Inspection on 14/12/06 for The Croft

This inspection was carried out on 14th December 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Croft 16/02/06

The Croft 05/10/05

The Croft 16/02/05

The Croft 28/09/04

The Croft 02/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 The Croft 11a Albany Road Morecambe Lancashire LA4 4JY Lead Inspector Mrs Joy Howson-Booth Unannounced Inspection 14 December 2006 2:00 th The Croft DS0000010065.V311974.R01.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 DS0000010065.V311974.R01.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 DS0000010065.V311974.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Croft Address 11a Albany Road Morecambe Lancashire LA4 4JY 01524 410972 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 Mahendranath Bhowruth Mrs Krisnawatee Bhowruth Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: The Croft is a small registered home for up to 6 people of either sex who have a learning disability. The home provides a domestic-type environment of care within a family style home. The home is owned and managed by Mr & Mrs Bhowruth, both being trained nurses. There is one carer who assists with providing care in the home, although Mr & Mrs Bhowruth’s family provide some non-personal care support. Each resident is enabled to maintain and develop their lifestyles with support as necessary from Mr & Mrs Bhowruth, the member of staff and/or or other professionals. The current range of fees for this service are £336.59 per week to £422.00 per week. Further details over fees can be obtained from the registered provider of the home. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first site visit and was unannounced so the registered provider and service users were not aware of the visit. The site visit forms part of the overall inspection for the home which makes sure people are being cared for properly and to make sure the home is a safe place for people to live in. As well as the site visit, judgements have been made about the service based on information supplied by the registered manager. Comment cards were also sent out to service users and relatives/friends. The site visit took place over one half day and included taking time to sit and speak with the service users, observing the registered provider on duty performing the day-to-day routines and examining documents held in the home. The inspector looked around the home, including the lounge, service users rooms, the bathroom and toilet. The tour also provided an opportunity to find out about any improvements made and to see if the home was a comfortable, clean and safe for people to live in. Additional information was also supplied from a pre-inspection questionnaire completed by the registered provider. The site visit was positive with everyone welcoming, friendly and co-operative during the visit. The Croft has been assessed as an excellent. No requirements were made during this inspection, although a small number of recommendations have been made. What the service does well: The five service users spoken with have all lived at the home for a number of years and continue to have firm friendships and relationships both with each other and the registered providers and their family. One resident again commented “we’re one big happy family”. Comments from friends include - “my friend has always been very happy in the home and we are always made very welcome when we visit”; “I feel the home is always very welcoming and friendly and everyone always seems happy and content”; “I always arrive without giving notice and immediately feel at home in a very caring home” and “it is lovely that there is such a comfortable and secure home for the service users”. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 6 The home continues to be run as a relaxed and friendly family environment with each resident having equal say and input. The service and care provided is supportive and respectful and given at a relaxed pace which the service users clearly enjoy. The registered providers continue to act as strong advocates for the ladies who live at the home to ensure they all have a very good quality of life. The member of staff employed has worked at the home for several years and provides both a familiar face and a consistency for the service users. The registered provider continues to have the best interests of the service users in providing the service and ensures that both herself and the member of staff receive training. 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Croft DS0000010065.V311974.R01.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 DS0000010065.V311974.R01.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. 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. There are very good arrangements in place to make sure information is gained and given so that all parties know identified needs will be met. EVIDENCE: The registered provider has already confirmed that any new referral would follow the home’s existing admission procedure which includes - ensuring any prospective resident would have the opportunity to have a number of trial visits, which would mean they would be able to make an informed judgement about the service users, to experience life at the home, allow the existing service users to pass on their comments and feelings, thereby allowing compatibility to be judged. Comment cards received from service users confirmed that they had good information about the home prior to admission, had the opportunity to visit and spend time and had support from their named social workers. The Croft DS0000010065.V311974.R01.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. 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. Service users are enabled to make decisions and follow their own routines EVIDENCE: Three of the care files were examined and again were found to contain a clear plan of care which identifies goals set, actions by whom, short term and longer term goals along with a timescale. All evidenced involvement of the resident and, where appropriate, have been signed by the resident concerned. Discussions with the service users confirmed that they continue to be are able to make choices and decisions about their lifestyles and receive support from the registered provider when necessary. All the service users have their own routines and lifestyles which they are happy with. