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Inspection on 20/02/06 for The Croft Nursing Home (Barrow)

Also see our care home review for The Croft Nursing Home (Barrow) for more information

This inspection was carried out on 20th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Throughout the inspection the inspector saw that staff and residents got on well together, that residents were treated sensitively and as individuals. Good procedures are followed to ensure that residents are protected through the recruitment and selection of staff and their induction to the home as well as by staff making referrals to other professionals for information and support when needs change or when issues are identified. The home is well staffed with a stable staff group who know the resident`s well and who are supported in their work and training. The staff work hard to involve residents in the daily life of the home and are creative in providing leisure and recreational opportunities for residents. Training provision is good in the home with staff doing regular updates, Learning Disability training and many care staff having attained NVQ level two and three.

What has improved since the last inspection?

The home has bought a new bus for residents and employed a qualified driver. The bus is used everyday by residents. Toiletries and lotions are being safely stored now and were not seen left in bathrooms.

CARE HOME ADULTS 18-65 The Croft Nursing Home (Barrow) Hawcoat Lane Barrow In Furness Cumbria LA14 4HE Lead Inspector Marian Whittam Unannounced Inspection 20th February 2006 13:00 The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 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 Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Croft Nursing Home (Barrow) Address Hawcoat Lane Barrow In Furness Cumbria LA14 4HE 01229 820090 01229 431645 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) The Croft Care Trust Mr George Spicer, Mr Derek Gwynn Position Vacant Care Home 23 Category(ies) of Learning disability (23), Physical disability (23), registration, with number Physical disability over 65 years of age (6) of places The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Must not exceed 20 places providing Nursing care One named person under 18 years of age category PD Date of last inspection 16th August 2005 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, resident’s 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 occupancy and 15 of these have en suite facilities. The home is on two floors and there is a passenger lift and a stair lift. The home has a hydrotherapy pool, which has a qualified attendant, and there is a light and sound stimulation room and treatment room for residents. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 20th February 2006. The inspection focussed on how well the home was meeting the needs of the people living there. This was assessed by speaking to residents, care staff, administration staff and the manager, observing activity in the home and reading a sample of the care plans, medication records and records of staffing meals and the homes policies and procedures. All areas of the home used by residents were seen during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home usually works hard at including residents and families in the daily life and decisions in the home however, the home has recently taken a quiet lounge out of permanent use only as a lounge and using it as a Committee meeting room as well. Although the home still has sufficient communal space The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 6 to meet the minimum standard it would have reflected a more open and transparent approach and good practice if the residents and their families had been consulted prior to making the decision to give the room a dual use. 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 (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 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 the following standard(s): 2 and 5 Resident’s have individual contracts/statements of terms and conditions so it is clear what the home will provide. Resident’s benefit from having their individual needs and aspirations assessed and met. EVIDENCE: Residents are admitted to the home following an assessment of their individual personal and nursing needs. Information and advice is taken from other agencies involved in the resident’s care. There is evidence of physiotherapy, wheelchair services and occupational health involvement at the assessment stage and consultation with residents and families. The home obtains copies of social services care management plans for those admitted under such arrangements. Service user plans have been developed from the initial and ongoing assessments. The home cares for highly dependant people with a range of complex needs and the assessment process reflects this. Staff were seen to communicate well with the residents and are aware of the preferred communication methods of different residents. A written contract/statement o0f terms and conditions is given to each resident and/or their families. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 and 8 A consistent care planning system is in place, showing resident’s changing needs and individual goals, and provides staff with the information they need to support residents and meet their needs. EVIDENCE: Care plans are clear, up to date and are being regularly reviewed. Family, residents and key workers and specialist services are closely involved in the gradual development of individual plans as well as agencies advising on particular behaviours and/or conditions. There is evidence in the care plans and from the homes procedures that residents are assessed for potential and already identified risks that might affect their choices and personal freedoms, such as the risks of choking, use of the hydrotherapy pool, use of lap straps or regarding mobility where behaviour has been unpredictable. In cases where the resident had been unable to make their wishes clear and in financial matters family members have been involved in supporting them in decisions. