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Inspection on 20/09/05 for Littlecroft Residential Home

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

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 is good recording of care needs and residents felt the care provided was "all I could ask for" "they couldn`t do more for me". Residents also commented on the good care provided by staff "I only have to ask and they will help me" "they are all very caring" "all very good". Training of staff is very good with a strong commitment for all staff to have NVQ qualification, which helps in making sure staff have the skills and knowledge to offer a quality service to residents.

What has improved since the last inspection?

No requirements were made at the last inspection though a recommendation to have a resident`s questionnaire has been carried out and gave positive comments about the quality of care at the home. The lack of level access to the garden has also been addressed with the installation of a ramp.

What the care home could do better:

The only area identified from this inspection was about the need to improve practice in relation to the formal supervision of staff.

CARE HOMES FOR OLDER PEOPLE Littlecroft Residential Home 44 Barry Road Oldland Common South Glos BS30 6QY Lead Inspector Jon Clarke Unannounced 20 September 2005 09:30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Littlecroft Residential Home Address 44 Barry Road Oldland Common South Glos BS30 6QY 0117 9324204 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Quality Care Home Limited Mr Mark Anthony Hewlett PC Care home 17 Category(ies) of OP Old age (17) registration, with number of places Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29-Mar-2005 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 accomodation for up to 17 older people. There are 17 single rooms, 10 of which have en-suite facilities. There is lounge with conservatory, a smaller lounge used mainly for visitors and dining area. Residents accomodation 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). Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. The manager and deputy manager were present during the inspection. Documents looked at included care plans, assessments, daily records, medication, recruitment and training. A number of residents and staff were spoken with to find out their views about living and working in the home. The results of a resident’s questionnaire were also seen. What the service does well: 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. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The necessary information is provided about potential residents to enable the home to make a judgement about whether they can provide the care to suit the individual’s needs. EVIDENCE: Assessments undertaken by the local authority were seen giving the health and social care needs of the individual. The home also completes an assessment on admission providing information about the routines, likes and dislikes and other personal information. A letter is sent confirming the home can meet the individual’s needs and informing the prospective resident of the trial period. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9 Individuals’ care plans provide the necessary information so that care staff are able to meet the care needs and associated tasks of residents. The arrangements for the managing of medication makes sure that the health and welfare of residents are protected. EVIDENCE: Care plans showed detailed information about the person’s care needs and their abilities, such as washing and dressing and managing personal hygiene. Mobility and handling assessments are completed, as are risk assessments. Regular reviews are held. The individual, if able, signed care plans. Medication administered records accurately recorded the giving of medication. The storage of medication is satisfactory, including that of controlled drugs in a secure separate cupboard. Records of returned medication were signed to show receipt by the pharmacist. Where able residents self-administer medication and a risk assessment is completed. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 9 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Dietary needs of residents are well catered for, with a balanced and varied selection of meals that meets individual choice. EVIDENCE: Residents confirmed the quality of meals provided: “ always good”, “ they know what I like” and “ I always enjoy the food”. Another resident commented how much they enjoyed the food: “ always can have something different”. In discussion with the cook she showed an awareness of residents’ needs, likes and dislikes and the importance of meals in the residents’ lives: “ Mrs ------doesn’t like ------ so I always do her something else” “ Mrs ----- only has -----” Menus showed a wide variety of meals, with a choice always available if a resident doesn’t like the meal on the menu. Menus changed weekly and seasonal changes are made. Residents have made suggestions about the food provided and these have been acted on. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 10 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The arrangements for the making of complaints are good with residents feeling confident that any complaint they make will be listened to and acted upon. Residents are protected as far as possible from the risk of abuse by staff being trained in this area and through the home’s policies and procedures. EVIDENCE: A number of residents commented that they “ would always say something” or “speak to someone” if they were unhappy about anything. They were aware of the complaints procedure, which is included in the home’s Statement of Purpose and informs complainants of their right to contact the CSCI if they wish and also gives timescales for responding to any complaint. Residents said they felt they would be “listened to” and “something would be done”. The home has a Vulnerable adults policy and staff have attended Adult Protection training. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 11 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The home provides a safe and well-maintained environment. EVIDENCE: The home is in good decorative order, with ongoing plans to decorate rooms as they become vacant and undertake any necessary repairs and updating. Maintenance of equipment takes place at regular intervals. Installation of a lift has improved access to the upper floors of the home. The manager discussed the improving of the exterior of the home. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 12 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29, 30 The home’s recruitment and training practice is thorough to make sure that individuals are suitable to provide safe and competent care for residents. EVIDENCE: Recruitment records seen (3) showed necessary checks through references and Criminal Record check. Application forms gave full information and details about previous employment. Medical declaration is obtained, stating that the prospective employee is physically and mentally fit to carry out the work required. Training records showed a good level of training around the mandatory areas of training - ie moving and handling, health & safety, food hygiene. Staff have also received training in the managing of continence, Physical & Psychological Care of the Dying. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 13 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 36 Residents are able and encouraged to comment on the quality of care provided in the home and there is an environment that recognises residents’ rights so that they feel empowered to contribute to the life of the home and the way care is provided. The home fails to provide regular structured supervision so that professional practice and development of staff is addressed in a formal way. EVIDENCE: Residents’ meetings are held every three months. Minutes showed residents had made comments and suggestions about the food provided and in discussing with the cook these had been followed up. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 14 Residents also made suggestions about outings and activities in the home. The providing of benches and additional seating in the garden had been discussed and both of these issues had been dealt with - ie there are now benches and additional seating in the rear garden. Staff meeting minutes showed that the issue of residents’ laundry had been raised; this had previously been discussed at a residents meeting. Resident’s questionnaires (May 05) gave positive comments on the care provided. In response to how residents were treated by staff the following comments were made: “very well indeed, just as I would wish to be treated”, “Treated very well” ,“excellent” and “I’ve always been treated well here.” Comments about wishes being respected included “most definitely”,“yes certainly”. Records of 8 members of staff showed that supervision or staff reviews had taken place but the practice was very variable, with some staff not having had any since 2004; another who had started in March 05 had not received any formal supervision. Staff confirmed the lack of regular supervision, though did comment that they did feel able to approach the deputy and manager if they had any concerns or worries. However, whilst this is a positive of the home it doe not replace the need for structured supervision of staff. Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x 2 x x Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 16 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 36 Regulation 18 (2) Requirement Staff to be appropriately supervised to include formal supervison recommended 6 times a years. Timescale for action From 20/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Littlecroft Residential Home D56 S61093 LittleCroft V238873 200905 Stage 4.doc Version 1.40 Page 18 - 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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