Inspection on 28/11/05 for The Croft Rest Home

This inspection was carried out on 28th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Croft Rest Home 28/05/08

The Croft Rest Home 24/05/07

The Croft Rest Home 30/01/07

The Croft Rest Home 26/04/06

The Croft Rest Home 20/05/05

The Croft Rest Home 09/12/04

The Croft Rest Home 15/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Croft Rest Home 84 King Street Whalley Lancashire BB7 9SN Lead Inspector Mrs Lynn Mitton Unannounced Inspection 09:30 19 December 2005 th 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 Rest Home DS0000009432.V256253.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 Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Croft Rest Home Address 84 King Street Whalley Lancashire BB7 9SN 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) 01254 822821 Lancashire Nursing and Residential Homes Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider should at all times, employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection The home can accommodate up to 26 persons in the category of OP who require personal care. When the service user occupying Room 9 moves out of this room this can no longer be used as a bedroom, and the Commission must be informed. 20th May 2005 2. 3. Date of last inspection Brief Description of the Service: The Croft is a detached property set within its own, well maintained grounds. The home is within easy reach of the main street and facilities of Whalley, including shops, churches, post office, health centre and public houses. The Croft is registered to offer accommodation and personal care to 26 older people, aged 65 years and over. Accommodation is provided in 24 single bedrooms, some with en suite facilities, and one double room with en suite facility. There is a lift to provide access to the upper floor, and there are various adaptations to assist service users with self- help and mobility. There are lounge areas on both floors, and a dining room on the ground floor. Smoking is permitted in one lounge area. The garden has seating areas for service users and there is car parking space available. The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. It took place over one day. There were 25 residents accommodated at this time. Over the course of the inspection approximately 8 residents were spoken to. Three staff members were also spoken to. A tour of the communal areas of the home took place. Documents were read and care observed. The registered manager who had taken up her post the week following the previous inspection in May had recently left. This inspection was mainly conducted with the registered person’s appointed consultant Mrs. Gillian Dawber. The Commission had received 1 complaint since the last inspection. What the service does well: What has improved since the last inspection? The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 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 Rest Home DS0000009432.V256253.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 Rest Home DS0000009432.V256253.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): OP3 & OP6 The current admission procedure for new residents does not ensure that information about their care needs are obtained before they arrive at The Croft. This would enable care staff to have a clear understanding of what they need to do to care for them. EVIDENCE: Whilst case tracking, there was no evidence that assessments of need had been completed for residents prior to their admission to the home. Intermediate care was not provided at The Croft. The Croft Rest Home DS0000009432.V256253.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): OP7, OP8, OP9 & OP10 All resident’s care and health needs, and how these were to be met were not appropriately recorded. Regular reviews of care plans would ensure that any changes were documented. Not all risks were assessed to ensure that residents were safe from harm. Appropriate, safe administration and disposal of medication must be ensured. EVIDENCE: The inspector was advised that there had been no change to the care and health plans since the previous inspection. (Information on each resident was recorded on a Cardex System, a medical model. On this, was information identifying each resident’s health and care needs, but not what support was needed in order to meet those needs.) The inspector was advised that a new care plan format would be developed and implemented. This was discussed at length with Mrs Dawber. The inspector was advised that a copy of the Royal Pharmaceutical Guidelines had been obtained. The inspector was advised that staff administering medication had undertaken ½ days training. Photographs of residents had been put onto medication records. The inspector was advised that the The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 10 supplying Pharmacist was due to visit in January 2006. The Controlled Drug register was seen; records for one resident had not been completed correctly. One resident said; “ the staff are respectful and kind”. The Croft Rest Home DS0000009432.V256253.