Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 10/05/07 for Littlecroft Residential Home

Also see our care home review for Littlecroft Residential Home for more information

This inspection was carried out on 10th May 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There have been a number of staff changes since the last visit including the appointment of a new deputy manager who has worked for Quality Care Homes for seven years and therefore has extensive experience in caring for older people. However despite these changes the continuity and quality of care has been maintained and whilst a person I spoke too said how it had been difficult with new staff she still felt the care provided and staff was "still very good and you couldn`t ask for better really". Staff also commented that they felt they "worked better as a team". Residents I spoke too said how much they liked the "homely and friendly atmosphere" "I get on with everyone here we all get on so well". A comment from a professional who visits the home is of particular note reflecting the high quality of care at Littlecroft along with a relative comment that highlights the homely and friendly environment. "I have rarely found a group of staff so well motivated, willing to provide effective care. Only wish all the homes I got involved with were so well organised and had such a positive culture" (from professional) "Friendly staff give more of a homely feel rather then institionalised" (from relative)

What has improved since the last inspection?

A number of requirements were made at the previous visit to the home. They related to care planning practice, medication records and the environment. From this visit it was evident that improvements have been made in care planning addressing how staff need to make sure people who live in the home are involved in care planning and their views are recorded. It was noted at the last visit that one of the bathrooms needed decorating to make it more welcoming and inviting this has been done as has replacing carpeting in one of the rooms that again was a requirement from the last visit. In talking to the manager he spoke of how the building of an extension to the home will not only increase the number of residents (by 3) but also improve the lounge area and importantly make the garden area more attractive and provide a paved seating area. Lastly a requirement was made about making sure that administering records accurately recorded the giving of medication. There had been significant gaps in this recording at the last inspection. There has been some improvement in this area of practice however the manager recognised it was something that required continued monitoring to make certain practice meets the required standard.

What the care home could do better:

This visit did not identify any areas for improvement and key National Minimum Standards examined were all met.

