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Inspection on 13/07/05 for MacIntyre - The Croft

Also see our care home review for MacIntyre - The Croft for more information

This inspection was carried out on 13th July 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

A copy of the statement of purpose was seen during the inspection. A copy of the service user guide is kept on individual service user files. Person centred plans showed that the care needs of service users has been identified and these are recorded and monitored. Wherever possible service users are enabled to take responsible risks with the help and support from staff. Service users are supported by staff to use community facilities, for example, shops, local beauty spots and day centres. It was evident that staff are aware of their responsibilities with regard to treating service users with respect and dignity. The menus showed that service users are offered a choice of meals. Health and personal care needs have been identified and plans are in place to ensure these are met. Plans of care showed that doctors and other health care professionals are involved in caring for service users. MacIntyre Care have an administration of medication procedure in place which ensures service users receive their medication as prescribed. A complaints and adult protection procedure is in place which ensures service users are protected from harm and are able to raise issues of concern. Service users live in a bungalow that is comfortable, safe and well maintained. Single bedrooms are individually decorated and furnished and contain lifting aids to help those with mobility problems. Policies and procedures are in place to ensure staff recruitment procedures protect service users form harm. Staff were seen communicating with service users and encouraging them to make decisions within their capabilities. The home is managed and run in the best interests of service users. The registered manager is experienced and has been employed by MacIntyre Care in a senior capacity for a number of years. One relative/visitors comment card was received which said `The staff always make us feel welcome and I think they do a very caring job. I`m very grateful to them all`.

What has improved since the last inspection?

The re-decoration of the entrance area and laundry has improved the appearance of these areas. A new hoist has been installed in the bathroom. The use of staff from within MacIntyre Care to care for service users instead of agency staff will improve the service offered. There are plans to further the care planning, this will further improve the service offered to service users.

What the care home could do better:

A wider range of activities for service users should be considered. The manager`s working rota should be reviewed so that she has more time to complete her management responsibilities. The home should continue to develop the service users` care plans.

