CARE HOME ADULTS 18-65
The Crescent Care Home 7 South Crescent Headland Hartlepool TS24 0QG Lead Inspector
Gavin Purdon Announced 7 June 2005 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 Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 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 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 Theresa Evans CRH 9 Category(ies) of LD Learning disability (9) registration, with number of places The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 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. Date of last inspection 6 December 2004 Brief Description of the Service: The Crescent Care Home is a nine bedded home for adults with learning disabilities. It is located in a substantial old terraced house on the sea front at Hartlepool Headland, overlooking the town walls and pier. 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 DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced, it was conducted by one inspector, and took seven and a half hours to complete. Before the inspection, the inspector received some useful up to date written information from the registered manager of The Crescent about the people living and working there, and things that had happened since the last inspection. The inspector was also sent some written comments by a relative of one of The Crescent’s residents. As part of the inspection the inspector talked to a group of 3 residents about life at The Crescent,and talked to 2 relatives about their experiences of having a family member live at The Crescent. The inspector was also able to speak with a social worker who knows this home very well, and a local authority work placement officer involved with some of The Crescent’s residents. The inspector also spoke with 2 members of care staff, a volunteer,and the management team of the home. These were detailed discussions, based on the national minimum standards, looking at how the care needs of specific residents are managed and provided for. This inspection did not look at The Crescent’s paper work in equal depth, but enough of it was seen to establish that there is a proper regard for the provision of policies and procedures and care taken to operate according to set plans and to keep good records. The inspector was also introduced to and spoke briefly with The Crescent’s other 4 residents. What the service does well:
The Crescent is good at fetching the best out in people, be they residents, members of staff, residents’ relatives, volunteers or outside professionals. The Crescent takes an open, positive, welcoming and enthusiastic approach to the work. It is a small scale service compared to some, but it runs with a level of organization, accountability, and attention to detail more typical of larger settings. The Crescent has just won the Investors In People award, which requires businesses to have good aims, policies, and procedures, that people understand, are happy with, and feel able to follow. Residents told the inspector, “It’s pretty good here.” “I like the view over the harbour.” “I share my bedroom. It’s alright.” “We have meetings to discuss things, going to the caravan and that.” “ I’ve got a key worker and like going into the town with
The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 6 them.” “ We went to Spain on holiday.” “ We do things, play bingo, go to the disco.” “ You can ask the staff about things.” “ I do things, I keep my bedroom tidy and help clean the garage.” “ The food’s good.” Relatives told the inspector, “ It’s a friendly home. If there’s a problem it gets ironed out. It’s not just a job for them, they are very professional, but very friendly. It’s like being at your aunty’s. They are on the ball. They know what’s going on, they are organized, but they always ask what it is that you want. I couldn’t have done what they’ve done. I would have been too anxious.” “It’s been a good thing for him coming to the home . He can do a lot of things that he never used to. I’ve seen development and change. This home has been good at doing that .” A social worker commented, “ The Crescent is prepared to go over and above. They are committed. They will identify difficulties and deal with them. They are knowledgeable but they will seek advice and they are very flexible. The Crescent has a good name.” Another outside professional commented, The Crescent encourages residents and is keen for them to develop skills. They believe in what they do. They believe in residents having good successful experiences.” Staff commented, “Some residents haven’t been that skilled, and it’s been good to work with them and see them do loads for themselves. If somebody manages to do something, we see that as a big thing, and everybody’s really pleased about it. You can’t take chances, but you can’t wrap them up in cotton wool either. You look at how the dangers can be dealt with, and you talk to everybody about the best way to go about things.” What has improved since the last inspection?
The one requirement, and four of the six recommendations, made at the last inspection have been attended to, with firm plans to deal with the two remaining recommendations. The inspector saw the required revisions to The Crescent’s Statement of Purpose asked for by the inspector at the last inspection. The recommended risk assessments for radiators and records of daily checks of bath water
The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 7 temperatures were also seen. Previously recommended induction and foundation training for staff has been completed by an external training provider. As such The Crescent has taken steps to improve safety measures for the benefit of their residents and can demonstrate that residents are being looked after by staff with a good standards of basic training. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Crescent Care Home DB54 S21731 The Crescent V225833 070605 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 Crescent Care Home DB54 S21731 The Crescent V225833 070605 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) 2 Residents coming to live at The Crescent have a very thorough assessment first. This assessment includes how residents and their families see things as well as what doctors, and social workers, or the care staff at The Crescent, think. This means that the needs of the resident coming to live at The Crescent are well discussed and well understood by everybody involved, and that there is a good plan to meet these needs, that people are happy with. EVIDENCE: A local authority social worker, who has done assessments for residents placed at The Crescent, was able to attend the inspection and discuss specific examples of assessments with the inspector. The social worker pointed out very good examples of professional liaison and support from health, mental health, and social care specialists, and very good support for potential residents and their families from local advocacy services, that contributed to very sound and well rounded assessments. The relative of a resident came to the inspection and told the inspector that they had felt very much involved in deciding what care was needed and how best that might be given. 