CARE HOMES FOR OLDER PEOPLE
The Croft 94 Irby Road Heswall Wirral CH61 6XG Lead Inspector
Inger Moynihan Unannounced Inspection 21st November 2005 1.00 X10015.doc Version 1.40 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 DS0000018944.V268612.R01.S.doc Version 5.0 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 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 DS0000018944.V268612.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Croft Address 94 Irby Road Heswall Wirral CH61 6XG 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) 0151 342 7004 Abbeyfield Heswall Society Limited Miss Anita Sharon Pickin Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st 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 DS0000018944.V268612.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over four hours and was the statutory unannounced inspection for 2005 / 2006. During the last three inspections all of the documentation required for the management of this service has been examined and is in good order. In the light of this, this inspection concentrated on speaking to the service users and finding out their views on the standard of care they receive while living at The Croft. What the service does well:
Service users are only admitted into the home on the basis of a full assessment, which ensures staff can provide the appropriate package of care. One service user stated each and every member of staff is excellent, I have only praise for them all. Efficient systems were in place to ensure service users good health. One service user stated the staff are very kind and patient, they never rush or hurry me at any time. The service users confirmed the staff always respected their privacy and dignity when carrying out personal care with one service user stating the staff of very discreet when helping me with my personal care and nothing is ever a problem. Efficient medication administration procedures were in place to ensure service users good health. All of the service users spoken to during the inspection confirmed they received their medication as prescribed by their GP. A varied and nutritious diet was provided to ensure service users interest and good health. The service users had positive comments to make about the food provided and said their particular preferences and medical needs were always met. One service user commented I enjoy my meals and a choice is always available. The kitchen was well-stocked with a variety of food and plenty of fresh vegetables. The service users spoken to during the inspection said they were aware they could make a complaint about any aspect of the service and who they could contact in the event of them wishing to do so. One service user commented I get the best of attention from the staff and I have absolutely no complaints to make. The senior member of staff conducting the inspection confirmed staff had undertaken training in relation to the protection of vulnerable adults from abuse, and through discussion with service users, it is clear they were well looked after. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 6 The standard of the decor at The Croft remains very high and provides a comfortable and pleasant environment for service users to live. The Croft has a full complement of staff who were evenly deployed across the week to ensure service users’ care needs were met at all times and to ensure their safety and well-being. Staff have completed appropriate training to ensure service users receive the correct level of care. The leadership, guidance and direction offered to staff ensured a high standard of care was provided and the home was run for service users best interest. The health, safety and welfare of the service users was well promoted. 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 Croft DS0000018944.V268612.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection The Croft DS0000018944.V268612.R01.S.doc Version 5.0 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 the following standard(s): 3 Service users’ care needs were assessed before they moved into the home to ensure the registered manager and staff team could provide the required care. EVIDENCE: All of the service users spoken to during the inspection confirmed their needs were met in every way. They said the staff were fully up-to-date on all of their particular needs and requirements and they felt well cared for. One service user stated each and every member of staff is excellent, I have only praise for them all. A number of service users explained how the staff met their particular care requirements and confirmed they were always up-to-date with their changing needs. It is clear the service users were completely satisfied with the standard of care they received and the way this care was provided. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 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 the following standard(s): 8 and 9 Efficient systems were in place to ensure service users good health. Efficient medication administration procedures were in place to ensure service users good health. EVIDENCE: The service users spoken to during the inspection confirmed they had access to relevant health care professionals when necessary. A record of service users general welfare was also maintained. One service user stated the staff are very kind and patient, they never rush of hurry me at any time. The service users confirmed the staff always respected their privacy and dignity when carrying out personal care with one service user stating the staff are very discreet when helping me with my personal care and nothing is ever a problem. Demonstrating discretion when carrying out personal care is very important and demonstrates the staff have an understanding of this aspect of care provision.