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): OP12, OP13, OP14 & OP15 Activities of interest and giving stimulation were not routinely in place for residents, nor was a record kept. Resident’s independence was encouraged, and some had opportunities to maintain contact with the local community. Risks were not being assessed. Visitors appeared welcome at the home. Meals were varied and enjoyed by the residents. EVIDENCE: Residents said that staff organised some activities but there was no regular programme. There was no record of any activities that had taken place. One resident said; “there’s not much going on, only the TV”. The inspector was advised that a Christmas party had taken place when the Mayor & Mayoress had visited. One resident was seen to access the local community of her own accord. The inspector was advised that another two also walk around Whalley. The inspector noted that risk assessment’s had not been completed with this regard. A number of visitors were seen visiting residents. They were able to meet in private, either in the residents’ room or in the small lounge. The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 12 Service users were able to bring personal items to the home. The inspector ate tea with the residents and complimentary comments were made by a number of residents about the quality and quantity of food served. The inspector was advised that the kitchen was due to be steam cleaned in the near future, and that a new window screen had been ordered. Kitchen equipment was due to be serviced and a new fridge had been ordered, as the seal was ineffective and not keeping foods at the correct temperature. The two cooks were due to spend some time together to promote team work and to plan their workload more effectively. The inspector advised that the sharp kitchen knives must be kept in a secure location. The Croft Rest Home DS0000009432.V256253.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): OP16 & OP18 Further revision of The Croft’s complaints and protection from abuse policies and procedures would be of benefit in ensuring the safety of the residents, and give care staff clear guidelines. EVIDENCE: There was a copy of the homes complaint procedure on display in a communal area of the home. There was a complaints record book, however, no entry had been made since 2003. The inspector advised that the complaints policy and procedures must be reviewed, for example, more detail regarding strategies for an informal and formal procedure. The home had a copy of the “No secrets in Lancashire” document. The inspector noted there was a policy entitled “Protection of Residents from Abuse” – this policy was not dated nor was it specific to The Croft. The Commission had received 1 complaint since the last inspection. The Croft Rest Home DS0000009432.V256253.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): OP19 & OP26 The home was clean, tidy warm and free from offensive odours. Laundry facilities were not fully adequate to the needs of the residents and staff at the time of the inspection. Some facilities at the home were not suitable for the residents accommodated. EVIDENCE: Following a tour of the communal areas of the home, the inspector noted that the passenger lift was not suitable for its intended purpose. It was not possible for one resident in their wheelchair and a member of staff to travel safely. Staff were transporting residents in the lift by using a bath wheelchair, getting this wheelchair into the lift involved manual handling of the wheelchair and residents. The inspector was advised that there were about 8 residents with mobility difficulties, and who had no other means of getting to their bedroom on the 1st floor. The inspector and Mrs Dawber discussed this issue at length, and the inspector asked that all possible solutions be considered as a matter of urgency. Resident’s rooms seen were furbished with their own belongings and were seen to be homely and personalised. The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 15 The home was clean and tidy, ensuring a pleasant environment for people living at The Croft. The inspector was advised that a new carpet was due to be fitted in the dining room and entrance hall. The kitchen was due to be steam cleaned. The inspector advised that the laundry room would benefit from a “spring clean” and tidy up. There continued to be no independent sluice or hand washing facilities (such as a suitable type of hand wash or paper towels) in the laundry. The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 16 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): OP27, OP28, OP29 & OP30 At times there were insufficient staff members on duty to meet service users needs. All procedures for recruitment of staff and checks to safeguard residents were not in place. Staff training needs as identified should be implemented as a priority. EVIDENCE: The staffing rota was examined and the inspector was advised this was a new rota recently introduced. It demonstrated that there were usually 3 care staff on duty between 8am and 5pm. In the evenings there were only 2 care staff on duty. It was also noted that the 2 wake and watch night staff finished their shift at 7.30am and day staff did not start until 8am. The inspector advised that consideration must be given to assessing the needs of all service users to ensure that current staffing levels are sufficient to meet these needs. Mrs Dawber and inspector discussed that a minimum three care staff were needed on duty in order to support the needs of the present service users, a number of whom were confused and some who also needed 2 carers to mobilise them, and support them in their personal care. Cleaners were employed for 42 hours per week, and cooks employed for a total of 42 hours per week. Two staff recruitment files were case tracked and one was found to have minor shortfalls in the documentation required by legislation. The inspector advised that an application form and all checks must also be completed for Mrs Dawber. The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 17 The inspector advised that the original