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 10 Risk assessments are carried out and evidence of these was seen on file. The registered provider has previously confirmed that if the service users wish to attend a new activity she will ensure support and risk assessments are carried out to ensure this is successful. Service users are provided with their own personal attack alarms. The Croft DS0000010065.V311974.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users have a very good quality of life EVIDENCE: Through discussion with the registered provider at this and previous inspections it is clear that it is important to the home’s aims that individual rights to live an ordinary and meaningful life are very important. The registered provider understands the importance of enabling the service users to have the opportunity to achieve their goals, follow their interests and be integrated into community life and leisure activities. Comments from service users include – “I am happy where I am and the activities I get to be able to do here at the home or in the community” The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 12 All the service users were spoken with and continue to say that they are very happy at the home – one resident again made the comment “we’re one big happy family”. Service users again confirmed that they are treated with dignity and respect and, if they have any problems or concerns, they are listened to and the appropriate action is taken. From viewing care records and from discussion with the service users at the home have a personalised lifestyle which they contribute to and make decisions about. Service users attend College courses, social activities, swimming, music lessons, Church, line dancing, craftwork, shopping outings, meals out, seeing friends and so on, using community or the registered providers own transport. Service users speak positively about their achievements. Service users are free to get about their local community and have regular contact with their relatives, friends and neighbours. The service users are also taken on holiday – this year they visited Blackpool. Service users were very chatty about this holiday and it was clear that everyone had a good time. One resident has recently started to attend music lesions and through her interest in music she has written a short story about her father’s life as a music teacher. This story has been printed in her local Church’s newsletter. Service users meetings are still held and, from the minutes read, these continue to be an opportunity for all to have a lively debate about their wishes and activities. Through discussion with the service users and the comment cards they have sent in, all the service users continue to follow their own lifestyles and interests and hobbies. Three service users have recently begun work at the local Colleges’ café. It was very interesting to hear how much they all enjoy this voluntary work and have pride in their own roles and responsibilities. Comment cards received from local neighbours and friends all comment positively about the service - that they see the service users about and all spend time talking with them. Comments include “It is lovely that there is such a comfortable and secure home for the service users”. The menus submitted by the registered provider evidence that an appropriate and nutritional diet is provided. Service users confirmed that they were happy with the meals provided. The Croft DS0000010065.V311974.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The registered provider is proactive in ensuring the healthcare needs of service users are met EVIDENCE: From discussions with the service users they are all very happy with the care provided at the home and are able to maintain their independence as much as possible, with support as needed. Service users again confirmed their routines are flexible and of their own choosing and this is endorsed by the relaxed atmosphere in the home. Care plans are signed by the resident themselves and include reviews. Each of the service users has their own clothing and personal care routines and assistance is given to make sure their appearance is appropriate. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 14 The care files examined evidence that each person’s healthcare is maintained and, from previous discussions, the registered provider acts as a strong advocate for each of the ladies accommodated. It was evidenced that the service users have access to a range of healthcare professionals, including orthopaedic clinic, podiatry clinic, warfarin clinic, GP, Dentist, and Community Learning Disability Nurse. Yearly healthcare checks are offered to the service users. There is clear evidence that the home provides the support and help needed for the service users to improve on their healthcare. Through observation at this inspection and from reading the daily diary records that one resident has notably improved health. This is mainly due to the dedication and input of the registered provider and the companionship and friendship offered by the other service users in this close knit home. This is an excellent demonstration of the registered provider’s commitment to the service users who she cares for. Medication records were examined and found to be accurately maintained. At a previous inspection it was noted that each resident has a signed consent form on their care file as it is there preference for the registered provider to manage their medications. Additional information has been written which includes guidance over the type of administration of medications to avoid any confusion. The registered provider asked about changing the medication system but it was felt that the system currently used works well and there is no need to make any changes. The Croft DS0000010065.V311974.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users are listened to and safeguarded EVIDENCE: Discussions with service users again confirmed that they all feel their views are listened to and acted on. Observations during this inspection again confirmed that the interaction between service users and between the service users and the registered provider is excellent, with opinions and views being sought and freely expressed. The service users all know that if there is a problem they can talk with the registered provider or their social worker and were able to speak in private. Comment cards received from the service users all indicate they know who to speak to if they are not happy, they feel they are listened to and the carers listen and act on what they say. The home has a complaints procedure in place and the registered provider has confirmed there have been on changes to this. This home benefits from being run as part of a family environment and there is only one external member of staff employed. As noted in previous inspection reports, abuse awareness training has been accessed by both the registered providers and also by the member of staff. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 16 There is a policy which outlines the actions to be taken should an incident of abuse be suspected or occur. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 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. 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. The home provides the service users with a homely and comfortable place to live EVIDENCE: On arrival at the home it was noted that the garden area is untidy and not presenting as positive an image as would be expected. This was discussed with the registered provider who confirmed that she was aware of this and is currently undertaking a clean up of the whole garden A tour of the home saw that each service users’ room was clean and tidy and all were personalised with their own individual treasured possessions. The bathroom flooring is needing attention, around by the shower area, and some parts of the stairway are needing a coat of emulsion as the walls are marked. These were brought to the attention of the registered provider who The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 18 confirmed they would be addressed as part of the ongoing redecoration programme. The newly decorated and carpeted lounge was used to speak with the service users and provides a comfortable and homely environment for the people to relax in. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The service users continue to be cared for by a competent and trained member of staff who is able to meet their needs EVIDENCE: Service users confirmed they continue to be happy with the care given by the one member of staff at the home. At the previous inspection it was confirmed that the member of staff has undertaken the Learning Disability Awards Framework (LDAF) training, a formal induction programme, Food Hygiene and First Aid course. At this inspection it was noted that a course on moving and handling has been attended and the carer has nearly completed the National Vocational Qualification Level III. No new members of staff have been recruited but it has already been confirmed that the home has an appropriate procedure in place to ensure all The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 20 the required checks are carried out prior to commencement of employment for any future staff. Supervision is now held every 3 months and supervision records were seen during this inspection. The member of care staff was not on duty at the time of this inspection so was not spoken with. However, this member of staff has now worked at the home for a number of years and, according to the registered provider, remains very happy and is an asset to the home. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users live in a safe and well-managed home EVIDENCE: The registered provider achieved National Vocational Qualification Level IV in March 2005 and the Registered Managers Award in April 2005. Training for the registered provider since the last inspection has included – sexuality, updates on mandatory training and attendance at a moving and handling course is being planned. At the last inspection, it was recommended that the registered provider try to access a course in “person centred approach” care planning offered by a local trainer. It was confirmed that the registered provider has now accessed this training and feels it has provided some information but also confirmed the good practices that currently are in place in the home. As well The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 22 as this, both registered providers have managed the home for a number of years and are very well experienced in the care of people who have a learning disability. Comment cards received from service users all indicate they are very happy with the care provided by the home. Comments received from friends and relatives include – “we are always made very welcome when we visit”; “I feel the home is always very welcoming and friendly and everyone seems very happy and content”; “I always arrive without giving notice and immediately feel at home in a very caring home”; and “It is lovely that there is such a comfortable and secure home for the service users”. Service users meetings are held every 3 months and minutes of these were seen during this inspection. Service users again confirmed their opinions and views are sought on daily aspects of the home and their own personal lifestyles. The home is also the home of the registered provider. Information supplied by the home confirms that regular maintenance takes place on equipment and facilities in the home. Fire drills also take place. The home’s accident book was seen during this inspection and was appropriately maintained and no issues were raised. Information supplied by the home indicates that whilst there are policies and procedures in place there is no review date for these. It is recommended that all policies and procedures be reviewed at least annually to ensure they reflect legislation and current good practices. Service users and the registered provider were not aware of this inspection but time was available to spend talking with the inspector in a relaxed and unhurried way. The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 23 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 X 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 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 3 X X 3 x The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 24 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. Standard 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 YA42 YA24 Good Practice Recommendations Policies and Procedures should be reviewed on an annual basis (or sooner if required). The bathroom flooring near the shower needs attention. The walls going to the upstairs are marked and would benefit from a coat of emulsion The garden area outside the home needs tidying up The Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Croft DS0000010065.V311974.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!