inspection on 08/06/05 for Crows Nest

This inspection was carried out on 8th June 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 but made no statutory requirements on the home.

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 05/10/05

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 Anne Urwin Brown Unannounced 8 June 2005 13:30 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 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 Stationary 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 B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 Mr John Ball Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss J Ball CRH 12 Category(ies) of LD Learning disability [12] registration, with number of places Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of registration. Date of last inspection 11.03.05 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. Minimum staffing levels are provided. 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 B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by two inspectors over half a day. It involved discussion with the Owners, one of whom is the Manager, six residents and three staff. Records of four residents and three staff were inspected. Other associated records were seen during the inspection. 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 B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 standard(s) 2, 3, 5 Not all residents’ needs are assessed prior to coming to live in the home. It was not possible to confirm that residents’ specialist needs are met as the assessments were not all completed. Residents do not have a written contract or statement of terms and conditions of residence apart from the local authority contract. EVIDENCE: Four residents records were inspected. Inspection of records confirmed that two residents’ needs had not been assessed. Information from care managers was not available in each resident’s file. Care plans are drawn up and were descriptive and informative but are not always dated. Residents sign care plans to confirm that they are aware of them. The Manager and staff described arrangements for the individual support of residents including the use of specialist services. The Home does not provide intermediate care or respite care. The Manager reported that there are only local authority contracts in place for residents. The Home does not have a separate contract or statement of terms and conditions with each resident. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 standard(s) 6, 7 9 Residents’ needs are not all identified (see Standard 2 and 3) and set out in an individual plan of care. Residents are encouraged to make decisions about their lives and are assisted with this as needed. Residents are supported to take risks as part of an independent lifestyle, however some records showed that not all risks have been appropriately assessed. EVIDENCE: The lack of a full assessment makes it difficult to comment on the accuracy of the care plans. Some evidence was available that residents’ changing needs were reflected in the record. Copies of reviews were not available in some residents’ records. The content of records has improved since the last inspection, although one file did not contain a basic information sheet. Residents’ records showed that they are able to make choices about how they spend their time. Some of the residents take an active part in life in the local community. Residents said they were free to go out and were encouraged to attend local social events. They felt satisfied with the opportunities available to them. Some risk assessments need to be updated to show current risks for individual residents. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 standard(s) 12, 14, 17 Residents are encouraged to continue their education or training. They are able to take part in valued and fulfilling activities. Residents are able to take part in appropriate leisure activities. A healthy diet is offered to residents and they enjoy their meals. EVIDENCE: Evidence was available that residents are encouraged to take up education and training opportunities. Most residents attend day services, educational courses or work experience that are suited to their needs and interests. Residents confirmed their satisfaction with the opportunities available. Staff were able to describe how residents are encouraged to make choices about their day time activities and these included working in a garden centre, voluntary work, college and training unit courses. Evidence was available that residents have had opportunities to go on holiday in Wales and Norfolk during the past year. Staff and records confirmed that residents regularly attend local community events including bowls club, darts and pool matches, Lifeboat functions, swimming, visits to local coffee mornings, pubs. Residents stated that they are satisfied with the opportunities available to take part in activities. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 10 Menus were available for inspection and these showed a varied diet is provided. Arrangements for the storage of food are satisfactory. Residents said that they enjoyed the food and that the quality was good. They also said they could get something different if they did not like what was on the menu. No nutritional assessments are carried out, but the Manager said that Healthy Eating training is organised for staff. After staff complete this training the Manager said that assessments will be carried out. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 standard(s) 19 Residents’ physical and emotional health care needs are met. EVIDENCE: Records showed that arrangements are in place for regular dental, optical and chiropody checks suited to individuals’ needs. The Manager was able to give examples of arrangements in place for monitoring and supporting individuals to access appropriate health care services. The daily log confirmed that individual support is provided. Residents said they were satisfied with the arrangements in place for their medical care. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 standard(s) 22 Residents are satisfied that their views are listened to and acted upon. The procedure for recording complaints needs to be altered to show whether or not a complainant is happy with the outcome of their complaint. EVIDENCE: Policies and Procedures are in place for dealing with complaints. A new recording system has been drawn up since the last inspection. This does not show whether or not a complainant is happy with the outcome of the complaint investigation. No complaints have been made since the last inspection. