Inspection on 16/10/07 for Croxteth Park Care Home

This inspection was carried out on 16th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Croxteth Park Care Home Altcross Road Croxteth Liverpool Merseyside L11 0BS Lead Inspector Lynn Paterson Key Unannounced Inspection 10:00 16th October 2007 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 Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 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. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Croxteth Park Care Home Address Altcross Road Croxteth Liverpool Merseyside L11 0BS 0151 286 6280 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) croxteth.park@fshc.co.uk Lunan House Limited Miss Lorraine Anne Disley Care Home 42 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (20) of places Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to service users of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, (maximum number of places: (20) Dementia over 65 years of age - Code DE (E) (maximum number of places: 22) The maximum number of service users who can be accommodated is: 42 Date of last inspection 22nd February 2007 Brief Description of the Service: Croxteth Park Care Home is situated in a residential community, close to all local amenities and is on a public transport route within easy reach to most areas of Liverpool. The home is purpose built in a single storey building that is spilt into two units to provide social care in a selection of differing rooms for the frail elderly and also those who experience dementia. Bedroom areas are all single occupancy and have en-suite facility. The residential unit and dementia unit each feature a TV lounge, quiet sitting room and separate dining room .All rooms are easily accessible. Car parking is available to the front and side of the premises. Fees are between £315.50 to £395.00 for residential care and £405.00 to £435.00 for EMI care. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Croxteth Park Care Home was carried out on 16th October 2007 and was undertaken on an unannounced basis. Information about the home was gained through examination of a pre inspection questionnaire and examination of the homes policies and procedures and supporting documentation to include care plans and daily records. Discussions took place with the people living in the home and their representatives, the registered manager and members of the staff team. A tour of the building also took place. What the service does well: What has improved since the last inspection? The manager has addressed the requirements made at the previous inspection and as a consequence has updated the pre assessment process and care planning documentation. The home has also benefited from some refurbishment to fabrics and furnishings. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 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 Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3.6.. Quality in this outcome area is good. Residents are only provided with a service after their needs have been assessed and staff, are sure that all assessed needs can be met within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records show, an assessment of resident’s care needs are carried out prior to any offer of placement being made. The assessment process incorporates issues relating to equality and diversity to include age, disability, gender, race, religion or belief and sexuality to ensure a holistic care package can be arranged. The assessment process also includes risk assessments being undertaken and case tracking methods show the risk assessments on file were reviewed and updated as and when necessary to ensure the safety and welfare of the people living in the home. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 9 Intermediate care is not provided at the home. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10. Quality in this outcome area is good. Residents health care needs are monitored and met. However daily recording systems need to be improved to ensure that information on file is an accurate reflection of how care is provided to meet assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care files examined held detail of the plan of support provided to each resident and staff say this gives them guidance and information as to peoples individual care needs. The manager said that care plans cover a full range of issues relating to diversity of needs to include age, disability, gender, race, religion or belief and sexuality and she said this ensures the plan is fully person centred and addressed holistic care needs. Records show that resident’s health care needs are monitored and reviewed with records being maintained on file. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 11 People living in the home said they see health professionals as and when needed to include GP, Dentist, Chiropodist and district nursing staff. Information on the care plan detailed the personal care needs of each individual living in the home, however daily records lacked detail and were inconsistent in their recording. 6 care files examined in detail lacked basic information in the daily record section. None of the 6 had any consistency with date recording. For example records were not maintained on a daily basis and consistency of “daily recording” was not in place for any of files examined. Staff must record all aspects of daily life in the residents care plan to enable information to be available to show individual care needs are being fully addressed. Discussions with people living in the home and observations of them interacting with staff indicated that the atmosphere in the home is one in which staff and residents are comfortable and at ease with each other. Comments from residents included: “The staff are kind and helpful and treat us well”, “Staff give us the respect we deserve”, “People working here are always courteous and respect us all as individuals”. Staff said they had been trained to carry out good care practices in which residents are always treated with respect and afforded privacy. The manager said that she held general chats with residents and did observations of staff to make sure that staff, were working as per the homes policies and practices and that people living in the home felt they were well treated. Medication systems are in place to ensure residents receive their medication as prescribed by their GP and only senior staff, are allowed to handle residents medication. Medication records were generally well managed however it was noted that a staff member had hand written details from a prescription to the medication records sheet. It is recommended that all information about the administration of medication is double -checked and double signatures recorded on the Medication records to ensure all details including dosage is accurate. The manager advised that this is the current practice however records seen held a single signature only. Residents spoken with said they generally receive their medication as prescribed by their GP and one resident said s/he had missed some medication by choice. Staff spoken with said they had been trained in medication management and had knowledge and understanding of the home medication policy. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 12 Discussions were held with the manager and senior carer about storage of medication and what happens if the medication records are not completed correctly in respect of the administration of medication. They acknowledged that it is essential that good medication procedures are followed at all times and the manager advised that she undertakes several spot checks per month on medication management to include carrying out checks of the storage and recording systems on each unit in the home. It was agreed that it is only by following good practice that the health, safety and welfare of residents will be maintained. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.15. Quality in this outcome area is adequate. The homes routines are flexible to enable residents to exercise choice about their daily life. Social activities are in place for some residents. Menus do not reflect choices available at meal times. Staff are attempting to work on a programme to make sure all residents interests are catered for. Improvements need to be made to the menus to ensure meal choices are readily available at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records show that a range of activities is provided at the home and the manager advised that an activities organiser has recently been appointed. The manager advised that residents social needs are assessed and activities provided accordingly. Staff said that residents have the opportunity to go out into the community and visitors from the community regularly visit the home. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 14 Residents spoken with said they could come and go as they pleased and some residents were observed being taken out by their friends and relatives and one resident was going swimming with a staff member. A number of residents said that the activities currently in place did not really meet their needs but they understood that “you cannot please everyone”. Residents said they were comfortable in the home and were generally allowed to do what they wanted. Observations of the unit, which caters for people who experience dementia, revealed that staff works hard to ensure that activities and interests are maximised and staff were seen to be actively involved in interactions with residents to enable them to have social stimulation. It was noted that the home have recently employed an activities co-ordinator and discussion with this staff member revealed that she is currently meeting with all the residents to seek their ideas of what activities they would like to be in place. Examination of future plans indicate that the activities will become far more varied to enable diverse needs to be met. Staff said that religious ministers of varying denomination visit the home each week to ensure that resident’s religious needs are met. The manager said a varied menu is in place. However several residents said that the food is OK but they are not given choices of menu. They agreed that they would be provided with an alternative if they asked but said they were not aware of the options until they made it clear they did not want the meal on offer. The home provides 2 dining rooms one for each unit and staff say they generally know what each resident likes or dislikes and what their dietary needs are. The manager must be aware that choices should be provided to the people living in the home and assumptions should not be made about their food preference each day. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16.18. Quality in this outcome area is good. Systems are in place for the protection of residents and people living in the home and their representatives know about the complaints systems and are confident about the process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre inspection questionnaire indicated that the home has not received any complaints within the last 12 months. A complaints procedure is in place and residents and their representatives said they fully understood how to complaint although none had made an official complaint. Residents and their representative said they were able to discuss any concerns or conflicts as a daily process with the manager or staff and were encouraged to speak out if they felt disadvantaged in any way. They said this process enabled them to deal with any areas of concern as and when they arose and as a consequence they did not feel the need to raise any official concerns through the complaints process. Staff training records indicates that a number of staff had received training in the protection of vulnerable adults. Staff appeared to have a good level of understanding of the differing types of abuse that can occur and the actions they should take in the event of them suspecting or knowing an incident of Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 16 abuse had occurred. Training matrix showed that newly appointed staff were due to receive adult protection training in the very near future. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19.26. Quality in this outcome area is good. The home has an ongoing refurbishment programme in place to ensure people living in the home are safe and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The overall standard of the premises is generally good and a refurbishment programme is in place to update some fabrics, furnishings and decoration. At the time of the visit a keypad was being replaced to one of the unit doors, a garden area was being landscaped and pictures of old film stars were being hung in the corridors. The home manager adds homely touches to ensure that the home does not present as being institutional in appearance and she states that the home Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 18 maintenance person works exceptionally hard to ensure the people living in the home are not disadvantaged by any technical faults to the essential service provision of the home. Bedrooms. The bedrooms viewed appeared homely and comfortable with residents being encouraged to personalise their rooms with pictures and ornaments and small furnishings of their choice. Bathrooms and Toilets. All bedrooms have en-suite facility and the home provides sufficient bathing facilities for the number of people living in the home. The home presented as clean, hygienic and free from unpleasant smells and staff advised that the laundry facilities are sufficient to provide a good service to the residents and to prevent the spread of infection. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27.28.29.30. Quality in this outcome area is adequate. The staff recruitment processes and training programme do not always ensure suitably qualified and competent staff are employed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre inspection questionnaire indicated that staff, have completed a range of training in the past 12 months and further training is planned for the forthcoming year. Staff turnover in the home has been fairly high with figures showing 4 full time and 14 part time staff have left the home within the past 12 months. Whilst newly appointed staff have undertaken mandatory training they have not yet been able to undertake training which concentrates on residents specific care needs to ensure staff fully understand all aspects of individual care needs. Issues of equality and diversity need to be included in early stages of staff training to ensure staff, have information and guidance on how to address this sometimes-complex issue. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 20 6 Staff files examined held all the required information with the exception of reference provision. 4 files held relevant referee information however 1 file had only I reference in place whilst another had I official reference with another written in pencil on blank paper, received from a person who had not been identified as an official referee. This was discussed with the manager who advised that this had occurred prior to her employment but understood the recruitment and selection process had not been as per the company policy. She agreed that it is essential to have robust recruitment and selection processes in place to ensure staff, are suitable to work with vulnerable adults. Staff said they are provided with induction training when they are first employed and they say they are supported in their role by each other and the senior staff and home manager who is always available for advice and support. It was noted that the home use an “employee of the month” system in which a staff member is nominated each month. Staff, are provided with a certificate and small award and say this makes them feel valued as part of the team. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31.33.35.38. Quality in this outcome area is, good The home is managed in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been employed as home manager for over 2 years and is qualified and experienced in the care of vulnerable adults. She is aware of the need for her to keep up to date with her continuous personal development and for the need for her to attend further training in order for her to maintain her skills. Staffs say there are clear lines of accountability within the home and advise that the support systems in place are excellent. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 22 The pre inspection questionnaire indicated that a range of policies and procedures relating to the care of the residents and the running of the home are in place and are reviewed and updated annually. Systems are in place to ensure the ongoing monitoring of the service. Staff are supervised and monitored in their role and administrative systems are reviewed. The registered provider carries out a quality assurance system and the manager has developed her own systems to make sure that the staff and people who live in the home and their representatives have an opportunity to raise issues relating to the quality of the services provided. The administrator takes responsibility for the management of resident’s daily money and gives advice and support to people moving into the home and their representatives about fees and benefit claims. Representatives of people living in the home said that the administrator is knowledgeable efficient and effective with her help and advice in relation to the financial aspects of residential care. Resident’s health and safety is promoted in the home. The pre inspection questionnaire indicated that the equipment in the home to include fire system, hoists and electrical working is checked and serviced regularly. The manager said the home maintenance person is responsible for maintaining appropriate records and certificates in respect of health and safety. Staff said they have completed a range of training in health and safety and that a heath and safety checklist is completed each week to ensure everything is addressed. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 23 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 A written plan of care that clearly identifies the needs of the resident and how those needs are to be met must be available People living in the home must be provided with a written choice of menu at all times to ensure that they are provided with food to suit individual tastes and dietary requirements. The forthcoming years staff training programme needs to include training on residents specific care needs and issues relating to equality and diversity. Staff, recruitment procedures must be followed to ensure all necessary information about staff is gathered prior to them being offered employment working with vulnerable adults. Timescale for action 31/12/07 2 OP15 12 31/12/07 3 OP28 18 31/12/07 4 OP29 18 31/12/07 Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 25 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 OP9 It is recommended that staff ensure that any hand written medication instructions are double checked with the signatures of the staff involved clearly visible on the medication record sheet. Croxteth Park Care Home DS0000068321.V347485.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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