Inspection on 19/09/05 for Crowtree House

This inspection was carried out on 19th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Crowtree House 09/02/09

Crowtree House 11/01/07

Crowtree House 25/04/05

Crowtree House 04/11/04

Crowtree House 17/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Crowtree House 39 Crowtree Lane Louth Lincs LN11 9LL Lead Inspector Ken Hague Unannounced 19 September 2005 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 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. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Crowtree House Address 39 Crowtree Lane Louth Lincs LN11 9LL 01522 552222 01522 552323 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) Lincolnshire County Council - Social Services Directorate Kathleen Goodacre PC Care Home Only 25 Category(ies) of DE(E) - Dementia over 65 years - 5 registration, with number PD - Physical Disability - 2 of places OP - old Age - 18 Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service Users within the category of PD are aged between 55 and 64 years inclusive. Date of last inspection 25 April 2005 Brief Description of the Service: Crowtree house is owned by Lincolnshire County Council and is situated in the small market town of Louth. There is public transport which enables visitors and relatives to visit the care home. The home itself is situated in a residential area close to Hubbards Hills a local beauty spot. Crowtree House is a resource unit, which provides intermediate care, short stay and day care services for male and female service users. The home no longer accepts service users for long-term placements, but continues to offer accommodation for some service users who were placed prior to this change in policy. The home is registered for 25 service users, this includes five service users over 65 with dementia, 18 service users who form the category of old age and 2 service users who are older people with a physical disability.The home is set with its own grounds: there is a car parking at the front and side of property, in addition to on road parking. The home is managed by an experienced manager. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 8am and 12.30pm. The main method of inspection used is called case tracking which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the premises was conducted and care records were inspected. One member of staff, four service users and one relative was interviewed. The care home supplied a pre-inspection report and 18 service users comments cards. As part of the inspection 10 exit questionnaires were obtained from the home. What the service does well: What has improved since the last inspection? What they could do better: The intermediate care plans have been improved since the last inspection and now meet the National Minimum Standards. There is still, however room for improvement to ensure that care plans reflect the total needs of all residents. The care plans should include social and personal care needs some of which will not necessarily relate to the reason for intermediate/rehabilitation care. The individual files or residents taking intermediate care would be improved if the filing system used for long-term service users was adopted. Long-term care plans exceed the National Minimum Standards. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 6 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. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 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 standard(s) 1,3&6 There are satisfactory procedures for the introduction and assessment of people to the service, ensuring that care needs are met. Residents and relatives are happy with the care provided and feel that their needs are being met. The home admits residents for intermediate care and successfully enables them to return to the community in a planned manner. EVIDENCE: The home has a statement of purpose which sets out the resources of the care home and are shown to all new residents prior to them being been admitted. This allows new residents to make an informed choice. All files inspected as part of the case tracking process contained detailed initial assessments carried out before the resident was admitted. This information was used to formulate the initial care plan and risk assessments. The home has admitted 284 new residents in the last year for intermediate care. The care records show that 269 have returned to their own home in the community in the last year. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 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 standard(s) 7,8&9 All service users have a detailed care plan which includes a full risk assessment and the management strategy for any identified risk. Residents are involved the writing of their own individual care plan. The home provides the opportunity for residents to self-medicate after a risk assessment has been carried out. Alternatively trained staff administer medication in accordance with the homes medication policy. The health care needs of residents are being met by the home. EVIDENCE: All of the files inspected contained the personal goals of individual service users. All residents receiving intermediate care have one common goal of being able to return home to live in the community. This was identified on their care plan. There were other goals identified specific to individual residents. One resident’s goals was to be able to get out of bed without assistance. Then moving on to being able to transfer to the toilet and carry out some personal care tasks while being supervised and assisted by his wife. The care records identify the goals targeted and the time period to learn the skills and are recorded when the skills were achieved. The records provided evidence that these goals were achieved within the set time periods. The Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 10 resident explained to the Inspector how he had been helped by staff to achieve these goals and confirmed that now he was looking at an early return home. A second service user being case tracked stated that she was being allowed to self medicate after a risk assessment carried out by the staff. Her medication was being kept in her bedroom in a locked item of furniture. The residents individual file stated that she had made a request when admitted to self medicate. The home care staff supervise her taking her medication for the first three days and complete a risk assessment. At the end of that time period she was judged to be able to take her own medication without supervision. The process of assessment, risk assessment and judgment that she was competent to take her own medication was recorded in the care records. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 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 standard(s) 13,14,15 Staff speak with service users on a daily basis to ensure that their wishes and choices are always considered. Service users are actively involved in the decision making process, in particular relating to the provision of intermediate care. The home provides a varied diet which offers choice and meets the dietary needs of the service users. EVIDENCE: Residents stated that their family and friends are encouraged to visit the home. A relative interviewed during this inspection stated that “staff are helpful and kind.” She added “they make me very welcome and I feel very comfortable visiting”. A second resident who was taking intermediate care stated “my wife has been involved in all of the discussions related to my care plan. The staff are helping me to improve my mobility so that I can return home. My wife will be able to supervise my personal care as long as my mobility improves.” The care records provided evidence that the statements were correct. This residents mobility has improved and he will be returning home. Residents stated in the exit questionnaires that there was a good variety of food provided by the home and confirmed that choice was offered. One resident stated “I enjoy my meals they are very good”. Four exit questionnaires stated “the food in this home is excellent”. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16,&18 There are robust procedures for handling complaints and allegations of adult abuse, staff were clear on the action to take in the event of this occurring, ensuring that service users are safe. EVIDENCE: There is information for residents and their relatives about how to make a complaint displayed in the entrance hallway. A copy of the complaints procedure was seen to be in every residents bedroom. Residents said they felt confident that they could raise any concerns with the management of home. A copy of the Lincolnshire Adult Protection Committee procedures were in place, enabling staff to follow the correct local procedures. These are crossreferenced with the home’s policy. Staff were able to describe how they would respond to allegations made by residents, in order to keep them safe. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19& 26 The standard of the environment within the home is very good, providing residents living there with a clean, comfortable and homely environment. EVIDENCE: A tour of the building showed that the home was well maintained with wellkept lawns and gardens. Bedrooms had been personalised by the residents or their families with photographs, mementoes and small items of furniture. There were areas within the care home which has been redecorated since the last inspection. Plans are in place to replace all windows in the home in October 2005. Work has been carried out within the home in toilet areas and bathrooms to make them more accessible to residents with disabilities. There is work being carried out the entrance of the care home game improve access for residents with a disability. On the day of the inspection the home was clean, tidy and odour free throughout. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29&30 Experienced well-trained staff supports residents. The home provides training for all care staff and encourages NVQ training. There is always sufficient staff on duty to provide essential care for residents. The care home staff and the intermediate care staff worked closely together to enable residents to be able to return home to the community. EVIDENCE: A resident stated “there are always enough staff on duty to help us”. The home has an excellent record of an enabling residents taking intermediate care to return to the community. The residents who were interviewed all stated “staff are very sensitive and kind and do help us to achieve our goal to return home”. The Inspector observed staff helping residents in a sensitive manner, talking and listening to them during the time they helped them with their care. They were seen to knock on doors before entering and spoke to all residents in a respectful manner. The member of staff in charge during this inspection confirmed that the recruitment policy of the home was being followed. The home has employed no new members of staff since the last inspection. The registered manager provided a written statement confirming that enhanced CRBs had been obtained for all existing members of staff. This was a requirement from the last inspection. The homes training records and staff interviews provided evidence that NVQ training has been increased. The training plan provided evidence that ongoing training including specialised training is being provided to all staff members. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35&38 The home consults with people to make sure that they are happy with the service provided. The quality assurance system in place checks that company policies and procedures are being followed to ensure that a consistent service is provided to residents living at the home. EVIDENCE: The home has a very experienced registered manager in post who has worked for many years in the field of community care. Staff stated that she is very supportive and approachable. In formal interviews staff stated that appraisals and supervision are being provided in accordance with the National Minimum Standards. The member of staff in charge stated staff development needs are identified during supervision and appraisals. The identified needs are then matched to the home’s training programme to ensure goals and aims set out in the appraisals are met. Staff confirmed this to be the case during a formal interviews. Residents stated that they felt safe living in a care home. The staff stated they felt safe working in the care home and that they were not aware of any health and safety issues relating to the environment. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 16 Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 18 no 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 Regulation none Requirement Timescale for action 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 5 Good Practice Recommendations It is recommended that the registered manager reviews with the intermediate care team care the records for intermediate care. This will be to improve the quality of recording for intermediate care and to ensure that care plans include all the needs of residents social and care needs. Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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 Crowtree House C53 C04 S41717 Crowtree House V247984 19-905 Stage 4.doc Version 1.40 Page 20 - 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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