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 standard(s) 24, 30 Residents’ accommodation is homely, but some residents require more support with cleaning of rooms. Risk assessments for the premises need updating. Systems for identifying regular replacement of furniture, bedding and carpets need to be in place. Most areas of the Home were clean and hygienic. EVIDENCE: The house is furnished and decorated in a homely style. A tour of the building showed that most areas of the Home are comfortably furnished. Some residents’ rooms were very untidy and had not been cleaned recently. Some bedding, pillows and mattresses required replacement. Risk assessments are not in place for windows that have not been fitted with restrictors. The kitchen was clean, but the fat fryer needed cleaning. Arrangements for laundry were satisfactory. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34 Residents are supported by appropriate numbers of staff, most of whom have received training in care. Residents are protected by the new recruitment policy and procedures that have been introduced. EVIDENCE: The Manager reported that all staff apart from one have completed recognised training in care. Two staff are undertaking training at a higher level. The Manager is undertaking training to achieve a qualification in the management of a care service. Residents confirmed that staff are approachable and aware of their needs. The Manager said that there is a consistent staff team in place who have cared for the residents for some time and who are aware of individuals’ needs. Staff demonstrated an appropriate knowledge of individual residents’ needs. There are no staff under the age of eighteen years working at the home. There were sufficient staff on duty at the time of the inspection. The rota showed that two staff are on duty throughout the day. This level of staffing was being maintained. One resident is currently in hospital and it has been possible to reduce the staffing level to two staff, but the Manager said that three staff will provide support when this person returns from hospital. The Manager is available throughout the week during the day and her hours are additional to the staffing on the rota. One person sleep in at night and Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 15 additional support is available if required. This level of staffing is adequate to meet the needs of the residents living at the Home at the time of this inspection. A new recruitment policy and procedure has been drawn up and is now in use the Manager confirmed. Inspection of staff files showed that appropriate checks are now being carried out. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 42 Systems for self-monitoring, review and development of the home need to be introduced. Information collected from this should be used to prepare an annual development plan for the home. Residents’ health, safety and welfare is generally protected, but some areas of staff training and risk assessment need to be reviewed. The fire records show that tests and training for staff are not happening as often as required. EVIDENCE: The Manager described how a brief questionnaire had been given to residents to seek their views about the service last year. A new questionnaire has been drawn up, but these have not been completed yet. There is not a annual development plan in place. Records for testing and servicing of the fire alarm system and fire equipment are maintained. These showed that the fire alarm was not tested weekly and was last tested on 19 May 2005. Five staff have received fire instruction once during this year. The fire alarm system and fire equipment has been service Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 17 within the past year. Accident records are maintained appropriately. Records show that moving and handling training has been provided and staff confirmed this. Some staff need first aid and food hygiene training updated. Staff confirmed that they were aware of written guidance on Health and Safety. The Manager confirmed that since the last inspection an appropriate check on the water storage arrangements has been carried out. Records confirmed this. There are no risk assessments in place about the provision of window restrictors. Some windows are not adequately protected. Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 18 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 2 2 x 3 Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME 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 x 1 x x 2 x B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement The needs of each resident must be assessed to ensure that the Home is able to meet their needs. A review of the current care plans must be undertaken to ensure that all areas of need are addressed with each residents plan. Management systems should be in place to regularly check records to ensure that all information required is in place. A system must be put in place to ensure all risk assessments are regularly reviewed and updated. The complaint records must include information about whether or not the complainant is satisfied with the outcome of the complaint. A system must be put in place to ensure regular replacement of furnishings and bedding. In particular bedding, pillows and mattresses identified during the inspection must replaced without delay. Arrangements for regular cleaning of residents rooms must be reviewed. A system of B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Timescale for action 31.08.05 2. 6 15 30.09.05 3. 4. 9 22 13 22 31.08.05 31.08.05 5. 24 23 31.08.05 6. 30 23 31.08.05 Crows Nest Version 1.30 Page 20 7. 17 17 Sch3 8. 39 24 regular checks by the Manager of individual rooms must be introduced to ensure appropriate standards of cleanliness and hygiene are maintained. The nutritional needs of 31.08.05 residents must be assessed and regularly reviewed. This is outstanding from the previous report. A system for reviewing and 30.09.05 improving the quality of care must introduced. This system must include consultation with residents and their representatives. Reports prepared of reviews carried out must be made available to residents and the Commission for Social Care Inspection. Fire and equipment testing must be carried out at appropriate intervals as advised by the Fire Officer. The provision of window restrictors must be based on thorough risk assessments taking into account the vulnerability of the residents. 9. 42 23 31.07.05 10. 42 23 31.08.05 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. Refer to Standard Good Practice Recommendations Crows Nest B53-B03 S632 Crows Nest V226537 080605 Stage 2.doc Version 1.30 Page 21 Commission for Social Care Inspection 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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