Inspection on 16/08/05 for The Croft Nursing Home (Barrow)

This inspection was carried out on 16th August 2005.

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 Nursing Home (Barrow) 22/11/06

The Croft Nursing Home (Barrow) 20/02/06

The Croft Nursing Home (Barrow) 08/11/04

The Croft Nursing Home (Barrow) 10/05/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 The Croft Nursing Home Hawcoat Lane Barrow in Furness Cumbria LA14 4HE Lead Inspector Marian Whittam Unannounced 16th August 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Croft Nursing Home Address Hawcoat Lane Barrow in Furness Cumbria LA14 4HE 01229 820090 01229 431645 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) The Croft Care Trust Colette Marie Hibbert Care Home 23 Category(ies) of 23 LD - Learning Disability registration, with number 23 PD - Physical Disability of places 6 PD(E) - Physical Disability, over 65 The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Must not exceed 20 places providing Nursing care 2. One named person under 18 years of age category PD Date of last inspection 08 November 2004 Brief Description of the Service: The Croft Nursing Home is a purpose built home providing nursing and personal care for 23 people aged over 18 years, with either a physical or learning disability. The home is run and operated by the Croft Care Trust, a registered charity. The home is in a residential area on the outskirts of the town of Barrow in Furness. The home is set back from the road in landscaped gardens and is on local bus routes and close to local amenities. The home is within the same grounds as the Croft Village residential care home, which provides accommodation in bungalows for less dependant service users with physical and learning disabilities. Both homes share the facilities of workshops, tuck shop, clubhouse, chapel and landscaped gardens. The gardens are accessible to wheelchair users and have seating and barbeque areas for residents. All the 23 bedrooms in the home are single and 15 of these have en suite facilities. The home is on two floors and there is a passenger lift and stair lift. The home has a hydrotherapy pool, which has a qualified attendant, and there is a light and sound stimulation room for residents. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 16th August 2005. The inspection focussed on how well the home was meeting the needs of the people living there. This was assessed by speaking to residents and care staff, observing activity in the home and reading a sample of the records which care homes are required to hold. What the service does well: What has improved since the last inspection? The home has built a new chapel in the grounds of the home not just to provide an extra spiritual focus to the life of the home but because it provided an additional quiet place for residents, relatives and staff. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 6 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 Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 3 Resident’s individual needs and aspirations had been assessed and these were being met. EVIDENCE: Residents had been admitted to the home following an assessment of their individual needs and information from other agencies involved in care. Service user plans had been developed from the assessments. The home cared for highly dependant people with complex needs and the assessment process reflected this. The manager or deputy had carried out assessments with prospective service users and families prior to their admission. The home had obtained copies of the care management plans for the service users who were admitted under such arrangements. Specialist needs and input had been assessed prior to admission and there was evidence of physiotherapy, wheelchair services and occupational health involvement at the assessment stage and consultation with residents and families. Methods of preferred communication for residents were stated. Staff were observed communicating effectively with residents and were aware of the particular communication methods of different residents. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 A consistent care planning system was in place showing changing personal and health needs and individual goals to provide staff with the information they need to support residents and meet their needs. EVIDENCE: On examination care plans were clear, up to date and had been regularly reviewed with some aspects evaluated daily. Family, residents and key workers and specialist services had been involved in the gradual development of individual plans as well as agencies advising on particular behaviours or conditions. There was evidence in the care plans and in the homes procedures that residents are assessed for potential and identified risks that might affect their personal choices and freedoms, such as the use of the hydrotherapy pool, use of lap straps or regarding mobility where behaviour was unpredictable and risks of choking. In cases where the resident had been unable to make their wishes clear their family members had been involved in supporting them. Information on advocacy was available and these services were available. Individual choices and preferences were recorded in the care plans where The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 10 these had been expressed; speaking to residents and observing their activities suggested that these were being respected. The staff group was stable and commented that as they had grown to know residents well, and by observing the reactions and body language of those with communication difficulties learned to assess when they wanted to be alone or did not want to do something. Picture symbols to help residents communicate their choices and needs were in use. It was observed that staff picked up on non- verbal signals and adjusted their approaches accordingly. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 16 The home supported residents to take part in activities inside and outside the home and for individual development and to fulfil their leisure preferences. EVIDENCE: Those who wanted to could attend workshops at the Croft Village next door where they could develop craft skills or just make social contact. Residents who enjoyed music had been enabled to attend musical events and the home had its own musical events. Some residents had community support workers that enabled them to go out and to shop and visit cafes and have a more varied social life. Two residents were spoken with who were going out with family and another with community support, which they enjoyed. All activities and leisure activities residents took part in were recorded. Every month a list of forthcoming events was distributed with the home’s newsletter to residents for them to choose what they wanted to do. Religious preferences were being respected with some attending a local church and the home has its own small chapel offering a quiet place for those who wanted it, resident, families and staff. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 12 Staff were observed interacting with service users individually and in groups and speaking in a friendly and appropriate manner and engaging them in conversation. Residents who were able and who wanted to, attended local day services and adult education facilities enabling them to mix with the other people attending, gain life skills and participate in activities on offer there. There was evidence from the certificates and pictures on display that residents had taken part in a variety of educational and recreational activities. Minutes of the residents meeting showed that residents were asked what trips and outings they wanted. Suggestions given had been followed up for group and individual activities. Many residents made use of the home’s hydrotherapy pool. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 There were systems in place to monitor and meet resident’s personal care preferences and physical and emotional healthcare needs and clear instructions for staff to follow. EVIDENCE: Individual care plans recorded service user preferences on personal support, daily routines and care, moving and handling needs, along with assessments and instructions for staff to follow. Routine health screening and immunisation was available and some residents had chosen not to take these up. Contact with medical, nursing and specialist services took place frequently due to the complexity of some resident’s needs and care records showed monitoring and health checks. Medical consultations, examinations and treatment took place in private either in bedrooms or the treatment room. Records had been kept of the personal and nursing care that had been given daily and reasons for any omissions. There was evidence of a variety of aids and equipment in use to promote resident’s independence and movement around the home and relevant assessments, advice from relevant professionals and alterations to equipment if needed. There were adaptations made in bedrooms to support individual problems and to prevent injury. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 14 There is a key worker system in operation to promote individual support and continuity for residents from staff who they know well and who are familiar with their needs. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a satisfactory complaints system available in different formats to suit resident’s needs. There was some evidence that residents feel their views are listened to and acted upon. EVIDENCE: The home had a clear complaint procedure, displayed and made available in pictorial formats. There is a logging system to record complaints received and the details of the investigation, its outcomes and any actions taken. Information on advocacy was provided for residents in the home and obtained for anyone who asked, although care plans indicated most people had family members to act on their behalf. Minutes of the residents meeting suggested that discussion was encouraged and that residents were reminded that if there was anything they were not sure about or if something was bothering them to speak to a member of staff who would try to help them. There was evidence that resident and family views are sought and affect what is going on in the home. A resident, when asked if staff listened to them if they were unhappy with something, said they did. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 and 30, The standard of the environment in the home was good providing residents with a well maintained, comfortable, clean and homely place to live. EVIDENCE: The home was well decorated, furnished and had ramps and adaptations to suit residents assessed needs and the communal rooms had plenty of natural light and ventilation. Furnishings, fittings, equipment and adaptations were appropriate including a stair lift and passenger lift, bathing aids, light switches at lower heights and easily reached wheel chair recharging points. Many residents had their own individually adapted equipment in their bedrooms, such as remote controls, computer key- boards and individually built wheelchairs. Bedrooms seen were decorated and arranged according to resident’s wishes. There was evidence of professional advice and assessment prior to the provision of equipment for individual residents. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 17 The building was well maintained, clean and tidy with appropriate sluice and laundry facilities and infection control procedures in place. Gardens are maintained to a high standard. There is plenty of communal and outdoor space for residents including places where they could go for more privacy and quiet. Automatic doors were fitted throughout the home so residents could move around easily and the corridors were spacious for their wheelchairs. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 and 36 There is a stable well supported and trained staff group that works well with residents to promote independence and quality of life. Recruitment procedures are thorough with appropriate checks being carried out to protect residents. EVIDENCE: Staff rotas indicate that sufficient nursing and care staff are on duty to meet residents assessed needs with a mixture of skills and experience. The staff group has little turnover providing continuity to residents and good morale. There are regular staff meetings and high involvement in the social and recreational activities in the home. Recruitment procedures had been followed and new staff records indicated that satisfactory criminal record bureau and vulnerable adult protection checks had been done and the registration status of registered nurses checked. Where there was any uncertainty the home had made further enquiries before offering employment. Training and staff development was well established and relevant to the residents needs including training using Learning Disability Award frameworks and NVQ at level 2 and 3. Staff spoken with felt well supported and enjoyed The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 19 their work. Records were kept of their regular formal supervision sessions and the topics and issues discussed. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 39, 40, 41 and The home reviews aspects of the service through review and seeking the views of residents, staff and relatives. There is clear leadership and direction for staff to make sure that people receive a consistent quality of care These practices promote the health and welfare of people in the home. However some substances that may harm residents were not stored safely placing residents at risk. EVIDENCE: Records and staff confirm that formal and daily supervision was in progress and regular staff meetings allowed feedback as well as internal reviews of policies and procedures, audits and information sharing. Residents spoken to agree their views were asked for. Minutes of residents meetings suggested their views and ideas were acted upon and satisfaction surveys were in use. However these had been done with staff assistance and this might influence resident responses, which the use of advocates outside the service should reduce. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 21 A sample of records required by regulation for the protection of residents were examined and found to be up to date and accurate. Records and servicing contracts indicated that the home had systems in place and established practices and procedures to promote resident health and safety; this included appropriate staff training and instruction. There was evidence that appropriate testing and cleaning was being carried out. However, some toiletries and lotions were left in bathrooms after use that could be harmful if ingested. The Croft Nursing Home F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Croft Nursing Home Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 3 3 2 x F58 F10 s6138 the croft, barrow v242369 160805 ui stage 4.doc Version 1.40 Page 23 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 YA 42 Regulation 13(4) Requirement Toiletries and lotions that may be harmful if ingested must be stored safely after use. Timescale for action 23.8.05 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 YA 39 Good Practice Recommendations Advocates should be used to complete resident surveys to promote objectivity. 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