Inspection on 02/04/07 for East Croft Grange

This inspection was carried out on 2nd April 2007.

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

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 East Croft Residential Home Scaw Road High Harrington Workington Cumbria CA14 4LY Lead Inspector Nancy Saich Unannounced Inspection 2nd April 2007 8:30 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 East Croft Residential Home DS0000069456.V333888.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. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service East Croft Residential Home Address Scaw Road High Harrington Workington Cumbria CA14 4LY 01946 832754 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) Brancaster Care Homes Limited Mrs Frances Sewell Care Home 31 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (10), Old age, not falling within any other of places category (21) East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 31 service users to include: *up to 21 service users in the category of OP (Older people, not falling within any other category). *up to 10 service users in the category of DE(E) (Dementia over 65 years of age). *Registration to include one named person under the age of 65 inclusive in the category (Dementia under 65 years of age). Date of last inspection Brief Description of the Service: Eastcroft is situated in a residential area of Harrington and is near to transport links and the village amenities and is set in its own very well tended grounds. The home is divided into two separate areas. The main house is for older adults and has single bedrooms and four shared areas where people can spend time together. The ‘Garden Unit’ is for older adults who have dementia. This specialist unit also has single bedrooms and two shared areas. The unit is secure so that people with dementia will not wander out into any danger. They have space to walk and access to a very nice secluded garden. The home has recently been purchased by Brancaster Care Homes Limited and the home continues to be managed by Elaine Sewell. The charges range from £317 to £422 per week depending on the needs of the individual. Further information about charges can be obtained from the company or the registered manager. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The lead inspector, Nancy Saich, sent out surveys to residents, their relatives and to doctors and social workers. She received a good number of responses to these surveys. In the main these were very positive. Where people expressed concerns these were discussed with the manager or checked out during the visit to the service. The visit to the home started just before 8.30 in the morning and lasted until mid afternoon. The inspector toured all areas of the home and spoke to residents privately and in groups. She had lunch with them and sat with people with dementia just to observe how they responded to staff and to each other. She met with relatives and other visitors during the day. She spoke to the staff on duty and to the manager and to a representative of the company. She also read files and documents that backed up what was said or what she saw during the visit. She judged that the recent change of ownership had been carried out smoothly and residents felt that their lives had not changed. Generally the home provides excellent levels of care and the residents and visitors were very happy with the way things are organised in the home. What the service does well: This home is good at only admitting new people who will fit in with the existing residents and who they can care for properly. The staff group deliver both personal and health care in the right way. Here is what residents or their relatives said to the inspector or in the surveys: • • • • • • • • • • ‘All of the staff have shown great care and sensitivity’ ‘The staff have all proven to be very responsive’ ‘There are always staff available when needed’ ‘Good environment and friendly staff’ ‘The staff always ready and willing to discuss any aspect of care and personal attention’. ‘We have the utmost praise for staff tackling some demanding situations…’ ‘Some initial concerns were addressed promptly and efficiently’ ‘The meals are excellent…they always use fresh produce and are varied and well cooked’. ‘I really enjoy the food …it is excellent.’ ‘I am very happy here…’. The written plans that help staff to deliver good care were detailed and up to date. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 6 The inspector checked on arrangements for residents to receive medical care. These were in order. She also checked on the medication kept in the home and watched as people were helped with their medication. She judged that this was done properly. These are some of the things that medical professionals said in surveys about the home: • • • ‘Very well organised and caring residential home…. sensible staff…’ ‘Care of mentally infirm especially good with good liaison with community psychiatric services…’ ‘They do everything well…the service has improved out of all recognition in the last few years…’. The home is good at dealing with any concerns or complaints. The manager had dealt with a situation that might have developed into a problem of abuse. Staff and residents felt confident that the home protects residents from harm. The inspector judged that the home is very good at spotting and dealing with abusive situations. Eastcroft is a very well furnished and well-decorated house. The rooms are airy and spacious and all areas were clean and tidy. The home has beautiful grounds and there is a walled garden where people with dementia can walk safely. All of the residents have ensuite bedrooms that are suited to their needs. These are nicely furnished and decorated but each of them reflected the personality of the person they belonged to. Residents said that the staff keep their clothes nicely laundered and all the bed linens were fresh and clean. This home has suitable levels of staff so that resident get good care. There are always two members of the team with people with dementia both day and night. Residents said that there were enough staff to meet their needs. The staff said they did work hard but that there were enough staff around to care for the residents. A relative backed this up by saying: • ‘Residents are treated with care and patience regardless of the pressures of the moment…’ The staff team are properly trained and have qualifications in care. They attend special courses that help them understand a range of things that the residents need. The residents were very complimentary about the staff team. The manger is careful to only take on new staff who have good references and haven’t been sacked from another care setting and who don’t have criminal records. The inspector checked all these records and found these to be in order. She also watched the staff as they worked and spoke to them about their jobs. She judged that Eastcroft has a highly motivated and well-trained staff group. They carried out their work without fuss and did everything efficiently but always had time to reassure residents or to have a conversation with them. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 7 The home has a mature, capable and skilled manager who is very much a ‘hands on’ person who has a thorough understanding of the whole operation. Residents and staff told the inspector that she was someone they could trust and talk to. Staff said they had the chance to meet regularly with the manger so they could talk about their work and their training and development needs. The home has a good system for ensuring that high quality standards are met all the time. The inspector checked on things like health and safety, fire safety, food hygiene and the way residents money is looked after. All of these things were in order. This was checked through observation and through looking at the very good records. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 8 be made available in other formats on request. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 9 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 East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home is good at making sure they can provide care to new residents and that they will fit in with the existing group. EVIDENCE: The inspector spoke to a resident (and also to this person’s partner) who had recently been admitted to the home. They confirmed that the staff had been open and friendly and helped them with the difficult process of settling into a new home. They also confirmed that the resident had both a medical and a social work assessment and that the manager of the home had visited before admission. There were really good notes of this on this persons file and on other residents’ files showing that assessment and admission is done correctly. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. This home provides excellent levels of personal and health care to all its residents that meet their often complex needs. EVIDENCE: The inspector read all of the written plans that help staff to understand how to give residents the care they want and need. She found that these ‘care plans’ were detailed and up to date. They covered both the small things that people prefer and the more complicated things that people with a lot of care needs have to have in place. She thought that the plans for people with dementia or behavioural difficulties were very good and explained to the staff how to manage difficult situations. Residents were aware of the plans and one person said • “I don’t need to read it again as the staff follow it to the letter – to the minute – and I get what I need….” East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 12 The inspector checked in the notes and these showed that when a resident was unwell the staff called on the GP or the nurse to come out to see them. Residents also see people like chiropodists, dentists and options on a regular basis. The inspector met a district nurse and a GP during the visit and they were happy with the care provided. The local surgeries returned very positive summaries back to the inspector. The inspector checked on the medicines kept on behalf of residents. She judged that the ordering, administration and disposal of drugs were all done correctly. Residents don’t get sedatives unless a consultant advises this. The inspector spoke to a lot of residents on the day and had a lot of summaries returned to her. They were all very positive about the staff team and used words like ‘kind’, ‘caring’, ‘happy’ and ‘good at their jobs’ to describe the staff team. Throughout the day the inspector watched the staff as they went about their work. They were patient, sensitive and kind to all the residents and spoke to them in a polite and respectful way. It was obvious that there was a lot of regard on both sides and there were several occasions where staff and residents talked together in a way that showed this regard and trust was well established in the house. East Croft Residential Home DS0000069456.V333888.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 good. This judgement has been made using available evidence including a visit to this service. Residents in the home feel that they have the kind of life style that they want. EVIDENCE: The residents told the inspector that they lived their lives very much how they wished. They got up and went to bed when they wanted and could spend time in their own rooms or could have the company of others. One person said she liked to be on her own most of the time and had very set routines. She was totally satisfied with the way the staff met her needs. The inspector was also impressed with the way the staff helped people with dementia to lead as normal a life as possible. The visitors’ book showed that a lot of people came to see their friends and relatives. The inspector met one person who was visiting and this person was very satisfied with the care provided. Surveys showed that visitors were always made very welcome in the home. Residents said they did have people from community groups visit from time to time. Staff said they tried to provide activities for residents when they could. The home did have an activities organiser but staff are now doing these themselves East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 14 until a new person can be recruited. Residents were happy with the activities provided and enjoy going out in small groups. Residents said that they were asked their opinions by the manager and the staff and that they could influence the way things were done in the home. They had been aware of the sale of the home and had been kept informed all the time. The inspector was invited to have lunch with the residents. She was impressed with the range of choices, the quality of the food and the presentation of the meal. The residents said the food was always of a very high standard and that staff knew and understood individual preferences. Everyone seemed to enjoy their meal and several people said how they preferred to sit in small groups in each lounge area and were happy that they didn’t use one room as a dining room anymore. East Croft Residential Home DS0000069456.V333888.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. This judgement has been made using available evidence including a visit to this service. The home is good at listening to residents and protecting them from harm. EVIDENCE: All of the residents were confident that the manager would deal with any complaints they had. They had met the representative of the new company and felt they could approach her. One person had made a minor complaint to the new company and this had been dealt with promptly and to the satisfaction of the resident. The manager had dealt with a problem that might have developed into abuse of residents’ money. This had been managed quickly and properly and no resident came to any harm. Although the manager had been alerted quickly to this she thought it was a good opportunity to discuss again with all of the staff how to protect the residents. This had been done and staff spoken to felt they were fully aware of any potential abuse. They were confident that they knew how to take action if something was wrong. Residents said that nothing unpleasant was going on in the home and they trusted the manager not to let anything abusive happen. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 16 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, 20,23,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home provides and excellent environment where residents feel relaxed, safe and comfortable. EVIDENCE: The inspector walked around the building and found that even first thing in the morning the home was clean, tidy and well organised. She judged that the home has very high standards of cleanliness. All parts of the house are very well decorated and furnished. The manager makes sure that maintenance and repair are ongoing so that the house and grounds are a safe and pleasant place for all the residents. The inspector sat with one person in her room and she was impressed with the comfortable and spacious room that this person spent her time in. This resident was very satisfied with the high standards and had nothing but praise East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 17 for the housekeeping staff. All of the other rooms were of a similar standard and everyone has their own ensuite toilet. The manager has recently changed things around the main house. The conservatory is now the area where people may smoke. The other three shared areas have had the furniture moved around so that there is no longer a formal dining room but each lounge has small tables in them. The residents said they liked this as they sat in smaller groups with their friends. One or two people who have difficulties eating thought that it was less public eating in small groups. The ‘Garden Unit’ is safe, spacious and secure for people with dementia and has its own secluded garden. The residents were very relaxed in this area and the environment seemed to suit their needs. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 18 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 excellent. This judgement has been made using available evidence including a visit to this service. This home has a well-trained and highly motivated staff team who put the care of the residents at the centre of everything they do. EVIDENCE: One or two of the surveys returned by relatives of residents said that they thought the home needed more staff. The inspector looked at eight weeks worth of rosters and found that the home had suitable staffing levels most of the time. She also spoke to staff who said that sometimes they had been a little hard pressed during one particular period of time but that they had: • ‘All pulled together and covered all the shifts’. She also said that they never worked with less than two people in the ‘Garden Unit’ to make sure the residents were given the best care. The manager had explained to the inspector at the time that there were some staffing difficulties. This problem had been dealt with and the staffing levels were back to normal. Residents said they thought that the staff worked hard but that there were always enough people around to meet their needs. One person said they never waited more than three minutes to have the call bell answered. Another person said that they understood that staff couldn’t always East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 19 give them full attention and that their time was shared out properly between all the residents. The manager had employed some new staff and the inspector checked on how she had recruited them. She saw that the manger made sure that any new person was the right kind of worker for older adults. New staff are checked so that they don’t have a criminal record and haven’t been dismissed from any other care setting. The inspector read staff files and saw that more than half of them had level 2 or 3 in National Vocational Qualifications. All staff had been trained in the core skills for care and had done training in things like food hygiene, fire safety and manual handling. Staff who work with people with dementia are properly trained to understand them and met their needs. The quality of training in this was very good with everyone given the opportunity to learn and understand the special needs of this group of people. The inspector also observed staff as they worked. She judged that they were very well organised, efficient and highly motivated. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 20 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, 35,36,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management systems in this home are very well organised and this means that residents don’t need to worry about routine matters. EVIDENCE: This home has recently had a change of ownership but the manager has been in post for a number of years and has worked in the home for some sixteen years. Elaine Sewell is a mature and experienced manager who is trained in the care of older adults and in managing the home. Residents and staff were complimentary about her skills and abilities. They said she was approachable and competent. There was lots of evidence that showed she was running a very good home where residents’ care was central. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 21 She has some very good systems in place that allow complex things to work smoothly. She had information to hand that allowed the inspector to check quickly that everything was in order. She has a system whereby she constantly checks that these systems work. The inspector saw this quality assurance system and judged that it was of a very high standard. She also saw evidence that showed that a common sense approach was taken in the home and the manager and the team worked together to achieve high standards. Staff in the home are properly supervised while they are working and they also get the chance to sit down and talk to the manager about their work, the care of the residents and their training and development needs. The inspector checked this out with staff and read the notes. These were of a high standard. The inspector also checked some practical details of how the home operated. She checked on money kept on behalf of the residents and this was properly accounted for. Some extra security measures had been put in place for cash kept in the home. The manager showed the inspector her records of all the things she had in place to keep residents safe. The fire safety records were of a good standard as was the food safety measures. Staff confirmed that they had training in these things and also knew how to deal with them on a daily basis. The inspector saw examples of good health and safety practice in the home. The home has good systems in place to make sure everything is maintained to the highest standard. East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 22 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 4 X X 4 X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X 3 4 East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NA 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. Standard Regulation 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. Refer to Standard Good Practice Recommendations East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. Extracts may not be used or reproduced without the express permission of CSCI East Croft Residential Home DS0000069456.V333888.R01.S.doc Version 5.2 Page 25 - 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. 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