CARE HOMES FOR OLDER PEOPLE
The Croft 17 Snydale Road Normanton Wakefield West Yorks WF6 1NT Lead Inspector
Tony Railton Unannounced Inspection 25th November 2005 08:30 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 DS0000006174.V265662.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 DS0000006174.V265662.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Croft Address 17 Snydale Road Normanton Wakefield West Yorks WF6 1NT 01924 893188 01924 898705 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) Croft Carehomes Limited Ms Susan Porritt Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Can accommodate one named service user under 65 years of age. Date of last inspection 15th June 2005 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, Chiropodist 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 DS0000006174.V265662.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection started at 08.30 and the inspector took the opportunity to observe the morning routines including breakfast and the administration of medicines. This was a very positive and enjoyable inspection with a number of residents’, relatives and carers taking the opportunity to talk to the inspector and comment on the quality of care provided by the home. A number of residents’ case files were looked at including assessments, care plans, medical and daily records. A number of staff files were also examined including training and supervision records. It was noted that the home continues to meet all statutory requirements and most minimum standards. A number of improvements to the environment and to the care management systems were also noted. The inspector would like to take the opportunity to thank residents, the manager and her staff team for their hospitality and co-operation throughout the inspection. What the service does well:
The home continues to provide a comfortable and homely environment which is also relaxed and inclusive. Throughout the inspection positive relationships between residents and care staff were observed and residents and their relatives are treated with dignity and respect at all times. One relative said that “the care staff are second to none” she went on to say that she has been visiting the home for a few years and has “ never had any cause for concern”. One new resident said that “everyone is great”, he went on to say that the food is “excellent”. Residents were observed been asked what they would like for breakfast and some chose to have a cooked breakfast. The manager said that there are a number of residents who request and enjoy a cooked breakfast most mornings. All residents have their care and healthcare needs assessed and there are care plans implemented to ensure that residents choices and preferences are considered. Descriptive words are used in the daily records to reflect and indicate when residents make a decision about their daily lives. Staff training continues to have a high profile and residents benefit from being cared for by NVQ trained staff. The staff team is very stable and there have been very few changes to the staff team over the past years. Residents’ benefit from the consistent approach to the care provided by the home. On the day of the inspection all parts of the home were clean and free from unpleasant odours. The care staff and in particular domestic staff are to be commended for their efforts in maintaining such a good standard of cleanliness throughout the home.
The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better:
Inspection of the home showed that there have been some major improvements and the service providers are to be commended for their efforts in improving the environment and standard of living of those living in the home. However, a number of bedroom carpets were observed to be ‘worn’ and may need to be replaced. The manager said that she will review all the bedroom carpets as she is aware that some are looking a little shabby and are difficult to maintain. The home does have a quality assurance monitoring system which includes a residents’ and their relatives survey questionnaires. The questionnaires showed
The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 7 that residents and their relatives are very happy with the care provided by the home. However, to comply fully with minimum standards the views of other stakeholders should also be sought and all of the information collated and a report provided to reflect the outcomes for residents. 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 DS0000006174.V265662.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection The Croft DS0000006174.V265662.R01.S.doc Version 5.0 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 the following standard(s): 2 Prospective residents benefit by having their personal and healthcare needs assessed before they are admitted to the home. EVIDENCE: Residents’ case files including assessments, care plans and reviews show that all residents have their care and health needs assessed before they are offered a place. Records also show that the majority of residents have an Integrated Care Management Assessment carried out by the local authority prior to admission. The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 10 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): 7,8,9 & 10 Residents’ benefit by having their care and health needs set out in their individual plan of care. Residents also benefit by having their health needs met by visiting healthcare professionals. EVIDENCE: Through observation it was established that there are positive relationships fostered between care staff and residents who are treated with respect and dignity at all times. The medical records showed that the home is supported by visits from healthcare professionals such as District Nurses, General Practitioners, Opticians and Chiropodists. Through observation and inspection it was established that residents are protected and safeguarded by the policies and practices governing the ordering, storage, administration and recording of medicines The Croft DS0000006174.V265662.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): 12,13,14 & 15 Residents’ benefit from living in a home where they have a choice, and the lifestyle experience matches their expectations and where contact with their relatives is encouraged. EVIDENCE: Discussion with residents, their relatives and examination of the quality assurance questionnaires show that residents and their relatives are happy with the care and support provided. One relative said that the care staff are “second to none” and the care they provide is “wonderful”. One resident said that he can do “what he wants” and if he needs anything “all he has to do is ask”. Another resident said that the meals are “great” and that there is a choice. The menus also show that residents have a choice of meals. The new dining room tables and chairs show that residents have their meals in comfortable and homely surroundings. Residents were observed making a choice at breakfast and they are also offered an alternative menu at other meal times. The activities records and daily records are full of descriptive words to show and reflect residents’ choices and preferences. The daily records have improved greatly and show when residents make decisions about how they live their lives.
