CARE HOMES FOR OLDER PEOPLE
The Croft 17 Snydale Road Normanton Wakefield WF6 1NT Lead Inspector
Tony Railton Unannounced 15 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 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 J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service The Croft Address 17 Snydale Road Normanton Wakefield WF6 1NT 01924 893188 01924 898705 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) Croft Carehomes Ltd Sue Porritt Care Home 29 Category(ies) of Older People 29 registration, with number of places The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: There are no conditions of registration. Date of last inspection 1 October 2004 Brief Description of the Service: The Croft continues to provide accommodation and personal care for up to 29 older people. Set back in its own grounds the home is situated in a residential area close to the centre of Normanton and all services and amenities.There is a large drive with parking to the front, a very large lawn to the rear and central courtyard with garden furniture for the use of residents during the summer months. There is a large reception area with an office to the right, large lounge/ dining room and small quiet room to the front. The accommodation is provided on two floors and there is a passenger lift and assisted bathing available. Care is provided by qualified staff and they are supported by other healthcare professionals such as District Nurses, Chiopodist and local GPs. Prospective service users are invited into the home to look at the services provided and visitors are made welcome. Activities are organised on a regular basis for those who wish to participate and there are annual fund raising events arranged. The home is close to a main bus route and situated between Wakefield and Castleford close to the M62/M1 link roads. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector arrived at 10.00 for this unannounced inspection to find residents relaxing in the lounges after morning tea. Care staff were sitting with residents’ socialising and updating their care plans and daily records. The inspector found this was a very positive and enjoyable inspection. Nearly all statutory requirements continue to be met along with most minimum standards. The inspector would like to take the opportunity to thank the residents, manager and staff team for their hospitality and patience throughout the inspection. What the service does well: The relationship between the staff and residents appears to be good. Positive relationships were observed throughout the inspection between residents, carers and a visiting District Nurse. The actions and manner of the care staff was particularly impressive when assisting two residents who could not feed themselves. The carers were relaxed, comfortable, sat correctly and talked to the residents throughout explaining everything that they were doing. The inspector could see that residents were well thought of and well cared for. Clearly, residents’ benefit from living in a relaxed homely atmosphere. Residents’ also benefit from being cared for by trained and qualified staff. The staff turnover is very low and one carer said “ it’s a really nice home” and that she “ could not work anywhere else”. Residents benefit from this continuity of care. The District Nurse said that “ the home is always nice to visit”, she also said that “ residents are well cared for”, and “ always ready for when she visits”. One resident’ said that “it’s a lovely home”, another called the staff “wonderful”. The meals were observed to be well presented and and service users said that they are tasty. One resident said that there’s “always a choice”. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 6 Residents benefit from living in a well run home and on the day of the inspection all parts of the home were clean and free from any unpleasant odours. What has improved since the last inspection? What they could do better: The manager said that she is due to finish her management training in September this year when she will meet the minimum standards. Although residents’ daily and activity records have improved they still need to contain descriptive words to show when residents’ are offered a choice and have a say in what happens to them and what they do. The lounges, hallways and some bedrooms are a little grubby and require some attention, for example, the paper border in the lounge was seen to need sticking back to the wall and dirty marks and scratches were seen on some bedroom walls. Although these things are only minor collectively they make the building look less homely. The manager said that she will provide a plan showing what work needs doing around the home and when it will be done. The person who owns the home and the manager are reminded to send a copy of the record of their monthly meetings to the CSCI. This is important as they show the CSCI that the home is run properly and that any problems are discussed and acted upon. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 7 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 J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 8 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 J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 9 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) 1,2,3,4,5 & 6. The information offered to prospective residents is good and their care and support needs are assessed before admission to make sure that the home can meet them.
EVIDENCE: The Statement of Purpose and Service User guide were seen and continue to give prospective residents the information they need to make an informed choice about the home. The manager said that there is a new information leaflet provided which also contains existing residents’ views on the quality of care provided by the home. She said that she would send one of the leaflets to the CSCI. Residents’ records show that they are provided with a written contract with the home. The manager said that prospective residents and their relatives are invited into the home to look at the services provided before they make a choice, and that visitors are welcome.
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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) 7,8,9,10 & 11 Residents’ support and healthcare needs are met by the homes care planning and reviewing systems. The systems for the administration of medicines are also good and ensure that residents’ medication needs are met.
EVIDENCE: Residents’ care plans seen have improved greatly since the last inspection. They are simpler, easier to follow and are reviewed on a monthly basis. They do not yet, however, use enough descriptive words to show when residents’ make choices about how they live their lives and what they do. Most of the care plans seen show residents’ physical health and support needs, these also need to be balanced with care plans to show residents social needs, as both are very important. The medicine storage and administration systems were checked and found to be safe. The last report following a visit from the Pharmacist showed that the medication system works well. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 12 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) 12,13,14,& 15. Residents are consulted at every opportunity about what they want to do and how they want to live their lives. The meals in this home are good offering a choice and variety to residents.