2 residents who spoke to the inspector said they came to see The Crescent and thought they would like to live there. The Crescent Care Home DB54 S21731 The Crescent V225833 070605 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, & 9 Different residents, at The Crescent, have different care plans, and, as their care needs change, the care plans change with them. This means that care plans at The Crescent keep pace with residents, as, over time, they grow more independent, or, as the case may be, more dependent. The very good assessment practices noted by the inspector are followed through into very good individual care planning practices. Care staff at The Crescent take a lead role in drawing up and revising care plans, helped by residents and their families, doctors, social workers, and advocates where necessary. This means that ways of meeting the day-to-day needs of residents living at The Crescent are also well discussed and well understood by everybody involved, and that people are happy with how this is planned for and conducted. EVIDENCE: The senior member of care staff responsible for care plans showed the inspector an example of a current care plan. The information in this care plan was detailed, organized, clear and accessible, and very much in tune with the National Minimum Standard for resident’s care plans. The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 11 The resident’s needs, and the day to day activities and arrangements to meet these needs were well recorded. The resident’s signature was noted, as were risk assessments regarding what the resident might safely do and what support they required. General aims and objectives of care were seen to be broken down into practical weekly programmes of activity. The 3 residents spoken with by the inspector liked The Crescent, thought it was a good place to live, and that the staff helped them to do the things that they wanted to do. The inspector saw that summary care plans for each resident were kept with the daily record of events for service users, so that these events could be considered and reported on in the light of the background care plan. Care staff spoken to by the inspector were very aware of the care plans, committed to providing care accordingly, and interested in helping to record and evaluate the results, with a view to trying to improve the plan. Relatives spoken to by the inspector felt that The Crescent was good at consulting with them and keeping them in the picture about how care was being provided and how that care might develop. The social worker who met the inspector thought The Crescent was good at empowering residents and that in her experience residents were not shy in making their views known, and that The Crescent would listen to these and do its best to act on them. In her experience, what residents thought about potential new members of staff or potential new residents was an important matter to the home. The Crescent Care Home DB54 S21731 The Crescent V225833 070605 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) 12, 13, 15, 16, & 17 Residents are helped to lead a variety of life styles according to their ages, individual preferences, and personal interests. Residents have a comfortable and convenient base for local work and leisure opportunities, and for staying in touch with family and friends. Residents are shown respect and expected to show respect for each other. Meals and meal times are lively and enjoyable communal activities. EVIDENCE: Staff of the home who talked to the inspector were very aware that different residents had different interests and that these changed as time passed, so that The Crescent had to be flexible about this, slowing the pace for some and increasing it for others. Staff thought there was a wide variety of skills and interests among staff at the home that helped deal with the different interests and preferences of residents at The Crescent.
The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 13 2 of the residents who spoke with the inspector mentioned their leisure interests and achievements. They showed the inspector a number of sports trophies, and competition photographs, including some for the Special Olympics and both were very proud of their success in golf and bowling. Other interests the inspector heard about from residents were shopping, fishing, parties, dancing, snooker, motor bikes, having a beer at the local pub, horse racing, caravanning, and gardening. Some residents said that they enjoyed their work activities helping out in care services for older people and other community services. The inspector met with the local authority co-ordinator for community supported employment for people with learning disabilities who found The Crescent very interested and supportive of residents who wanted to go out to work. The 2 relatives who spoke to the inspector thought that The Crescent was very good at helping residents and relatives stay in touch and to visit one another if that was what people wanted to do. Both relatives thought that in their experience, being at The Crescent offered better opportunities and a better quality of life than they had hoped for and improvements they had not expected. The inspector had lunch with residents and staff. The mealtime was very relaxed enjoyable and friendly. Catering is a staff duty but with residents assisting with shopping, meals, snack and drink preparation as part of their domestic skills activities. Residents who have particular diet requirements have those noted and have the support of specialist advice. The Crescent Care Home DB54 S21731 The Crescent V225833 070605 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 Residents personal care is provided in a way that suits them and is aimed at being as much benefit as it can. EVIDENCE: Staff who spoke to the inspector gave a good account of the effort that goes into providing the right amount and the right kind of care at the right time for residents. Staff are keen to find out what residents like, and what ways of working are most successful. Staff said that they were proud of any achievements that they helped residents to make. Staff thought they were enthusiastic about finding solutions to problems and that they felt really good when a resident managed to do something they had not been able to do before. The Crescent has a fairly settled staff group, and group of residents. It is impressive in a situation where staff and residents know one another quite well that so much effort still goes into written plans and records of the care provided to residents, and that this is seen as very proper and necessary by the staff team. It is also impressive how ready The Crescent is to seek and incorporate outside specialist advice and guidance into care plans and practices for the benefit of residents.
The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 15 The Crescent has male and female residents and benefits from having male and female staff with a wide range of skills and interests. The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 16 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) Not assessed on this occasion. EVIDENCE: The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 17 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) Not assessed on this occasion. EVIDENCE: The Crescent Care Home DB54 S21731 The Crescent V225833 070605 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) Not assessed on this occasion. EVIDENCE: The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 19 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) Not assessed on this occasion. EVIDENCE: The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 20 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 4 x x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 4 4 x 4 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 4 4 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Crescent Care Home Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 21 yes 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 none Regulation 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. 2. Refer to Standard YA28 YA37 Good Practice Recommendations The stair carpet should be replaced. The manager should continue taking action to ensure that she is qualified to level 4 in care by 2005. The Crescent Care Home DB54 S21731 The Crescent V225833 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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
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