Inspection on 26/07/05 for The Crescent

This inspection was carried out on 26th 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.

Other inspections for this house

The Crescent 02/10/07

The Crescent 19/07/06

The Crescent 19/12/05

The Crescent 19/10/04

The Crescent 05/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Crescent 1 Island Crescent Newquay Cornwall TR7 1DZ Lead Inspector Alan Pitts Unannounced 26 July 2005 10:00 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 Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Crescent Address 1 Island Crescent, Newquay, Cornwall, TR7 1DZ 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) 01637 874493 01637 854254 Mr Michael Westmore Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/10/04 Brief Description of the Service: The Crescent is registered as a residential care home that provides personal care and accommodation to 14 individuals who suffer from a mental illness. The Crescent is a three storey Victorian building that is situated in Newquay, overlooking the sea. The town centre is within easy walking distance, as are the bus and train stations. There is accommodation for 12 Service Users in the main house and more independent living for two in the annexe flat, which is attached to the main building. The property is a former hotel situated in close proximity to Newquay town centre. There is no designated car park and parking is on the road, this may be particularly difficult in the summer months. The location offers service users easy access to local amenities and shops. Newquay has its own cottage hospital that acts as an outpatient centre for all aspects of medical care, including mental health care. The owner of the home, Mr. Westmore, manages the homes running on a day-to-day basis and also owns a smallholding, just outside Newquay. Service Users can go to help out with a variety of tasks e.g. gardening, grass cutting, mucking out, if they wish. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Crescent is an established home with a stable staff team and a happy, informal atmosphere. Service users were clearly comfortable within this environment. What the service does well: What has improved since the last inspection? What they could do better: The home could do more in respect of staff training and quality assurance programmes. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 6 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 Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 7 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 Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 8 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, 4, 5 Prospective service users have the opportunity to ‘test drive’ the home, and existing service users have the opportunity to voice an opinion about prospective admissions. EVIDENCE: There is a Statement of Purpose that includes the information listed in Schedule 1 of the Care Homes Regulations 2001. The Service Users Guide includes the required information, a copy of this document is made available to all prospective residents. Prospective service users meet with the existing service users, the latter then have the opportunity to voice any opinions about the suitability of the referral to the home. A full care needs assessment is carried out, and all admissions have a one month trial period. There is a Statement of terms and Conditions for each service user. The registered provider should review and amend these to show the individual service users room. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 9 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) 7, 8 Service users are able to make informed choices and as such determine their own lifestyles, within the terms and conditions of residence. Staff are available to offer support where necessary. EVIDENCE: Service users largely determine their own activities and lifestyle. An activity plan, which functions more as a guideline, is included with each care plan. The registered provider holds 6-monthly service user meetings. Service user questionnaires have been used in a quality assurance capacity. Discussion took place regarding the possibility of some of the service users being involved in policy development via a ‘policy group’, and the registered provider undertook to look into this. Any restrictions on service users are agreed with the respective service user, who is asked to sign to this. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 10 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) These standards were not inspected at this time. EVIDENCE: The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 11 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 encouraged and supported to meet their emotional and health needs. EVIDENCE: Service users are encouraged to be as self-caring as possible, with staff offering prompts and support as necessary. Service users and staff were observed to interact well in an informal and professional manner. All service users are registered with a local GP. A consultant psychiatrist and/or CPN’s are involved in the care of some service users. No Service Users are self-administering medication. There are no controlled drugs stored on the premises and no facilities to do this. The registered provider should replace the existing medicines cupboard with a plastic coated concertina door, with a cupboard which complies with the Royal Pharmaceutical Society guidelines and the Misuse of Drugs Act 1971. The main door to this room, which operates as an office, is now fitted with a five lever lock. The Pharmacist visits twice annually. Staff sign for the drug keys at the beginning of their shift. All the staff have completed a ‘Medicines In Care Homes’ course provided by the National Pharmaceutical Association. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 12 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) These standards were not inspected at this time. EVIDENCE: The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 13 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, 27 Service users live in a relaxed, domestic environment, which they are able to personalise to their own tastes. The accommodation suits the service users needs and lifestyles, and independence. EVIDENCE: The premises are suitable for their stated purpose and meet the needs of the Service Users. There is no designated maintenance person, these duties are undertaken by the staff. Rooms have natural light and opportunities for ventilation. The home is situated very close to the local amenities and transport. A new carpet, new worktops in the kitchen and new lino have been provided. Hot water is unregulated, hot surfaces uncovered and windows are restricted. The Provider, who assesses that the risk is manageable, has undertaken an environmental health risk assessment. The Service Users are self-caring and the facilities meet their needs. There are two toilets and two further bathrooms with toilets, all are lockable. Both bathrooms have had new lino put on the floor. The sign on one door which stated ‘Shower and Toilet’, has been masked with tape to accurately read ‘Toilet’ only. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 14 The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 15 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) Service users are supported by a small, but established staff team who know the service users well. Service users are protected by the home’s recruitment policy. Further input in respect of staff training is needed. EVIDENCE: The registered provider is in day-to-day control of the home though his working day varies, and for this reason he enters his hours worked 24 hours retrospectively on the duty rota. The staff undertake generic roles with no designated laundry, domestic, maintenance or catering staff. The current rota shows that there are two members of staff on duty for most of the day, except from in the evening where there is usually only one. No agency staff are used within the home. No staff are under eighteen and no one under twenty one is left in charge of the home. Two staff employment files were inspected which showed adherence to a robust employment procedure. National Training Organisation documentation was available, but this was incomplete and therefore does not show evidence of competence. The registered provider must implement an induction programme that complies with the National Training Organisation (www.topss.org.uk). The registered The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 16 provider stated that all staff had received a copy of the General Social Care Council Handbook. Five of seven staff are qualified to NVQ Level 2 or above. Recorded supervision is occurring on a 6-weekly basis, and is supported by staff and service user meetings. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 17 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) 38, 39, 40, 41 Service users rights and interests are protected, and the involvement of service users in determining their own care is evident. EVIDENCE: The registered provider is in day-to-day control. Miss S. Crosswood is the assistant manager. There are 6-monthly service user meetings. Staff and service users were seen to interact in an open and friendly manner. Service user questionnaires are used approximately every 6 months. There is a variable return rate, though the service users sign to acknowledge receipt of the questionnaires. The registered provider should review the quality assurance tools to provide more focused questions and to widen the scope to other agencies as well as service users. The registered provider should make arrangements for the publication of a summary of the findings, including any action taken in response to these. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 18 The registered provider said he would look to implement a ‘policy group’ including service users for the development and review of the home’s policies. Service users sign to acknowledge receipt of money. Service users purchase their own personal shopping. Small amounts of service user savings are held securely. Records are maintained and supported by receipts were necessary. Service users agree to any restrictions and sign their care plans to confirm this. The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 19 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 x x 3 2 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 3 x 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Crescent Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 2 3 3 x x D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 20 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 35 Regulation 18 Requirement The registered provider must implement an induction programme that complies with the National Training Organisation (www.topss.org.uk). Timescale for action 01/10/05 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. 2. Refer to Standard 5 20 Good Practice Recommendations The registered provider should review and amend the Statements of Terms and Conditions to show the individual service users room. The registered provider should replace the existing medicines cupboard with a plastic coated concertina door, with a cupboard which complies with the Royal Pharmaceutical Society guidelines and the Misuse of Drugs Act 1971. The registered provider should review the quality assurance tools to provide more focused questions and to widen the scope to other agencies as well as service users. The registered provider should make arrangements for the publication of a summary of the findings, including any action taken in response to these. 3. 39 The Crescent D52 d04 9012 The Crescent V235164 260705.doc Version 1.30 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell PL25 4AD 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. 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