The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 10 A discussion took place with one service user who moved into the home approximately two weeks before the inspection. This service user outlined the fears she had of moving from her own home into a residential care home. She went on to explain how these fears had been unfounded and that the staff had been nothing other than kind and courteous. She said the staff had gone out of their way to meet her needs and to make her comfortable during her stay. The service users confirmed the routines within the home were flexible and they could come and go as they wished. Efficient systems were in place for the safekeeping and handling of service users’ medication and only trained staff were allowed to administer medication. All of the service users spoken to during the inspection confirmed they received their medication as prescribed by their GP. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 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 the following standard(s): 12 and 15 A varied and nutritious diet was provided to ensure service users interest and good health. Limited social activities were provided which could lead to boredom and lack of social interaction. EVIDENCE: The service users spoken to confirmed that two activities took place during the week, one being a game of bingo and the other being a coffee morning. The service users gave mixed views on this situation with some saying they were happy to carry on with their own routines and did not wish to join in group activities. Others stated they would enjoy more varied activities. One service user commented I am happy with the activities provided as this gives me an opportunity to socialise with the other service users, although I do enjoy my own company is well. In the light of this, the registered person is required to assess the service users social care needs and provide a range of appropriate social activities. It should be noted that activities on an individual basis could also be provided within this programme as this one to one time with staff can be very beneficial to service users mental health. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 12 The service users had only positive comments to make about the food provided and said their particular preferences and medical needs were always addressed. One service user commented I enjoy my meals and a choice is always available. The kitchen was well stocked with a variety of food and plenty of fresh vegetables. The dining room was a pleasant area which ensured service users could enjoy their meals in a leisurely and comfortable environment. Service users confirmed they were never rushed or hurried at mealtimes. The service users confirmed their friends and relatives could visit The Croft at any time. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 16 and 18 Service users were aware of who to contact if they wished to make a complaint. Staff were appropriately trained to ensure service users were protected from harm and abuse. EVIDENCE: The service users spoken to during the inspection said they were aware they could make a complaint about any aspect of the service and who they could contact in the event of them wishing to do so. One service user commented I get the best of attention from staff and I have absolutely no complaints to make. Another service user commented I find the staff very kind and I really cant speak highly enough of them, they are all excellent. The senior member of staff conducting the inspection confirmed staff had undertaken training in relation to the protection of vulnerable adults from abuse, and through discussion, it was clear the service users were well cared for. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 19 and 26 The standard of the decor at The Croft remains very high and provides a comfortable and pleasant environment for service users to live. EVIDENCE: The standard of furnishing throughout The Croft remains very high and the grounds are well kept. An efficient cleaning schedule has been set up and the inspector noticed the home was clean and tidy throughout. Sufficient laundry facilities were in place along with systems to ensure the prevention of cross infection. It is clear the staff continue to work very hard to ensure a high standard of cleanliness is maintained. All of the service users spoken to commented on the high standard of cleanliness throughout the building with one service user commenting that her laundry was always washed on time and returned in good order. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 Service users needs were met by the number and skill mix of staff. Staff have completed appropriate training to ensure service users receive the correct level of care. EVIDENCE: The Croft has a full complement of staff who were evenly deployed across the week to ensure service users’ care needs were met at all times. The senior member of staff conducting the inspection confirmed the staff had completed a range of appropriate training for the management of the home and the care of vulnerable adults. The matter of training in relation to issues of diversity was discussed and it was confirmed that training in this area had not been provided. In the light of this, the registered person is required to ensure all staff are updated in this aspect of care to ensure service users specific care requirements are met in relation to their religion, sexuality or cultural background. The Abbeyfield Heswall Society has a positive approach towards training and development which ensures service users are being cared for properly and their needs are being met in accordance with current good practice. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The leadership, guidance and direction offered to staff ensured the home was run for service users best interest. The health, safety and welfare of the service users was well promoted. EVIDENCE: The registered manager was not available on the day of the inspection as she was on annual leave. Throughout this inspection the service users spoke highly of the staff team and the standard of care they received. In the light of this, it is clear The Croft is run and managed for service users best interest. The service users spoke highly of the registered manager and said she was kind and caring in her manner. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 17 Safe working practices have been developed and staff have been provided with appropriate training to ensure service users safety and welfare. For service users further safety and welfare, the registered person is advised to keep upto-date with all of the information provided on the Health and Safety Executive and Medical Devices Agency Web Sites. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 4 9 4 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 4 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x x x x x x 4 The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? na 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 OP12 Regulation 16 Requirement The registered person is required to ensure that a range of social activities are provided to reflect service users social interest. The registered person is required to ensure staff are provided with training on issues of diversity. Timescale for action 31/12/05 1 OP28 18 31/03/06 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 OP38 Good Practice Recommendations It is recommended that the registered person keeps up to date with the information provided on the Health and Safety Executive and Medical Devices Agency Web Sites. The Croft DS0000018944.V268612.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Liverpool Satellite Office 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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