EVIDENCE: Staff were seen to continually ask residents what they wanted to do and with they way they helped them make choices. Residents’ were also asked what they wanted to eat and where they wanted to have their meal. The activities record showed that residents have the opportunity to join in with organised activities if they want to, and that relatives are encouraged to visit the home and join in. One resident laughed and said that she had enjoyed a visiting Opera singer and that she was “ fantastic, apart from the high notes”. Another said that she “enjoyed the fund raising day for the Tsunami victims”. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 13 Although the inspector witnessed residents’ having autonomy and control over their own lives the carers need to be better at ‘capturing’ this in the daily and activities records. An increase in the use of descriptive words would help to do this and show all the good work going on in the home. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 14 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) 16,17 & 18 The home has a good complaints system showing evidence that residents’ and their relatives are listen to and what they say is acted upon.
EVIDENCE: Complaints are well recorded. The home has had six complaints since the last inspection and records show that they have been handled and dealt with appropriately. The manager said that she welcomes complaints and views them positively. The home continues to provide a complaints and Adult Abuse and Protection Policy and procedure which forms part of staff training. The visiting District Nurse said that she “has no complaints about the home” and that “ staff are always polite and helpful”. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 15 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 & 26. The home has a ‘lived in’ feel to it and is comfortable. The general standard of the environment is ‘alright’, however, residents’ would benefit from some minor improvements to the décor to make the environment more homely and presentable.
EVIDENCE: A relaxed and homely environment was found and residents appeared to be comfortable and happy. Residents’ rooms are personalised, clean and tidy. Some have their own beds and others have brought their own furniture with them. Several of the bedrooms have grubby marks, scratches or small holes and nails where pictures have been and require some minor remedial work to provide a better environment for residents. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 16 The lounges/ dining rooms have a paper border which needs resticking to the wall. The manager agreed that individually many of these appear minor, however, these have an accumulative effect on the general appearance of the home. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 17 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) 27,28,29 & 30. Staff have a good understanding of residents support and care needs and personal support is offered in such a way as to promote and protect service users privacy and dignity, and residents care needs are met by competent and skilled staff.
EVIDENCE: The care staff were observed to be very caring, competent and skilful. Positive relationships were observed between care staff and residents. The manner in which carers conducted themselves and carried out their work is exemplary. Discussion with carers showed an intimate knowledge of residents’ care and support needs. It also showed that they are caring, dedicated and professional. Staff records showed that new staff receive TOPPS induction training and all staff receive training in First Aid and Moving and Handling. The staff on duty said that they have a NVQ Level 2 and one is currently undertaking a Level 3 qualification. Staff records also showed that appropriate checks are carried out including Police and Protection of Vulnerable Adults Register and that appropriate references are obtained. The inspector was impressed by the positive attitude of care staff towards residents and the work that they do.
The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 18 The manager said that the care hours provided have had to be adjusted to reflect the vacancies and number of residents in the home. On the day of the inspection there appeared to be enough staff on duty to meet residents’ care needs in a relaxed and unhurried manner. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 19 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) 31,32,33,34,35,36,37 & 38. The manager is supported well by care staff, providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. Residents’ benefit from living in a well run home.
EVIDENCE: The manager is a qualified nurse and experienced manager who said that she is due to complete an NVQ Level 4 in Management this September. Observation of the interaction between care staff and residents showed that staff and residents benefit from the ethos, leadership and management style of the home. Residents finance records show that they are appropriately maintained and correct. Staff training records show that they receive the appropriate health and safety training and receive
The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 20 regular line management supervision. The Passenger lift and hoist service certificates show that they are well maintained and serviced regularly. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 21 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3
COMPLAINTS AND PROTECTION 2 2 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 1 3 3 3 3 3 3 3 The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 22 N/A 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 OP31.7 Regulation 26 Requirement Copies of the Regulation 26 meetings between the Registered Manager and Resoponsible Individual need to be sent to the CSCI Timescale for action Ongoing 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 OP12.2 OP14 Good Practice Recommendations The record of activities would benefit from descriptive words to reflect and indicate residents choices and preferences. Daily records would benefit from the use of descriptive words to indicate residents choices, preferences and reflect any discissions they make regarding how they live their daily lives. A programme of routine maintenance and renewal of the fabric and decoration of the premis is produced and implemented with records kept. The minor remedial work should be carried out in the lounges and corridors for the benefit and comfort of residents. The minor remedial work in the bedrooms identified should be carried out for the benefit and comfort of residents. The manager should have an NVQ Level 4 Management
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The Croft OP19.2 OP20.7 OP24.1 OP 31.2 qualification. 7. The Croft J51J01_s6174_the croft_v231455_150605.doc Version 1.30 Page 24 Commission for Social Care Inspection Park View House Woodvale Office Park Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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