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Inspection on 22/11/05 for The Crescent Care Home

Also see our care home review for The Crescent Care Home for more information

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

The people living at the home who were spoken to were content with their living arrangements and felt their lifestyle lived up to their expectations. People were supported and encouraged in their chosen hobbies and pastimes. They said the food was good. The home had good links with local health and social care services and people made use of community facilities. One person said in the build up to Christmas that, "Christmas is always good here," and they were looking forward to the festivities. People liked the home.

What has improved since the last inspection?

The recommendations outstanding from the last inspection have not been completed though the hall carpet had already been bought it has not been laid. The manager was not present at the inspection due to holidays and had not achieved NVQ level 4.

CARE HOME ADULTS 18-65 The Crescent Care Home 7 South Crescent Headland Hartlepool TS24 0QG Lead Inspector :John Trainor Unannounced Inspection 22nd November 2005 10:30 The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Crescent Care Home Address 7 South Crescent Headland Hartlepool TS24 0QG 01429 861350 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Theresa Evans Mrs Claire Morgans Mrs Theresa Evans Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide residential care to one named individual with learning disabilities aged over 65 years until such a time as this care is no longer needed. 7th June 2005 Date of last inspection Brief Description of the Service: The Crescent Care Home is a nine bedded home for adults with learning disabilities and is jointly managed by MrsTheresa Evans and Mrs Claire Morgans. It is located in a substantial old terraced house on the sea front at Hartlepool Headland, overlooking the town walls and pier and is indistinguishable from any other house. This is a heritage and preservation area with much character, but with modern amenities close by. The views from The Crescent, across the harbour and Tees Bay to the Cleveland Hills are exceptional. The Crescent is not a purpose built care home. Its facilities are located on 3 levels and some residents are accommodated in double bedrooms. The Crescent is careful to ensure that the premises are suitable for potential residents and that residents are happy with their living arrangements. Support is provided to the people who live there in such a way as to involve them as much as possible in their own care. A full meals service is provided and relatives and visitors are welcome at the home at any reasonable time. Service users take part in various activities during the day. Generally, The Crescent operates with 1 member of staff per shift, with double cover provided around shift change times, for parts of the weekend and for particular activities. The Crescent does use volunteers occasionally and has a network of dedicated informal supporters. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over four hours during which there was a tour of the building, some of the people living in the home were met and spoken to about their experience of living there and care plans, policies and health and safety documents were inspected. The registered manager was on holiday so the representative on the day of inspection was George Evans who works in the home. 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 The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 6 contacting your local CSCI office. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were inspected at this inspection. EVIDENCE: The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were inspected at this inspection. EVIDENCE: The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were inspected at this inspection. EVIDENCE: The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 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 the following standard(s): 19 and 20. People had their physical and emotional health care needs met and medicines were managed safely. EVIDENCE: People had access to input from primary and specialist secondary health services. Medication was recorded properly, administered from a blister pack and stored safely. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 People were confident their complaints and comments were listened to and taken seriously. The home took adequate precautions to protect people from potential abuse. EVIDENCE: There was a complaints policy in place but it needed updating with accurate contact details for the Commission for Social Care Inspection following a recent change in the office responsible for inspection of this home. Staff had received training in Adult Abuse issues and there was a copy of the multi agency policy and procedure document. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 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 the following standard(s): 24 and 30. Though the building was clean, homely and comfortable some improvement was necessary to make the accommodation safer and nicer for people. EVIDENCE: The home was clean and there was an infection control policy in place. People said they liked the home and it was comfortable. One bedroom had wallpaper pealing form the walls but the proprietors were aware this needed attention. The hall carpet still needed to be replaced despite having it in the garage ready to be laid. One bedroom had a broken radiator guard which needed to be fixed. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 14 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Staff were available to meet the needs of the people living in the home safely. EVIDENCE: Recruitment files showed adequate precautions taken to ensure people were protected by the recruitment policy. Although there was only one care staff member on duty additional staff were called in to enable the inspection to take place and people still be looked after. Most people who live at the home are out during the day participating in employment or leisure activities. There was a dedicated cleaner. Staff supervisions were taking place though one file showed someone had requested quarterly supervision and this needs to take place 6 times per year. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 15 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42. Though people can be confident the home is run in a way which takes notice of their views additional focus to the health and safety issues in the home was necessary to ensure potential risks were managed safely. EVIDENCE: Service user meetings were held quarterly and recorded. People spoken to said their views were taken notice of. Questionnaires have been used in the past though there was no formal quality assurance tool in place to measure outcomes based on the statement of purpose as declared by the provider. Fire equipment was checked annually but there was evidence doors were being wedged open and the fire safety risk assessment needed review to ensure risks were properly managed. The landlord gas safety certificate could not be found to evidence the safety of the installation. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 16 The electrical hard wiring certificate was not completed correctly so the safety of the installation could not be verified. Pat tests could not be produced to evidence the safety of appliances. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 17 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 X X X X X Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Crescent Care Home Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 1 X DS0000021731.V252228.R01.S.doc Version 5.0 Page 18 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 YA42 Regulation 23 Requirement Timescale for action 22/11/05 2 YA42 13 (4(c)) Doors must not be wedged open unless by those devices approved by the fire officer for this purpose. Evidence must be supplied to the 16/12/05 Darlington office of the Commission for Social Care Inspection of the safety of the gas and electrical installations including Portable appliances. 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 3 4 Refer to Standard YA24 YA36 YA37 YA39 Good Practice Recommendations The stair carpet should be replaced. Staff should be supervised 6 times per year in line with the National Minimum Standards. The manager should continue taking action to ensure that she is qualified to level 4 in care by the end of December 2005. It is recommended that a formal system of quality assurance be implemented to measure the home meets its stated aims and this information is shared on an annual DS0000021731.V252228.R01.S.doc Version 5.0 Page 19 The Crescent Care Home 4 YA42 basis with residents, the Commission for Social Care Inspection and other stakeholders. The fire risk assessment should be updated with guidance from the fire safety officer. The Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Crescent Care Home DS0000021731.V252228.R01.S.doc Version 5.0 Page 21 - 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. 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