Inspection on 14/08/06 for The Croft

This inspection was carried out on 14th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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.

Other inspections for this house

The Croft 10/07/07

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Croft Thorrington Road Great Bentley Colchester Essex CO7 8PR Lead Inspector Jane Greaves Key Unannounced Inspection 14th August 2006 08:15 The Croft DS0000063989.V308127.R02.S.doc Version 5.2 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 Croft DS0000063989.V308127.R02.S.doc Version 5.2 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 Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Croft Address Thorrington Road Great Bentley Colchester Essex CO7 8PR 01206 251904 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) Mr Ramoo Sunnassee Mr Ian J Thomas, Mrs Selimah Thomas, Mr Yoosoof Morowa Mrs Selimah Thomas Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 6 persons) Mr Sunnassee will not have any part in the day to day running of the home 1st March 2006 Date of last inspection Brief Description of the Service: The Croft is a large detached bungalow located in the pretty Essex village of Great Bentley. The home provides care and accommodation to 6 service users with learning disabilities. The roof space has been converted to provide an office, laundry facilities and staff facilities. The bungalow has a large well maintained rear garden that backs on to fields with a substantial vegetable plot and barbecue area. There is some ‘off street’ parking to the front of the property. There is an outdoor swimming pool that is currently fenced off for safety reasons and this area is currently under consideration to extend the premises. Charges levied for the care and accommodation provided at the Croft range from £630 - £650 per week, items such as hairdressing, chiropody and aroma therapist are extra costs. Inspection reports published by the Commission for Social Care Inspection were available from the manager on request. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included an unannounced site visit on 14th August 2006 which took place over 4 1/2 hours. 22 of the 38 National Minimum Standards were assessed at this visit and 19 were met. In order to undertake this inspection, evidence has been accumulated from a number of sources. An inspection record has been compiled taking into account any notifications that have been received since the last inspection, any correspondence and matters arising from the previous inspection report. Records, care plans and other significant documents were examined. The residents within The Croft were observed within their home environment and the staff team were observed interacting with them. Relative’s survey questionnaires have been left with the manager for forwarding to residents’ representatives. What the service does well: What has improved since the last inspection? What they could do better: There was no evidence that families and representatives were involved in their loved ones’ care planning or decision making, whilst the manager was able to verbally give examples of where family input had been received there was no documentary evidence of this. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 6 The registered manager must ensure that all potential risks to all aspects of individual residents’ daily life are fully assessed under the home’s risk management framework. These assessments must be documented together with the actions required to minimise identified risk and hazards and subject to regular review. The Commission for Social Care require a copy of the home’s summary of the annual quality assurance surveys and the resulting action plan. 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 DS0000063989.V308127.R02.S.doc Version 5.2 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 Croft DS0000063989.V308127.R02.S.doc Version 5.2 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents could be confident that their individual care and welfare needs were assessed before being admitted into the home on a permanent basis to ensure the home could meet their needs. EVIDENCE: The home had not admitted any new residents since the previous inspection visit and the home’s admission policies and procedures were in place and subject to regular review. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 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): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents could be confident that their changing needs were reflected in their individual care plans and support was provided with decision making and risk taking within individuals’ capabilities. EVIDENCE: The previous inspection report for this service identified that care plans did not contain evidence of regular reviews. The registered manager had since developed a system to ensure that the care plans were reviewed 6 monthly in house. Historically the home had experienced difficulty in obtaining local authority reviews and assessments for some residents. It was reported that placing authority reviews had taken place for 3 residents with complex needs for the first time for three years despite concerted efforts by the manager to obtain more frequent regular assessments. This client group did not have the cognitive awareness to make conscious decisions; the registered manager reported that decisions affecting the residents’ health, safety and well being were made on their behalf by the home The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 10 in conjunction with family/representative where possible. The manager was able to provide instances where families had been involved in decision making processes however there was no documentary evidence of this. The registered manager was able to demonstrate that some areas of risk had been assessed surrounding the residents and their life at the Croft such as one resident who had difficulty walking up ramps. However there were many areas of daily life that were not underpinned by risk assessments and a discussion was held with the manager around what constituted a ‘risk’. The manager requested a copy of the guidance issued by the Commission for Social Care Inspection. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 11 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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were supported to lead as fulfilling a life as possible within their reduced capabilities, were encouraged to maintain family and friendship links outside the home and received a nutritious and appealing diet. EVIDENCE: The residents living at the Croft did not have the physical abilities or the cognitive awareness to undertake work outside the home. The registered manager was appointee for 5 of the residents and actively supported them with benefits and finance problems. One resident had a good understanding of money and was supported to maintain her own finances. The residents were supported to visit the local shops and attend community events such as the carnival. One resident who had been ‘withdrawn’ and unable to do much exercise was now reported to walk the length of the village and chat happily with passers by. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 12 It was reported that family members were always welcomed at the home and that the residents were actively encouraged to maintain family links. One resident had been supported to attend a Christening; the home had provided transport to enable them to attend. On the day of this inspection visit one resident received a telephone call from a family member and the manager reported that another received a regular monthly visit from relatives. As at previous inspection visits to this service it was observed that there were no strict daily routines and that the home was run as a family unit. Mealtimes and activities were arranged around variables such as the weather, individuals’ arrangements and commitments on the day. Residents’ health and well being were ensured by the provision of a nutritious, varied and appetising diet. Mealtimes were relaxed and unrushed. Food hygiene training had been provided for all staff members. The kitchen was in good repair and adequate food stocks were maintained. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 13 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): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents received sensitive and flexible support for their physical and emotional health needs and were protected by the home’s medication policies and procedures. EVIDENCE: Staff provided personal support for residents according to their assessed needs and wishes. Residents did not have the ability to verbalise their preferences regarding moving and handling, a community nurse had visited the home and made assessments of individuals’ needs for care staff to follow. The registered manager reported that as a result of the community nurse’s visit an occupational therapist was due to attend the home however this had not yet taken place. Personal support was provided in private and where practicable by a person of the same gender, it was reported that a female member of staff was on duty at all times. The registered manager reported that the residents were not ‘woken up’ but as they woke they were provided with support with their personal hygiene and dressing. Some of the residents were able to select their own clothes to wear. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 14 Evidence was available to confirm that residents were supported to access NHS healthcare facilities, records of appointments made and attended were present in the care plans. A discussion took place with the manager regarding more appropriate recording to provide a clear audit trail of the outcome of the healthcare appointments and the impact on the individuals’ plans of care. Visits from healthcare professionals took place in the privacy of the residents’ own bedrooms. No resident at the home was able to self medicate. All the staff team had received training in the safer administration of medicines; a training course was taking place on the day of this visit. Medication was stored appropriately in a locked cupboard secured to the wall of the office. Medication Administration records were maintained appropriately. The manager reported the GP undertook regular reviews of individuals’ medications. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their families/representatives could be confident that their views were listened to and acted upon and that the home had policies and procedures for safeguarding vulnerable adults. EVIDENCE: There had been no complaints, concerns or allegations received by the home or the Commission for Social Care Inspection since the previous inspection visit to the service. The home’s policy and procedure for dealing with complaints was subject to an annual review. All the staff team had attended training in the Protection of Vulnerable Adults. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a homely, comfortable and safe environment that appeared clean and hygienic on the day of the inspection. EVIDENCE: A physical tour of the building was undertaken as part of this inspection process. The home was clean with no unpleasant odours and was comfortable light and airy. The staff team had attended infection control training. The bathroom had been retiled and fitted with a ‘walk in’ bath and wheelchair friendly shower since the previous inspection. New flooring was to be fitted in the days following this visit. Carpets had been replaced in two of the residents’ bedrooms and the office had been re-decorated and re-carpeted. A discussion took place with the manager regarding plans to move the laundry facilities to the ground floor of the home and moving the office into this vacant space. This would result in a room suitable for residents to receive visitors, holding review meetings and staff training sessions. On the day of the inspection a training course was taking place in the residents’ dining area. This is a small home and there were no other facilities available, however, a The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 17 discussion was held with the inappropriateness of this practice. registered manager regarding the The Croft DS0000063989.V308127.R02.S.doc Version 5.2 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 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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ safety and well being was protected by the home’s recruitment policies and procedures and their individual and joint needs were met by a competent and qualified staff team. EVIDENCE: The previous inspection report identified that the ratio of staff trained to NVQ level 2 in care did not meet the required 50 . The manager was able to report that 3 of the 6 staff members had now achieved this qualification and were now keen to take NVQ level 3. It was reported that further staff members currently studying for this qualification were experiencing difficulties as the training provider had ceased to operate. The home had not recruited any new employees since the previous inspection. Two staff files were sampled and were found to contain all relevant documents including evidence of a Criminal records Bureau enhanced disclosure. The manager was able to demonstrate that the service had a budgeted training and development programme. A training matrix provided clear information as to when staff had attended the mandatory training such as moving and handling, infection control, first aid, health and safety, medicines and The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 19 Protection of Vulnerable Adults. There was no service specific training provision at this point however the manager reported that training in epilepsy awareness was planned for. Discussion was held with the manager regarding staff training in communicating with residents with impaired communication skills. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 20 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): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents lived in a well run home. EVIDENCE: The registered manager had the relevant experience to run the home and had been working towards the Registered Managers’ Award. It was reported that, with just one day needed to complete this award, the training provider ceased to operate. The manager reported efforts being made to secure this last day. Mandatory training and refresher courses were attended alongside the staff team. The home undertook an annual quality assurance survey gathering views of the service provision from the residents’ families and representatives, healthcare professionals and other stakeholders, the most recent survey had taken place immediately prior to the previous inspection visit. Discussion was held with the registered manager regarding supplying the commission with a The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 21 summary of the responses received from the surveys and the resulting action plan to resolve any identified shortfalls. The registered manager was able to demonstrate that regular health and safety checks were undertaken. Certificates were available to confirm that gas safety checks, fire alarm tests, and electrical system checks were undertaken and routine visits from the environmental health department were documented with outcomes. The staff team had received training in health and safety, control of infection, Protection of Vulnerable Adults, safer administration of medicines, moving and handling, and first aid in order to protect the health, safety and well being of the residents. Risk assessments were available for any identified hazards within the home, an example being that whilst the bathroom was awaiting repair a risk assessment was in place regarding any potential harm to residents. The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 23 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 YA9 Regulation 13(b)(c) Requirement Timescale for action 30/11/06 2 YA39 24 The registered person shall ensure that any activities in which the residents participate in as part of their daily lives are so far as reasonably practicable free from avoidable risks and that unnecessary risks to the health and safety of the residents are identified and so far as possible eliminated. The registered person shall 30/11/06 supply to the commission a report in respect of any review of the quality of care provided at the home conducted by him and make a copy of the report available to residents and their representatives. 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 The Croft Refer to Standard YA6 Good Practice Recommendations It is a recommendation of good practice that the registered DS0000063989.V308127.R02.S.doc Version 5.2 Page 24 person secures documentary evidence to confirm when residents’ families or representatives have been involved with formulating or reviewing their plans of care The Croft DS0000063989.V308127.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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