CARE HOMES FOR OLDER PEOPLE Littlecroft Residential Home 44 Barry Road Oldland Common South Glos BS30 6QY Lead Inspector Jon Clarke Key Unannounced Inspection 10th May 2007 10:00 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 Littlecroft Residential Home DS0000061093.V335511.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. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Littlecroft Residential Home Address 44 Barry Road Oldland Common South Glos BS30 6QY 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) 0117 9324204 Quality Care Homes Ltd Mr Mark Anthony Hewlett Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2006 Brief Description of the Service: Littlecroft is one of three care homes owned and managed by Quality Care Homes Ltd. It is a converted property located at Oldland Common providing accommodation for up to 17 older people. There are 17 single rooms, 10 of which have en-suite facilities. There is a lounge with conservatory, a smaller lounge used mainly for visitors and a dining area. Residents accommodation is on the ground and first floors with lift access. There is an extensive garden, with level access, to the rear of the property. Aims of the home include to ensure quality of life for residents, by providing first class care in a friendly, relaxed yet stimulating environment and we aim to ensure that living in a residential setting is a positive experience (taken from the homes Statement of Purpose). Fee £338-550 depending on assessed need. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of an inspection to examine key standards, establish actions taken from requirements made at previous visit and make a quality rating judgement about the service provided. Please note the quality rating will not be published as part of this report but from January 2008 will be made public. As part of this visit a number of records were looked at including assessments, care plans, medication documentation, staff records (training and recruitment). There was also an opportunity to discuss with people who live and work in the home their experiences and what they thought about the quality of the care in the home. “Have Your Say” questionnaires were sent to the home and 8 Residents, 8 relatives and 1 professional responded. Comments and results have been used to inform the judgement made about the quality of the service provided at Littlecroft. What the service does well: What has improved since the last inspection? Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 6 A number of requirements were made at the previous visit to the home. They related to care planning practice, medication records and the environment. From this visit it was evident that improvements have been made in care planning addressing how staff need to make sure people who live in the home are involved in care planning and their views are recorded. It was noted at the last visit that one of the bathrooms needed decorating to make it more welcoming and inviting this has been done as has replacing carpeting in one of the rooms that again was a requirement from the last visit. In talking to the manager he spoke of how the building of an extension to the home will not only increase the number of residents (by 3) but also improve the lounge area and importantly make the garden area more attractive and provide a paved seating area. Lastly a requirement was made about making sure that administering records accurately recorded the giving of medication. There had been significant gaps in this recording at the last inspection. There has been some improvement in this area of practice however the manager recognised it was something that required continued monitoring to make certain practice meets the required standard. 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. Littlecroft Residential Home DS0000061093.V335511.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 Littlecroft Residential Home DS0000061093.V335511.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: A number of pre-admission assessments were looked at and showed that the health and social care needs of individuals are identified. The home undertake their own assessment and where possible visit the individual as well as invite them to spend a day in the home which also helps in finding out their care needs. Where the person is known to social services and funded by the local authority a copy of their assessment is obtained to further inform the home of the care needs. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 9 The home’s Statement of Terms and Conditions (Contract) must have a statement about fees and the giving one months notice of any increase and individuals to be informed of reason for raising fee. This follows new Care Home Regulation (5a) being introduced in 2006. Littlecroft Residential Home DS0000061093.V335511.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. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents are met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were looked at and showed that there is generally good practice in this area. Information was provided about the daily tasks and abilities of individuals, their likes and dislikes. Moving and Handling profiles had been completed these being reviewed on a regular basis as were care plans and updated where there was any change in needs. Risks assessments are completed in one instance where an individual can at times be aggressive towards staff. Where an individual has mental health needs these are recorded. Care Plans had been signed by the individual. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 11 The home arranges access to health services with regular visits from services such as chiropody, dental and optician. District nursing is provided where this is needed. A relative comment was, “ my mother is very happy at Littlecroft and her health has improved”. Where individual have mental health needs the home seeks support from GP to obtain referral for community psychiatric nurse (CPN). A comment from a CPN “My patient in this home has presented complex and intense psychiatric problems which the staff have responded to with enormous humanity, determination and skill”. The arrangements for storage and managing of medication were looked at and these were satisfactory with secure storage including separate secure storage for controlled drugs. In examining administering records there had been some improvement in recording however there were still gaps failing to evidence that medication had been given as prescribed. People who live in the home are able to self manage their medication and currently there are two residents who do so. Risk assessments had been completed and reviewed to identify any concerns about the ability of the individual to take responsibility for their medication. Secure storage is provided in individual’s accommodation. In talking with a number of individuals they spoke positively of the approach of staff who “always treat us well” and “treat us with respect”. They also confirmed that they felt their privacy was respected and importantly felt able to choose how they spent their day, “its always up to me what I do here”. A comment from a relative was, “the home respects my mother’s need for privacy and as much independence as she is able to manage”. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 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. 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. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: The home has an activities organiser who visits 2 or 3 times a week undertaking activities such as quizzes, games and exercise. Individuals I spoke to said they felt there was “enough going on” “ there’s enough for me”. A recent trip to the local zoo had also been arranged and individuals said how much they enjoyed this and would like to have more opportunities to go out. