CARE HOMES FOR OLDER PEOPLE
The Croft 94 Irby Road Heswall Wirral CH61 6XG Lead Inspector
Inger Moynihan Announced 13/07/2005 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 Older People. 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 Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Croft Address 94 Irby Road Heswall Wirral CH61 6XG 0151 342 7004 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) Abbeyfield Heswall Society Limited Miss Abita Sharon Pickin CRH Care Home 8 Category(ies) of OP Old age - 8 places registration, with number of places The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: There are no conditions attached to the registration of this service. Date of last inspection 1 December 2004 Brief Description of the Service: The Croft is a single storey building owned by The Abbeyfield Heswall Society. Service users bedrooms are large and are single occupancy. The communal rooms comprise of a lounge/dining room with a conservatory leading off this area. The bathing facilities comprise of a walk in shower and a special bath. The home is set back from the main road so providing a quiet environment for service users to live. The gardens are mature and comprise of lawns and shaded areas for service users to sit. There is parking space for about six cars within the grounds of the home. The home is situated in a quiet residential area on a bus route to local shops. Heswall town centre, which has a good selection of shops, banks and restaurants is within a ten-minute drive of the home. The bus station in Heswall gives easy access to Liverpool and other parts of the Wirral. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over five hours and was the statutory announced inspection for 2005/2006. A tour of the premises took place and service users records were inspected. Four staff and eight service users were spoken to during this inspection. What the service does well: What has improved since the last inspection?
The last inspection took place on 1 December 2004 when two requirements were made in relation to the documentation of risk assessments and training in respect of the conditions of old age. Both of these issues have now been addressed. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 6 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 Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 Service users’ care needs are assessed before they move into the home to ensure the registered manager and staff team can provide the care that is required. EVIDENCE: An assessment of service users individual care needs is carried out prior to any service user being admitted into the home. This ensures the registered manager and staff team are able to meet the service users’ specific care requirements. Service users confirmed their care needs were met in every way. The service users spoken to stated they were completely satisfied with the standard of care they received and commented on the kind and caring nature of the staff team. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Details of service users care needs were compiled into a documented plan of care which gave staff information on how to look after the service users properly. Thorough medication procedures were in place. Service users spoken to confirmed the staff respected their privacy and dignity at all times. EVIDENCE: Service users’ health, personal and social care needs were set out in an individual plan of care. This is in line with good practice and ensures staff know how to care for the service users in accordance with their particular needs. Service users confirmed they have access to their GP, chiropodist and any other healthcare professional to ensure their physical and mental well being. A record of this information is also kept so staff can monitor service users’ general welfare. This is further supported by a system whereby staff spend time each day discussing any issues or concerns that have arisen over the past 24 hours. All of these factors contribute to providing a safe environment for service users to live. Efficient systems are in place for the safekeeping and handling of service users’ medication. To ensure the close monitoring of this medication, only trained
The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 10 senior staff are allowed to administer medication. Documentation was in place to demonstrate staff have undertaken appropriate training in this area. All of the service users spoken to during inspection confirmed the staff team were polite, caring and helpful. Comments included ‘the staff are kind and always rerspect my dignity’, ‘the staff are wonderful, i cant fault them, theyll do anything for me and the care is excellent, the routines are flexible and i can come and go as i please. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The daily routines within the unit are flexible and service users can come and go as they choose. A range of social activities are provided and contribute to creating an interesting environment for the service users to live. A varied and nutritious diet is provided which ensures service users good health. EVIDENCE: A range of social activities are provided which the service users confirmed they were free to participate in if they wish. A number of service users confirmed the activities were appropriate and enjoyable. During discussion they confirmed their friends and relatives could visit the home past any time and they were free to go about their routines as they wished. The menus demonstrated a varied and balanced diet is provided with service users’ medical needs being catered for. All of the service users commented on how much they enjoyed the food with one service user stating I always enjoy the meals and I am given an alternative if I do not like what is being offered. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 A complaint procedure was in place to ensure service users views are taken into account with regard to the care provided. Wirral adult protection procedure was in place to further ensure service users safety and welfare. EVIDENCE: The CSCI has not received any complaints about the standards of care provided at The Croft. The registered manager confirmed she had not received any complaints about the care provided in the home. The registered manager informed the inspector that all staff have undertaken training in relation to the protection of vulnerable adults from abuse. The staff spoken to demonstrated they were clear on the action they would take in the event of them receiving a complaint or suspecting or knowing an incidents of abuse had taken place. They were all so clear on who to contact in the event of this situation occuring. Information on my Action on Elder Abuse telephone line was available to staff and service users. The service users spoken to during inspection all commented on the caring nature of the staff team. Some of these comments included ‘the staff are lovely, i have absolutely no complaints to make about the care. If i did want to make a complaint i know who to contact. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and 26 This standard of decoration throughout the home remains very high and provides a comfortable and pleasant environment for the service users to live. EVIDENCE: The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 14 The standard of the decoration throughout the home remains very high and provides a comfortable and homely environment for the service users to live. An efficient cleaning system has been set up and a member of staff stated they had enough equipment and materials to carry out their work. Sufficient laundry facilities are in place along with systems to ensure the prevention of cross infection. A programme of routine maintenance and renewal of the fabric and decoration is in place. The grounds/garden is kept tidy, safe and well maintained and provide service users with a pleasant area to sit when the weather is good. The staff at the home continue to work very hard to ensure all parts of the home are kept clean and tidy which ensures service users are kept safe within their environment. A selection of bedrooms were inspected and were all noted to be clean and tidy as were the bathrooms and toilets. A number of the service users commented on the standards of cleanliness throughout the home. Service users have sufficient, toilet and washing facilities and there are adaptations and equipment to assist service users with their bathing and mobility. In order to make their environment more homely, service users had personalise their rooms with their own belongings. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 There are sufficient trained and competent staff to meet the service users needs. Thorough recruitment and selection procedures are in place to ensure service users safety and welfare. EVIDENCE: The staff rota indicated the staff were evenly deployed across the week to ensure service users’ care needs are met at all times and to ensure their safety and well-being. The staff spoken to during the inspection confirmed that a range of relevant training was available and that the registered manager encouraged them to become involved in all aspects of training. Through discussion it was evident that staff had completed training relevant to the care of elderly service users. The staff spoken to confirmed procedures were in place to ensure their continual development within their role. The Abbeyfield Society has a positive approach to training and development which ensures service users are being cared for properly and their needs are being met in accordance with current good practice. This also allows staff to continue with their learning and keep up to date with current good practice in relation to the care of older people. Thorough recruitment and selection procedures are in place which includes carrying out the necessary Criminal Records Bureau disclosure checks. This ensures suitably qualified and competent staff are employed in the home and service users’ safety is promoted.
The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The manager offers clear leadership to staff to ensures service users receive a high standard of care. Efficient systems are in place to ensure the home is run for the best interests of the service users. The health, safety and welfare of the service users is well promoted. EVIDENCE: Through discussion, the registered manager demonstrated she was aware of her responsibilities with regard to the management of the home, supervision of staff and the care of service users. The staff spoken to during the inspection spoke highly of the registered manager and senior staff and said they were supportive and approachable. Efficient communication systems within the staff team have been established for the smooth running of the home; staff confirmed the systems are effective for the purpose of their role. The staff spoken to commented they worked well as a team and enjoyed their work. One member of staff spoken to during inspection commented I love my work and have access to arrange a training, we all work well as a team. Discussion with staff confirmed that safe working practices were promoted
The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 17 within the home and they were provided with appropriate training for this purpose. All of these issues demonstrate a high quality of care continues to be provided at The Croft. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 4 x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 4
COMPLAINTS AND PROTECTION 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 x 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 4 x x 4 x x x x 4 The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement There are no requirements resulting from this inspection. Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations There are no recommendations resulting from this inspection. The Croft F52 F02 s18944 The Croft V229022 130705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 3rd Floor, Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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