Inspection on 06/03/06 for Crowstone Manor

This inspection was carried out on 6th March 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Crowstone Manor 05/09/07

Crowstone Manor 10/10/06

Crowstone Manor 10/10/05

Crowstone Manor 21/02/05

Crowstone Manor 14/06/04

Crowstone Manor 08/12/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Crowstone Manor 38 Crowstone Road Westcliff On Sea Essex SS0 8BA Lead Inspector Mrs Nikki Gibson Unannounced Inspection 6th March 2006 11:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Crowstone Manor DS0000015429.V282236.R01.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crowstone Manor Address 38 Crowstone Road Westcliff On Sea Essex SS0 8BA 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) 01702 333594 01702 333594 manager@crowstonemanor.fsnet.co.uk www.crowstonemanor.fsnet.co.uk Mrs Angela Murray Sally Faulkner Care Home 13 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (13) of places Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Accommodation and personal care to be provided to no more than 13 older people over the age of 65 years (OP). Accommodation and personal care to be provided for up to 3 service users with dementia over the age of 65 years (DE). Total maximum number of service users to whom accommodation and personal care is to be provided shall not exceed 13. 10 October 2005 Date of last inspection Brief Description of the Service: Crowstone Manor is registered to provide accommodation and personal care for up to thirteen older people over the age of sixty-five, of whom up to three may have a diagnosis of dementia. The home has a separate lounge and dining room and bedrooms are situated on the ground and first floor. A passenger lift gives access to both levels. The home is well maintained throughout. Crowstone Manor is an attractive and spacious property, built in 1912 as a family home in a pleasant residential area. Many of the original features are still in place, such as an oak panelled hall and dining room with parquet flooring. There are nine single rooms of which two have en-suites and two shared rooms both with en-suite facilities. Crowstone Manor is close to local shops, public transport and local amenities. There is a garden and small area to the front of the building for parking and an attractive and secure garden at the rear with seating and tables for the use of the residents. Residents and staff who smoke are required to do so in the garden. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place over six hours. The inspection focussed on the statutory requirements not met at the last inspection. During the inspection there was a tour of the premises and a random selection of records and documents were studied. Time was spent in the lounge observing care practice and with residents in their own rooms. Four residents were spoken with about life at Crowstone Manor. The inspection process also included discussions with the manager and members of staff. The home takes an active interest in the inspection process, unfortunately they see it as a negative experience, and become defensive which could prevent them from fully benefiting from the feedback and advice offered. What the service does well: What has improved since the last inspection? What they could do better: The home needs to look at positive and sensitive ways of increasing the involvement of residents, and their families as appropriate, in decisions about their care and the running of the home. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 6 The range of pastimes available and staff social interaction with residents needs to be developed further. This will include a further review of staffing levels and deployment. The home must provide for the CSCI evidence that electrical shortfalls have been addressed to ensure safety in the home. 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. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 146 Information about the home is comprehensive and enables prospective residents to make informed choices. EVIDENCE: The home has a comprehensive Statement of Purpose and Service User Guide which are periodically updated. The information would enable a prospective resident and their family to make an informed choice. In general Crowstone Manor caters for the more able and mobile resident, however the home is registered to cater for three residents with dementia and staff have received appropriate training. Crowstone Manor does not provide intermediate care. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 9 10 Development of the care plans is slow and there is no evidence that residents have been involved. The home was again advised to follow the Royal Pharmaceutical Society of Great Britain guidelines on the administration of medication. EVIDENCE: A number of care plans were studied and discussed with the manager. There was no evidence that the residents or their representative had been consulted or had assisted in drawing up the care plans or agreed the care to be delivered. This has been discussed with the manager at previous inspections and advice given that residents need to be supported and enabled to express their views and make decisions with regard to their care. The care plans did not set out in detail the actions which need to be taken by care staff to ensure that all aspects of the resident’s health, personal and social care needs are understood and met. Some care plans had limited instructions e.g. ‘assist with all personal care needs’. Care plans need to be more personal and specific to the very different needs of each resident. The home had misconstrued information given at the last inspection with regard to the recording when medication is carried forward on the Medication Administration Records and this was discussed with the manager. The home’s Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 10 procedure for recording medication should be in line with the Royal Pharmaceutical Society of Great Britain guidelines for ‘The Administration and Control of Medicines in Care Homes and Children’s Services’. Further copies can be obtained by contacting 0207 572 2409 or e-mailing: ifearon@rpsgb.org.uk. It was noted positively that the home has introduced PRN Protocols to ensure that medication which is prescribed ‘as and when required’ is taken appropriately. All personal care takes place in private and toilets and bathrooms have appropriate locks. From comments by residents and from observation it was evidenced that staff respect the privacy of the residents. However, some terminology used in the home was not appropriate. Comments such as residents “kicking off” or “she is attention seeking” could imply a possible lack of respect and understanding. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 14 The range of social activities is developing and this needs to continue so that it becomes an integral part of the day. Residents’ choice and autonomy is an area of care which the home needs to review. EVIDENCE: Care plans lacked detail of the resident’s social needs and how staff plan to support them. The manager said that when available an additional member of staff is rostered to provide activities between Monday and Friday. A member of staff spoken to said that she sits with the residents when she has finished her other jobs. Some time during the inspection one member of staff sat in the staffroom sewing while another worked in the kitchen. The home is again reminded that providing stimulation and meaningful pastimes is an integral part of good care of the elderly and is not an optional addition conducted by one member of staff. The home has introduced an activity list to help staff with ideas of what may be offered. The home has discussed at length their views on resident’s autonomy and choice. They have expressed the view that residents have come into the home to be cared for and that they do not want to be bothered with making choices. While they feel that residents views are sought there was little to back this up. Residents/relative meetings do not take place. The home needs to consider good practice and developing ways of working more closely in partnership with residents, families, the CSCI and other agencies. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 12 Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home has policies and training on the Adult Abuse which will protect residents. EVIDENCE: The home has comprehensive policies on the protection of vulnerable adults, which is backed up by Southend on Sea Adult Protection policy which was also freely available. All staff have attended training and those spoken to were aware of the action to be taken if there was an allegation of abuse. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 24 26 Crowstone Manor provides a pleasant and homely environment in which to live. EVIDENCE: The premises are clean, bright and welcoming, with many attractive features. Bedrooms are personalised and comfortable. A resident said that she had been consulted before her room had been redecorated and she had chosen the colour. Standards of hygiene in the home are good and protect residents from the risk of the spread of infection. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 The staff are caring yet due to deployment spend limited time with the residents. Staff are well trained and further training is encouraged and supported. EVIDENCE: Residents spoke warmly of the staff and named staff they felt were most supportive to them. Since the last inspection the staff rota has been amended but to fully meet National Minimum Standards the rota needs further clarification. It needs to identify which member of staff is undertaking the main catering duties over which period of time. The manager confirmed that she worked on the rota providing care for thirty hours per week. In addition she had 10 hours per week supernumerary time to undertake management duties some of which are undertaken out of the home. The manager said that the present staffing levels are: 1 senior and 2 care staff 8 am to 2 pm 1 senior and 1 care staff 2 pm to 8 pm Care staff undertake all catering duties Domestic staff work 9-12 Monday to Saturday. There is an additional member of staff assigned to undertake activities Monday to Friday in the mornings. At the last inspection the home was asked to review staffing levels in the afternoons as concern was raised that there were insufficient care staff Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 16 interacting with the residents particularly as the home does not have any catering staff. Staffing levels and deployment has not changed since the last inspection and it was noted during the inspection that staff were rather task focussed. A member of staff said she would sit with the residents if she had finished her other jobs. The home is committed to training and most staff have undertaken NVQ training in care at levels 2 or 3 as well as other appropriate courses related to the care of the elderly. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 38 There is a strong management team committed to providing a high standard of care. EVIDENCE: Three staff spoken to said they enjoyed their work and felt that a good standard of care was provided. A member of staff praised the management of the home. She said the proprietor was a frequent visitor and the manager made her expectations of the staff clear. The home is continuing to look at effective ways of seeking the views of residents and their representatives as a means of measuring their success in meeting the aims, objectives and Statement of Purpose of the home. They hope to produce and use a questionnaire shortly. The manager said that she talks to residents on an individual basis but nothing is recorded. This continues to an area which the home finds difficult to address. The proprietor Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 18 is reviewing the manner in which her monthly report is conducted and recorded so as to meet the regulation requirements. Working practices in the home generally provide a safe environment. The manager said that annual Portable Appliance Testing is undertaken by the Proprietor who is appropriately trained. Staff have appropriate training in moving and handling, fire safety, food hygiene, First aid and infection control to provide a safe environment for residents and staff. COSHH items are stored securely and clinical waste is appropriately disposed of. The premises are secure and the home has a gas safety certificate. An Electrical Periodic Inspection Report was provided for inspection dated 15 December 2005 which detailed some urgent remedial work was required and the overall assessment of the installation was graded as ’unsatisfactory’. Work needs to be undertaken so that a satisfactory certificate can be provided. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 2 X X X X 2 Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 20 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 OP7 Regulation 15 Requirement The Registered Person must (unless it is impracticable) consult with the resident or their representative as to how their needs will be met and prepare a written care plan. They must also be involved in the reviews. (Previous timescale of 10.11.05 not met) The Registered Person must ensure that the home is conducted in a manner that respects the dignity of residents. This refers to the terminology sometimes used. The Registered Person must consult with residents about their interests and provide a programme of activities and provide facilities for recreation. This element of care requires further development. (Previous timescale of 10.11.05 not met) The Registered Person must as far as practicable enable residents to make decisions with respect to the care they receive and their health and welfare. DS0000015429.V282236.R01.S.doc Timescale for action 03/05/06 2 OP10 12(4) 03/05/06 3. OP12 16(2) 03/05/06 4. OP14 12(2) 03/05/06 Crowstone Manor Version 5.1 Page 21 5. OP27 18 6. OP33 24(3) (Previous timescale of 10.11.05 not met) The Registered Person must ensure that at all times there are suitably qualified, competent, and experienced persons working at the Home in such numbers as are appropriate for the health and welfare of the residents. This refers to continuing to review levels and deployment of staff to ensure residents needs are met. The Registered Person must maintain a quality assurance system for reviewing and improving the quality of care provided which includes consultation with residents and their representatives. (Previous timescale of 10.11.05 not met) The Registered Person must ensure that all parts of the home are free from hazards. This refers to the level of electrical safety in the home. A copy of a electrical safety certificate is required to be sent to the CSCI. 03/05/06 03/05/06 7 OP38 13(4) 03/05/06 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. Refer to Standard OP9 OP15 Good Practice Recommendations The Royal Pharmaceutical Society of Great Britain Guidelines should be followed. It is recommended that choices and options regarding meals are made clearer to residents. DS0000015429.V282236.R01.S.doc Version 5.1 Page 22 Crowstone Manor 3. OP35 It is recommended that residents’ money is stored in a manner which allows for individual accounts to be audited separately. Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Crowstone Manor DS0000015429.V282236.R01.S.doc Version 5.1 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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