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 13 From the Have Your Say questionnaire 5 said there was “always” activities arranged by the home that they could take part in, 1 “usually” and 2 “sometimes”. In talking with staff they felt that they had better routines in the home and some tasks had been delegated to night staff that had previously been done by day staff this had enabled them to spend more time with residents. Visitors are encouraged to the home and individuals I spoke to said how the “staff were always friendly and welcoming” “its such a friendly environment”. Relatives response to Have Your Say questionnaire all said that the home “always” helps in keeping touch with their relative and were kept up to date with important issues affecting their relative (such as being admitted to hospital or had an accident). One relative commented, “staff were excellent, kept us informed of mum’s progress”. The home provides a varied and homely range of meals and records of meals provided were looked at to confirm this. In talking with individuals they all said how much they enjoyed the food provided however there were a number who spoke of the lack of daily lunchtime choice. Whilst there is always a choice available this is not made known to residents in that staff felt if someone said they didn’t like something there would always be an alternative rather then a clear choice on the day. In talking with the cook and manager about this they said how they were looking at changing the menus and would be involving people who live in the home in this opportunity to provide a greater variety of meals. Whilst I recognise the possible practical difficulties in providing a daily choice there is the option of asking individuals the previous evening what their choice is for the following days main meal. Indeed this is a practice that is widely available in care homes I inspect and does offer a better quality of service to people who live in the home. In response to “Do you like the meals in the home”, 5 said “always”, 3 “usually” (From Have Your Say questionnaire). Following an environmental health inspection the home has been awarded 4 stars Food Safety Certificate reflecting good hygiene practice. This is to be commended. In talking with people who live in the home they felt that there was a lack of routine “other then meals” and said how they were able “to choose when I get up and go to bed its always up to me” “its very relaxed here”. One individual I spoke to who spends most of her time in her room said that was what she preferred and she never “feel I have to go to the lounge staff understand this is what I want”. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 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. 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 has clear procedures and policy in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having a policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: When talking to individuals in the home I asked what they would do if they were unhappy about anything. All spoke of telling “a member of staff”, tell “my care worker”. They said they knew they could if they wish make a complaint, all respondents to the “Have Your Say” questionnaire said they were aware of the home complaint’s procedure. There had been no formal complaints since the last inspection; however, a relative had written to the manager about a situation they were unhappy with. I looked at the response and it was appropriate and clearly the matter had been dealt with as required and sensitively. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 15 All staff attend Safeguarding Adults training and on the previous inspection staff illustrated a good understanding of abuse and how to response to any allegations made by individuals in the home. Littlecroft Residential Home DS0000061093.V335511.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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents EVIDENCE: In walking around the home it was very evident that there is a high standard of cleanliness and individuals I spoke to confirmed how the home is always clean and free from unpleasant odours as on the day of this visit. This was also confirmed in questionnaires, all respondents saying the home was “always” fresh and clean. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: Staffing arrangements are satisfactory and rotas showed that there are adequate staff available. Staff are on duty 2 am until 6 pm, pm 2 until 10pm with waking night and sleep-in member of staff. In addition there is deputy on duty part of the day. I spoke to individuals about staffing in the home and they told me that they felt there was “sufficient staff” “always there when you want help” “they are there to help me if I want it”. It is a policy of the home that staff undertake NVQ 2 or 3 reflecting the importance placed on staff having the necessary skills and competence. Staff records looked at showed that the required training had been completed: Moving and Handling, Fire safety. In addition there are a range of training opportunities available to staff including Managing Continence, Dealing With Constipation and Stoma, Urostomy care. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 18 Staff recruitment records were looked at and showed that the necessary checks had taken place with two references being obtained and Criminal Record (CRB) checks. I also signed off a number of CRB certificates as having been seen. Application forms gave the required information about the applicant including full employment history and health declaration. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 19 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): 33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for residents and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff is protected. EVIDENCE: The home undertakes regular questionnaires to residents and relatives as part of their quality assurance importantly providing an opportunity for individuals to give their views about the service they receive. I did not look at questionnaires on this visit but will do so on my next visit to the home. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 20 Residents meeting are regularly held providing further opportunity for people who live in the home to give their views and make suggestions about the service they receive. Records relating to health and safety were looked at and showed that regular checks and maintenance of equipment takes place. Weekly fire alarm tests are carried out, as are monthly emergency lighting checks. The home’s policy regarding the handling of individual’s finances is that they will assist where necessary but individuals or their representatives maintain responsibility and control of their affairs. When dealing with resident’s monies receipts are obtained or if cash given this is signed for by the individual or two members of staff records confirmed this practice. Two individuals raised with me that they were not aware how the home’s amenity fund was being spent or how much was in the fund. I discussed this with the manager and he showed me an account of the monies and how they had been spent. It was agreed that the home’s monthly newsletter would be used to inform people who live in the home about the money in the amenity fund and how it was being spent. Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 21 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 22 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. 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 Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Littlecroft Residential Home DS0000061093.V335511.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!