Inspection on 06/11/08 for The Crescent

This inspection was carried out on 6th November 2008.

CSCI found this care home to be providing an Good service.

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 06/11/06

The Crescent 03/10/05

The Crescent 14/04/05

The Crescent 08/11/04

The Crescent 11/06/04

The Crescent 05/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Crescent 27-29 Meyrick Park Crescent Bournemouth Dorset BH3 7AG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joanne Pasker     Date: 0 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Crescent 27-29 Meyrick Park Crescent Bournemouth Dorset BH3 7AG 01202553660 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rhetor 17 Limited care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 40 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home The Crescent cares for 40 older people in two converted houses that have been joined together. Up to 24 of the 40 people can have nursing care. The home is situated in a residential area close to Meyrick Park and near the centre of Bournemouth. It overlooks the tree lined Meyrick Park Crescent and is close to the regular bus route into the town. Car parking spaces are available in the grounds at the front of the home or in the road immediately outside. There is a large attractive patio area with a fishpond and bench situated at the front and a grass area at the side of the home, both easily accessible by service users and visitors. The home is on two floors with 23 bedrooms on the ground floor and ten on the first floor. 26 of the rooms are single rooms and 7 are doubles. 5 of the single rooms have an en suite toilet. There are five Care Homes for Older People Page 4 of 26 Brief description of the care home bathroom toilets, one bathroom without a toilet, one shower room toilet and one toilet. A passenger lift provides easy access to the first floor and there are a variety of aids and adaptations around the building to allow residents to move about more independently. The current weekly charges for this home range between 450 and 700 pounds. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out over approximately 4 hours on the 6 November 2008. This was a statutory inspection and was carried out to ensure that the residents who are living at The Crescent are safe and properly cared for. The registered manager and owner, Mrs Helen Graham, was on hand to aid the inspection process. Information gathered for this report came from several sources including: -Reports made to the Commission for Social Care Inspection. -The annual quality assurance assessment (AQAA) completed by the home. -2 questionnaires completed by residents. -Tour of the premises. -Review of a variety of documentation including care records, Care Homes for Older People Page 6 of 26 staff records, maintenance records, policies and procedures. -Discussion with residents and staff. During the course of the inspection 11 residents and 3 members of staff were spoken with and asked their views on the service provided at the home. Comments received through the surveys and inspection included: The home is excellent Im very happy here I feel well looked after Good food. What the care home does well: What has improved since the last inspection? What they could do better: Aspects of medication documentation, specifically regarding as and when required medication, could improve. Consideration could be given as to how the daily menu is displayed for the benefit of residents and visitors. Concerns and complaints could be more clearly and accurately documented, specifically Care Homes for Older People Page 8 of 26 identifying complaints from safeguarding alerts received. All staff would benefit from receiving regular refresher updates in safeguarding training. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good admissions procedure by providing sufficient information and visits, prior to admission and only offering places to people whose needs, The Crescent can meet. Evidence: The pre admission documentation for 2 residents was looked at, one of whom had been an emergency admission. Both showed that the home has a good procedure in place, with Mrs Graham undertaking all assessments and writing letters to confirm that the home can meet peoples needs. The home has produced a new, larger format brochure, making it easier for residents and others to read and also includes a link to the CSCI website, encouraging people to view the most recent report. Care Homes for Older People Page 11 of 26 Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear, up to date care documentation is in place and health needs and medication are well managed, ensuring that peoples needs, dignity and respect, are well supported. Evidence: The care files for 3 residents were reviewed and all contained a variety of appropriate assessments. The information from these was then used to develop care plans and all documentation viewed was clear and simple, with good specific interventions written for each persons needs, regularly reviewed and changes updated. A nutritional assessment is now carried out on all residents, specialist disability aids have been obtained for those needing them and a physiotherapy assistant is employed to help with residents mobility. There was clear evidence of peoples health needs being met, with General Practitioner support and regular visits, optical appointments and chiropody provided. Appropriate referrals are also made to specialist services, such as speech and language therapy, Care Homes for Older People Page 13 of 26 Evidence: when needed. The medication storage and administration records were reviewed. All medicines were securely stored and all documentation seen accurately recorded. However, medicines that are prescribed to be given as and when needed (PRN), should record in greater detail why and when these are to be given-either on the medicine administration record (MAR) or in the care plan. Residents spoken with confirmed that they felt well looked after and listened to and received good support from the staff. Observation of care showed that staff had good rapports with people and knew their needs well. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social opportunities, recreational activities and a good choice of food, ensure that peoples lifestyles, choices and preferences are well met. Evidence: The home has a regular programme of activities which residents can choose to join in if they wish. An activities organiser arranges different things including an extend movement group, visiting keyboard player, games, attendance at church services and trips out. Social assessments are carried out for each person and help to provide a more personalised approach to the residents daily lives. Visitors are warmly welcomed and spouses actively encouraged to eat at the home with their partner. All bedrooms contained personal items and were arranged to suit individuals preferences and needs. Lunch on the day was a choice of cottage pie, fresh vegetables and boiled potatoes or an alternative of haddock, with fruit sponge as pudding. Residents were seen to be enjoying their meals and confirmed that they could choose whether to eat in the dining room/lounge or in the privacy of their room. Comments received about the food Care Homes for Older People Page 15 of 26 Evidence: included, The food here is lovely!, Theyll find us something different if we dont like whats on. It was discussed with Mrs Graham how the home could consider displaying the daily menu choices for residents and visitors to see. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good complaints system in place and provides staff with adequate training to ensure that people can feel listened to and well protected. Evidence: The homes AQAA stated that it had received 6 complaints in the last year, all of which had been resolved, however two of these appeared to have been safeguarding referrals-neither of which was upheld. The home has a good complaints policy in place but it is recommended that its procedure for recording information should improve. More details are needed in recording complaints and distinguishing whether it is a complaint or safeguarding referral. The home does demonstrate good practice though by sharing all concerns raised with staff, to try and develop greater understanding and communication. Body mapping has also been introduced for every new admission to the home. Appropriate policies and procedures for the protection of residents from abuse or neglect are in place and all staff have received some safeguarding training. It is recommended that all staff undertake regular refresher courses in this area. When residents responded to the survey question do you know how to complain, both answered yes and felt that the home always responded appropriately to concerns raised about care. Care Homes for Older People Page 17 of 26 Evidence: Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Crescent provides a clean, homely and safe place to live, ensuring that people live and work in a pleasant and comfortable environment. Evidence: A tour of the premises found the home to be clean, pleasant and well maintained. Comfortable communal areas are available and recent refurbishment has included replacing the corridor carpets, fitting a second ceiling hoist and installing a new call bell system. It was discussed that some areas could benefit from redecoration and refurbishment, in order to update them but this is not possible until the call bell system is completely fitted. People responding to surveys and spoken with, said that the home is always clean with no unpleasant smells. The laundry was seen to be well managed and staff aware of good infection control procedures, with evidence of recent training arranged displayed on the office door. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient, well trained staff are employed and safely recruited, to ensure that people are well looked after and protected from unnecessary risks. Evidence: Staff rotas demonstrated that there were sufficient staff on duty to meet the needs of the residents and this was observed in practice, during the inspection. Residents spoken with confirmed that staff were available when they needed them and appeared to have a good knowledge of individuals needs. The home has an on going training programme, which includes NVQ level 2 and 3 in care and at the time of the inspection more than fifty percent of the care staff held the minimum or equivalent of a level 2 award in care. Three staff files were checked and all contained the documentation and information required and demonstrated that the home has a robust recruitment policy and procedure. The staff training file was seen and showed that regular in house courses were held to ensure that staff remained updated in all mandatory areas and fire training received as required. There was evidence of newly employed staff all having an appropriate Care Homes for Older People Page 20 of 26 Evidence: induction course and other staff undertaking additional training in stoma care, Parkinsons, dementia and palliative care. Further information on training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a stable, experienced management in place, supported by good quality assurance and health and safety procedures, to ensure that the home is run in the best interests of people living there. Evidence: The registered manager and owner of The Crescent is Mrs Helen Graham, who is suitably experienced and qualified to manage the home, with a nursing background, current registered nurse status and a foundation degree in care management. Staff and residents spoken with spoke very highly of her and felt that she ran the home well and was very supportive of everyones needs. The home submitted a completed annual quality assurance assessment (AQAA) prior to the inspection, detailing how they currently meet Care Standards and how they plan to improve. Annual questionnaires are given to residents, relatives and other stakeholders, such as GPs, by the home and asked to give their views on the service Care Homes for Older People Page 22 of 26 Evidence: provided. The most recently completed ones were seen and all comments received were positive bar some minor concerns and a GP had described the home as delivering excellent care. Some money is kept on behalf of residents and records and monies checked, showed that this was well managed. The home does not hold appointeeship for any resident. Regular staff supervisions take place, including team meetings and staff spoken with and records seen, confirmed this. All servicing certificates seen were up to date, substances stored securely and regular audits carried out on the accident book, to identify any trends and take appropriate action as necessary. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Medicines that are prescribed on an as and when needed basis should clearly document the reasons why and when they should be given, either in the care plan or on the medicine administration record (MAR). Consideration should be given as to an appropriate way in which to display the daily menu choices, for the benefit of residents and visitors. All staff should receive regular refresher training in safeguarding. 2 15 3 18 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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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