CARE HOME ADULTS 18-65 The Croft 59 Mill Lane Great Sutton South Wirral CH66 3PE Lead Inspector Val Flannery Announced 13 July 2005 2:45 pm 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Croft Address 59 Mill Lane Great Sutton South Wirral Cheshire CH66 3PE 0151 339 1988 0151 339 1988 www.macintyre-care.org MacIntyre Care 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) Mrs Patricia Cox Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home is registered for a maximum of 4 service users in the category of LD (Learning disability) 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 03/02/05 Brief Description of the Service: The Croft is a care home for four adults with a learning disability. Although located in a residential estate in Ellesmere Port the semi-rural area surrounding the home ensures the privacy of service users is protected. A range of local shops, pubs and other facilities are within easy reach of the home. The home is a four bed bungalow, all the bedrooms are single. The rooms are individually decorated and furnished and contain handwashing facilities. A range of hoists and other lifting aids are available to assist service users with mobility problems. Communal space consists of a large lounge and dining room. There is a secure, well-maintained garden to the rear of the home. Sufficient bathrooms and toilets are provided. Staff are on duty twenty four hours a day to deliver care to service users. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over four hours. One hour was spent reading the previous inspection report and reviewing the service history of the home. All the service users were seen during the inspection. The manager and the staff on duty were spoken with. Two students on placement in the home were also spoken with. A tour of the building was carried out. All the bedrooms were seen. One relative/visitor’s comment card was received. Two resident and a sample of the home records were also seen. No relatives or other visitors were seen during the visit. The residents have limited communication skills. What the service does well: A copy of the statement of purpose was seen during the inspection. A copy of the service user guide is kept on individual service user files. Person centred plans showed that the care needs of service users has been identified and these are recorded and monitored. Wherever possible service users are enabled to take responsible risks with the help and support from staff. Service users are supported by staff to use community facilities, for example, shops, local beauty spots and day centres. It was evident that staff are aware of their responsibilities with regard to treating service users with respect and dignity. The menus showed that service users are offered a choice of meals. Health and personal care needs have been identified and plans are in place to ensure these are met. Plans of care showed that doctors and other health care professionals are involved in caring for service users. MacIntyre Care have an administration of medication procedure in place which ensures service users receive their medication as prescribed. A complaints and adult protection procedure is in place which ensures service users are protected from harm and are able to raise issues of concern. Service users live in a bungalow that is comfortable, safe and well maintained. Single bedrooms are individually decorated and furnished and contain lifting aids to help those with mobility problems. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 6 Policies and procedures are in place to ensure staff recruitment procedures protect service users form harm. Staff were seen communicating with service users and encouraging them to make decisions within their capabilities. The home is managed and run in the best interests of service users. The registered manager is experienced and has been employed by MacIntyre Care in a senior capacity for a number of years. One relative/visitors comment card was received which said ‘The staff always make us feel welcome and I think they do a very caring job. I’m very grateful to them all’. 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 Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1/2/4/ Information on the service offered by the home is available. Residents and their representative are able to visit the home prior to making a decision about moving in. EVIDENCE: A copy of the statement of purpose and service user guide are included on residents’ files. New residents have not been admitted for some time as the current group have lived in the home for a number of years. Plans of care seen showed that residents’ care needs have been identified; also that their needs are monitored and action taken to address these changes. It is the policy of the organisation that prospective residents are invited to visit the home before making a decision about moving in. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6/7/8/9/ Service users assessed care needs are included in their plans of care. This ensures staff have the necessary information to care for the service users. EVIDENCE: The resident plans of care seen showed that their care needs are monitored and action taken to address any concerns. Included in the plans is the level of assistance residents need with personal care, moving about the home and attending community based activities, for example, day care centres. Discussion took place with the manager and senior support worker on the proposed changes to the care plans and how these would improve the service to residents. Staff were observed talking to residents and discussing what to have for tea and if they wished to stay in the dining room or watch TV in the lounge. Because of their limited communication abilities, staff have developed an understanding of residents’ care needs and how these are to be met. The records seen, including risk assessments, showed that residents are supported to be as independent as possible. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 11 The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11/12/1/3/14/16/17/ Staff support service users to visit and utilise community facilities. Service users are offered a choice of meals. EVIDENCE: Service users are supported to take part in community-based activities such as day care centres and leisure activities such as visiting local beauty spots. On the day of the inspection staff were planning to take service users on a trip in the mini bus. A list was displayed on the office wall of daily activities for individual service users. Although the home is located on a residential estate there is limited contact with the immediate community. Because of the assessed care needs of service users they require staff support and supervision at all times. Staff are aware that the rights of service users are to be observed when offering help with daily living tasks. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 13 The mealtime seen was relaxed and unrushed. Service users were helped by staff in a discreet and respectful manner with their meal. Menus showed that service users are offered a choice of meals. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18/19/20 Service users are well looked after with regard to their health and personal care. Staff are aware of the level of support service users require with daily living tasks. EVIDENCE: During the inspection staff were seen helping service users with personal care, for example, using the toilet and eating. This was done in a quiet and caring manner. Service users were comfortable in approaching staff for help with different tasks. Plans of care showed that the home is aware of the level of assistance service users require with personal care. Plans of care showed that service users receive visits from doctors, nurses and other health professions. The reason for the visits and the recommended treatments are also recorded in the care plans. Service users’ needs are such that they require staff help with the administration of medication. A sample of the medication administered to service users was seen. These were satisfactory. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22/23 Arrangements are in place to ensure service users and others are able to raise issues of concern/worries. There is a procedure in place for protecting service users from abuse. EVIDENCE: A copy of the complaints procedure was seen during the inspection. It included details on how to contact the Commission for Social Care Inspection. The registered manager said no complaints have been received since the last inspection. CSCI have not received any complaints. An Adult Protection Procedure is available, a copy of which is kept in the home. A copy of the government’s guidelines ‘No Secrets’ is also available in the home. Staff spoken with were aware of the complaints and adult protection procedures and what to do if a problem arose. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24/25/26/27/28/29/30/ The home provides a well-maintained and safe environment for service users. A high standard of accommodation is provided for service users. EVIDENCE: The home is a domestic type bungalow, is well maintained and provides a comfortable environment for service users. Bedrooms are individually decorated and furnished and meet the assessed needs of service users. All bedrooms are single and have hand-washing facilities. Two bathrooms and two toilets are provided for the service users. Communal space consists of one large lounge and a dining room which is next to the kitchen. The garden to the rear of the home is secure and well maintained. Service users would need assistance from staff to use the garden. Lifting aids such as bath hoists, grab-rails and wheelchairs are provided for service users with mobility problems. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 17 On the day of the inspection the home was clean and free from unpleasant smells. The registered manager said the carpet in the corridor and office is to be replaced because of wear and tear. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31/32/33/34/35/36 Staff are employed in sufficient numbers to meet service users’ assessed needs. Staff recruitment procedures are robust and provide safeguards for the protection of service users. EVIDENCE: The staffing rota showed that there are normally two members of staff on duty during the day and one waking staff during the night. The registered manager can be included as part of the rota. Staff on duty were able to discuss the care needs of service users as identified in their plans of care. Staff roles and responsibilities are discussed and re-enforced by the manager in individual supervision sessions and staff meetings. During the inspection staff were observed helping service users with a range of daily living tasks. This was carried out in a calm and sensitive manner. Two staff personnel records were seen during the inspection. Included in the files were Criminal Record Bureau checks, two references and application form. Staff said they have access to training courses including NVQ in care. Records seen showed that staff have access to further training including fire safety, adult protection and manual handling. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 19 The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37/38/39/42/ The home is run in the best interests of service users. Staff are supported and supervised by the manager in the delivery of care to service users. EVIDENCE: The registered manager has worked for MacIntyre for a number of years in a senior capacity. She has achieved NVQ Level 4 in care and has also completed the registered managers award. She has also attended training to manage the day-to-day running of the home. As part of her employment contract the manager works nineteen hours per week supporting service users and nineteen hours per week in her role as manager of the home. Plans of care showed that service users’ care needs have been identified and underpin the overall running of the home. For example, layout of bedrooms, like and dislikes, activities and how their personal care needs are meet. The layout of the communal space ensures service users have space in which to spend their leisure time. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 21 A tour of the building (including the laundry which is in an adjacent building) showed that maintenance issues are addressed. The fire safety record book was seen during the inspection and showed that satisfactory checks are carried out. The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 N/A Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Croft Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 3 F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 23 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 Regulation None 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. 1. Refer to Standard None Good Practice Recommendations The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 The Croft F51 F01 S6667 The Croft V231130 130705 Stage 4.doc Version 1.30 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. 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!