Inspection on 25/04/05 for Crowtree House

This inspection was carried out on 25th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Crowtree House 09/02/09

Crowtree House 11/01/07

Crowtree House 19/09/05

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 25 April 2005 @ 08:30 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 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 V220272 25-405 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 Mrs Kathleen Goodacre Care Home for Older People 25 Category(ies) of DE(E) - Dementia over 65 - 5 registration, with number OP - Old Age - 18 of places PD - Physical Disability - 2 Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Services users within the category PD (Physical Disability) are aged between 55 and 64 years inclusive Date of last inspection 4 November 2004 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 within 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 V220272 25-405 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over an eight hour period and was carried out by two inspectors. There were six service users spoken to the during this inspection and one relative, care records and other documents were inspected. Three care staff were interviewed. What the service does well: What has improved since the last inspection? What they could do better: All information relating to service users needs changing must be recorded on their care plans, not passed on verbally avoiding the updating of care records. It is important particularly for service users on intermediate care and respite care that records are reviewed and updated consistently. The assessments forms for respite care and intermediate care must be fully completed. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 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 V220272 25-405 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 V220272 25-405 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) 2,3 and 6 All service users are given an assessment prior to their admission to the care home. However, the quality of the recordings for these assessments was found to be inconsistent. The home was therefore unable to demonstrate that all service users needs had been identified at the point of assessment. Not all service users had been given copies of their terms and conditions for their stay at Crowtree house. EVIDENCE: A service user’s file inspected was found not to be signed by the individual service user. A note on the file stated that the service user was unable to sign for themselves, but gave no reason. The individual service user told the Inspector that she was able to sign her own papers, but her signature had not been requested. Service users were not aware of the terms and conditions for their stay at the care home. Three individual service users files were studied. The assessments were not recorded in a consistent manner. One service users assessment stated that they needed special cutlery. This information was not on their individual care plan. The wishes and choices of individual service users were not found on all care plans inspected. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 9 The intermediate care plans have improved since the last inspection. There were however, details established at the assessment which were not transferred onto care plans. Some assessment forms were not fully completed. Staff stated that since the last inspection the number of people returning home after rehabilitation and not requiring long-term care has increased. The interviews with staff confirmed that peoples needs are reviewed regularly, but changes identified in service users needs had not been transferred onto their care plans. A member of staff stated that a service users skin condition had changed since they had been admitted to the care home. This details had not been added to their care plan. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 10 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,and 10 New service users have not been provided with the information to make an informed decision whether they wish to stay at the care home.The individual assessment records do not demonstrate that the homes assessment policy is being followed. The home can therefore not be confident that all of the service users needs are being identified EVIDENCE: A service user’s file did not contain a signed copy of their terms and conditions. A service user who was interviewed was not aware of the terms and conditions for her stay at the care home. The service users interviewed confirmed that they had been assessed prior to them being admitted to the home. The inspection of their individual files confirmed this to be the case. The quality of initial assessments was, however varied some forms were not completed and there were gaps in assessment documents, particularly relating to respite care and intermediate care. Information obtained at reviews of service users needs was not always transferred onto their individual care plans. One service user stated he needed special cutlery. this was not on his care plan. The home’s records provided evidence that service users admitted for rehabilitation were returning to their home in the community within set timescales. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 11 A service user gave examples of the assistance given to her to enable her to return home. A service user stated “staff are lovely they do so much for you I have never been anywhere like this before. The attention they give me is out of this world”. Service users spoken to stated that they had no complaints one commented, “everything is wonderful.” Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 12 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) and15 12,13,14 The service users health, personal social care needs are not being consistently recorded onto all care plans. The home is not recording in detail the outcomes of reviews particularly relating to intermediate and respite care service users. Changes in service users needs are not always being transferred onto their care plan. The medication policy of the home is being followed. EVIDENCE: The service users taking intermediate care stated their needs were being met by the care home. One service user said ”this is a very beneficial place to stay, staff are helping me to plan my return to my home”. A second service user stated ”the staff are helping me to become more independent and teaching me the skills which I need when I return home”. One service user stated I have been to other care homes “this is my third stay at Crowtree House it is the best home that I have stayed at”. All service users spoken to during this inspection stated their friends and relatives were made very welcome when they visit the home. A service user stated “when my relative visits, the home provides him with a lunch”. The inspection of files, discussions with staff and service users provided evidence that the individual choices and wishes of service users are identified and recorded on some care plans. All service users confirmed their satisfaction with the quality and quantity of the food provided by the care home. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 13 One service user stated “the attention given is out of this world and the food is good and lovely”. An inspection of the medication records and storage facilities demonstrated that the medication policy of the home was being followed. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 14 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 The home has in place policies and procedures to ensure that all service users are protected from any possible abusive situation. The home has, however failed to follow its recruitment policy consistently. By not carrying out appropriate checks on all new staff service users could have been placed at risk. The initial assessments carried out by the home for service users did not contain a comprehensive risk assessment. If all risks are not being identified management strategies to reduce or eliminate any risk can be put in place. EVIDENCE: The home has a complaints policy which meets the National Minimum Standards and is displayed in the care home. Service users stated that they were confident that they could raise any concerns or complaints with the management of the care home. The home has a whistle blowing policy and a abuse policy which is contained within the home’s procedures manual. There is a copy of the Lincolnshire County Council Vulnerable Abuse Procedure in the care home. Staff have been provided with training in the recognition, prevention and management of abuse. The inspection of initial assessments for service users provided evidence that a comprehensive risk assessment had not been completed for all service users. The individual files for two members of staff were inspected. One file contained only one written reference the second file contained a standard criminal record bureau check not an enhanced disclosure as required by the Care Home Regulations. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 15 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, 20, 21, 22, 23, 24, 25 and 26 The home has a rolling maintenance program which ensures ongoing work is carried out to the care home throughout the year. There were no health and safety issues identified at this visit relating to the environment. EVIDENCE: A tour was made of the care home and all areas were found to be clean tidy and free from any offensive odours. The paved area to the entrance of the care home was undergoing repairs on the day of this inspection. One of the service users lounges was being redecorated. All service users spoken to during this inspection expressed their satisfaction with the facilities offered to them by the home. A service user stated you will find that the dining room is very nicely decorated . A visitor told the Inspector this home is very good there is no odour anywhere in the building. There were no health and safety issues identified during this inspection. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 16 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, 28, 29 and 30 The home has a recruitment policy which meets the National Minimum Standards. This policy was not being followed consistently by the management team. It is therefore possible that staff could have been recruited who could place service users at risk. The home ensures trained staff are on duty in sufficient numbers to answer the needs of the service users. EVIDENCE: The home has reviewed its staffing levels and increased staffing hours by 25 hours per week to ensure service users needs can be met. The staff stated that in their opinion service users needs are being met and the increase in staffing hours have proved to be very beneficial. A service user stated that the attention given to them from staff is excellent she stated “I couldnt be better looked after they meet my every need”. Training records for staff and staff interviews confirmed that training is being provided to all staff including specialist training and NVQ training. There were two staff files seen during this inspection which did not contain all the information required before a new member of staff is employed. One file contained only one written reference, the second file contained a standard criminal records bureau check not an enhanced one as required by the Care Home Regulations. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 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 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 and 38 The care home has an experienced and supported registered manager who has worked in the provision of residential care for many years. She ensures that staff are provided with appraisals and supervision as required by the Care Home Regulations. All service users financial interests are safeguarded by the policies and procedures of the care home. The home is a safe home in which to live and a safe working environment. EVIDENCE: The registered manager was on holiday on the day of this inspection. The Inspectors were asked to produce identity cards before being admitted to the care home. A member of staff in charge was able to supply details of all service users in the home and had a sound base knowledge of all their needs. This information was given without the member of staff having to refer to the home’s care files. Staff stated that some staff had been given appraisals. Supervision was being provided at least six times per year. An inspection of the records confirmed this to be the case. All staff interviewed stated that the registered manager was very supportive to all staff. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 18 The service users who were interviewed stated that they would feel confident in being able to raise concerns either directly with the registered manager or at the service user meetings. There were no health and safety issues identified at this inspection staff stated the home was a safe environment to work in, service users stated they were comfortable and felt safe living in the care home. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 2 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 2 3 3 2 3 3 Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 20 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 2 Regulation 5-1 Requirement The registered person must give to each service user a copy of the terms and conditions for their stay at the care home The registered person must after consultation with the service user prepare a written care plan. The plan must set out all the service users needs in respect of health and welfare stating how the needs are to be met The registered person shall not employ a person to work at the care home unless he may have obtained in respect of that person information and documents specified in (i) paragraphs 1-7 of Schedule 2 Timescale for action 30/09/05 2. 7 15-2 30/09/05 3. 18 and 29 19-1 30/09/05 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 18-2 Good Practice Recommendations The staff should be given annual appraisals. Crowtree House C53 C04 S41717 Crowtree House V220272 25-405 Stage 4.doc Version 1.40 Page 21 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 V220272 25-405 Stage 4.doc Version 1.40 Page 22 - 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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