The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 & 18 Residents and their relatives are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: Examination of the complaints book and quality assurance survey questionnaires, discussion with residents, relatives and the manager show that complaints are taken seriously, investigated and acted upon. The inspector agreed with the manager when she said that the home welcomes all complaint’s as they are an important part of quality assurance monitoring. It was noted that the home has a copy of the Wakefield Social Services and Health Multidisciplinary Adult Abuse and Protection Policy and Procedure which forms part of the induction training for new staff. The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21, 24, 25 & 26 Residents live in a safe, well-maintained home where the shared space is homely and comfortable and their private space is as they want it. EVIDENCE: Through inspection some major improvements to the environment were noted. Since the last inspection new tables and chairs and easy chairs have been provided in the main lounge. The small dining room also has new tables and chairs. On the day of the inspection these had table cloths and flowers and presented well. The main lounge is currently been re-decorated and the manager is also seeking to provide new curtains to match the colour change. One resident commented on the good quality of the workmanship of the decoration. A number of bedrooms have also been re-decorated and one provided with a new carpet. Upon inspection it was found that three bedroom carpets are looking a bit worse for wear. The manager said that she is aware of these carpets which are looking a bit shabby and are becoming difficult to maintain. She said that she
The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 14 will undertake a review of all the bedroom carpets and see about replacing those that need replacing. The Croft DS0000006174.V265662.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): 27,28,29 & 30 Residents’ needs are met by the numbers and skill mix of staff and they also benefit from having NVQ trained staff. Residents are also protected by the staff selection and recruitment policies and practices. EVIDENCE: Staff records show that the staff team has remained the same for a number of years. The manager said that staff retention is very good indeed and offers consistency in the approach to the care provided in the home. Training records also show that nearly all care staff have a National Vocational Qualification to Level 2 and above. Records show that some care staff have also undertaken the Working in Care Induction and Foundation Standards with Learn Direct. This revision practice is to be commended and can only benefit residents by improving and maintaining the care standards within the home. Staff personal records show that the staff selection and recruitment policies and practices make sure that residents are supported and protected. Discussion with care staff showed that they are happy and confident and have a positive attitude towards residents and their work. One relative said that she has been visiting the home for a number of years and that she has never had cause for concern she also said that the staff are “wonderful and very caring”. One new resident said that the staff are “very good” and treat him well. The Croft DS0000006174.V265662.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): 31,33,36 & 38 Residents live in a well run home which is open and inclusive and where the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: Through observation, examination of staff rotas and discussion with residents the manager, care staff and visitors it was established that residents live in a well run home. The manager is a registered nurse and a very experienced manager. She said that she has nearly completed the NVQ Level 4 Registered Managers Award. The Homes Quality Assurance Audit Report showed that a complete audit of the home has been undertaken by the Manager and newly appointed Development Officer. The manager said that it is the homes intention to have a full audit every six months as part of quality assurance monitoring. Residents’ quality assurance survey questionnaires showed that residents and their relatives are asked their opinion about the quality of care provided by the
The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 17 home. However, the manager said that these are due to be carried out again in the new year. She said that the views of other stakeholders and in particular visiting healthcare professionals will also be sought. Staff training records show that staff receive training and update training in Moving and Handling, First Aid and Food Hygiene and that residents are protected by the health and safety policies and practices. Staff supervision notes showed that staff benefit from one to one line management supervision sessions. It was noted that the manager combines direct observation of staff performance with discussion and appropriate records are maintained. The Croft DS0000006174.V265662.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 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 x X 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 2 x 2 X X 3 X 3 The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? N/A 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 3 Refer to Standard OP24 OP31 OP33 Good Practice Recommendations A review should be undertaken of the bedrooms with a view of replacing the three bedroom carpets identified as been shabby. The manager should inform the CSCI upon completion of the Registered Managers Award As part of quality assurance monitoring as well as the views of residents and their relatives, the views of other stakeholders such as visiting healthcare professionals should also be sought. To comply fully with minimum standards the quality assurance monitoring report provided by the manager should be published and made available for residents and their relatives. 4 OP33 The Croft DS0000006174.V265662.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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