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 11,15 and 17 The home supported residents to take part in activities inside and outside the home to fulfil their leisure preferences and in working to fulfil their individual development. EVIDENCE: Residents who want to can attend workshops at the Croft Village within the home grounds where they can develop craft skills or just make social contact if they want. Other residents go out to the local day centres and meet others and develop skills and interest that way. 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. One resident seen was going out shopping in town and to have a coffee with community support, which they said they enjoyed. All the activities and what residents individually enjoy are recorded as well as trips out in the home’s minibus. Every month a list of forthcoming events is distributed as part of the home’s newsletter to residents so they may choose what they want to take part in or see. Menus and records of food served showed a varied and nutritious diet and details of assistance and aids needed by residents in their plans. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 18 and 20 Medication practices and handling are good and there are systems in place to monitor and meet resident’s personal and physical and emotional healthcare needs with clear instructions for staff. EVIDENCE: Individual care plans show residents preferences on their personal support, daily routines and care, moving and handling needs, along with assessments and instructions for staff to follow. There are a variety of aids and equipment in use to promote resident’s independence and safe movement around the home and relevant assessments, advice is taken from relevant professionals and alterations to equipment is made if needed. There are adaptations made in bedrooms to support individual problems and to prevent injury to the resident. Medication systems and storage are well organised and records are clear and up to date with systems in place for the safe disposal of medicine waste. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 23 Policies, procedures and guidance on the abuse of vulnerable adults are in place to inform staff and promote the protection of residents. EVIDENCE: There are procedures in place to protect vulnerable adults and for whistle blowing. Multi agency guidance is available for staff in the home. Staff receive training on vulnerable adults and abuse and dealing with aggression. There have been no changes to these procedures or the complaints procedures since the last inspection. All financial transactions are recorded and residents have their own individual accounts and records of spending money. The home keeps only small amounts of spending money securely for residents. Residents and their families may choose to give the allowance for mobility to the home for the use of the minibus or may pay for transport. of whatever kind they want, as they use it. A record is being kept of individual use of the home’s transport if a resident is giving their mobility allowance. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 24, 25, 28 and 30 The standard of the environment in the home is good providing residents with a well maintained, comfortable, clean and homely place to live. EVIDENCE: The home is well maintained, well decorated, is clean and tidy and has adaptations to suit residents assessed needs. Many residents have their own individually adapted equipment in their bedrooms, such as remote controls, computer key- boards and individually built wheelchairs. Bedrooms are decorated and arranged according to resident’s wishes and for the use of equipment. There is sufficient communal and outdoor space for residents including places where they could go for more privacy, including a new chapel. The home has altered the use of a quiet lounge and this room is now also used as a meeting room with a large table permanently in the room limiting its use as a lounge. Despite this reduction in permanent communal lounge space the home still meets the minimum communal space requirements. However residents and their families should have been asked about this change before it was done in their home as a matter of good and open practice. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 32 There is a stable well supported and trained staff group that works well with residents to promote independence and quality of life. EVIDENCE: Staff rotas indicate that sufficient nursing and care staff are on duty both day and night, with a mixture of skills and experience to meet residents assessed needs. The home has a high percentage of staff with NVQ level 2 in care and an NVQ trainer was in the home on the day of the inspection working with staff. The staff group has little turnover providing continuity to residents and good morale. There are regular staff meetings and staff are closely involved in the social and recreational activities in the home. Speaking to staff there was evidence of good staff morale despite recent management changes and that staff enjoyed their work and knew the residents well. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38 and 43 The home is well run with systems that promote residents personal and financial interests. EVIDENCE: The home has had a recent change in manager and the new manager is in the process of applying for registration with CSCI and has enrolled on the Registered Managers Award. A new deputy has also been recruited. The new manager is familiar with the home having previously been the deputy and is able to relate to the aims and purpose of the home. Management and financial systems in the home are subject to review and there is clear accounting and audit system and minutes of the homes annual General meeting provide information on the accounts and business planning and investment policy for the year. Insurance cover is in place for the home and displayed. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 3 X X X X 3 The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA28 Good Practice Recommendations Residents and their families should be asked about changes to communal space in their home before a decision is made to permanently change it. The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Croft Nursing Home (Barrow) DS0000006138.V281035.R01.S.doc Version 5.1 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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