CRB certificate must be held on each staff member’s file. A number of staff training needs had been identified, including moving and handling, 1st aid, food hygiene infection control and fire prevention/evacuation procedures. Induction for new staff consisted of working alongside experienced senior staff for one week. The inspector advised that this did not comply with TOPSS specification for induction and foundation training. The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 18 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): OP31, OP33, OP34 & OP38 A manager with the skills, competence and qualifications to effectively manage the home must be appointed as soon as possible. Residents and regular visitors to the home must be consulted about the dayto-day running of the home. Some facilities at the home were not safe or suitable for the residents accommodated. Risk assessments and a management framework must be completed to enable residents to take responsible risks. EVIDENCE: Since the last inspection the registered manager had left the home. The inspector advised her concerns that there had been 2 managers leave The Croft in less than one year and that this was a cause for concern. There were no records of residents meetings available. The inspector and Mrs Dawber discussed how this could be done on an informal basis, but that the outcomes must be recorded. The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 19 The inspector was advised that a visitors’ questionnaire had been developed, and that this was left out at the homes entrance, however it was rarely if ever completed. The inspector advised that this should be posted out to residents and their regular visitors (family, friends and visiting professionals) twice a year, and the response collated and published. The registered person advised the inspector that a business plan was not yet in place. The inspector and Mrs Dawber discussed an issue raised by a concerned resident regarding the safety of the passenger lift. On examination it is the inspectors opinion that it is not suitable for its intended purpose. It is not possible for one resident in their wheelchair and a member of staff to travel safely. Staff were transporting residents in the lift by using a bath wheelchair. This did not have footplates and was not at all suitable. In addition staff had to lift the wheelchair in order to get it into the lift. There was no alternative means of residents with mobility difficulties to get to their rooms on the 1st floor. The inspector and Mrs Dawber discussed this issue at length, and the inspector asked that all possible solutions be considered as a matter of urgency. As previously noted, the inspector advised that sharp knives in the kitchen must be kept securely when not in use, and risk assessment’s must be completed in order to ensure that risks taken by residents are measured The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 20 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 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 2 X X X 2 The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement The registered person must not admit residents to the home unless they have been assessed to ascertain that the home can meet their needs. The registered person shall have in place a written plan as to how the residents’ needs health and welfare are to be met. The registered person shall have in place a written plan as to how the residents’ needs health and welfare are to be met. The registered person shall make arrangements for the recording, handling, safe keeping, administration and disposal of medication. The registered person must, after consultation with residents provide a programme of regular activities. Risks to the health and safety of residents must be eliminated. The complaint policies and practices must be in accordance with this legislation. The registered person must ensure that by staff training or DS0000009432.V256253.R01.S.doc Timescale for action 31/03/06 2 OP7 15(1) 31/03/06 3 OP8 15(1) 31/03/06 4 OP9 13(2) 31/03/06 5 OP12 16(2n) 31/03/06 6 7 8 OP15 OP16 OP18 13(3c) 22 & Schedule 4 (11) 13(6) 31/03/06 31/03/06 31/03/06 The Croft Rest Home Version 5.0 Page 22 9 OP27 18 (1a) 10 OP28 18 (1a&c) 11 12 OP29 OP30 19 Schedule 2 12, 18 1(a&c) &19 8 13 OP31 14 OP33 24 (3) 15 OP34 25 16 OP38 13 other measures, to prevent residents from harm, abuse or being placed at risk or harm or abuse. The registered person must ensure at all times suitably qualified competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of residents. The registered person must ensure that a minimum of 50 of care staff have achieved the NVQ 2 in Care award. The registered person must operate a thorough recruitment process at all times. Persons working in the care home must receive training appropriate to the work they perform. A registered manager must be appointed, as this is a condition of registration with the Commission. The registered person must provide evidence of consultation with residents regarding the quality if care provided at the home. The registered person must provide the Commission with such information as it may require for the purpose of considering the financial viability of the home. The registered person must ensure that any activities undertaken by residents are so far as is practicable free from avoidable risks. 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Croft Rest Home DS0000009432.V256253.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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. 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