Inspection on 12/05/05 for The Croft Unit

This inspection was carried out on 12th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 19 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Croft Unit 24/02/09

The Croft Unit 02/04/07

The Croft Unit 25/04/06

The Croft Unit 26/10/05

The Croft Unit 18/01/05

The Croft Unit 28/09/04

The Croft Unit 25/02/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 The Croft Unit 25-29 Ashburnham Road Hastings East Sussex TN35 5JN Lead Inspector Jeanette Denereaz Unannounced 12 May 2005 10:00 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 Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Croft Unit Address 25-29 Ashburnham Road Hastings East Sussex TN35 5JN 01424 434921 01424 435893 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) Parkcare Homes (No. 2) Limited Mrs Valerie Riedel Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (MD) 12 of places The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents accommodated must not exceed twelve (12) 2. The people accommodated will be between the age of forty five and sixty five on admission 3. The people accommodated will have a pre-senile dementia Date of last inspection 18 January 2005 Brief Description of the Service: The Croft Units are registered to accommodate younger adults with a pre senile dementia type illness. The property is detached and is set in a residential area of Hastings. The property is on four floors and the first two floors are registered as Kilncroft, a home for older people with a dementia type illness. The top two floors are separately registered as the Croft Units. Both homes operate independently of each other although there is only one registered manager. The whole building is owned by Parkcare Homes Ltd, which in turn is owned by Craegmoor Healthcare Limited. The home is registered for 12 service users. The home as local shops and amenities close by and is approximately one mile from the centre of Hastings. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 10.00 until 13.30. The home currently has ten service users in residence. The manager was away on a training day, and the deputy manager was not on duty and therefore the inspectors spoke directly with the senior carer, four members of staff and most of the service users. The inspectors returned to the home on the 16th May 2005 to give feedback of the inspection to the registered manager. What the service does well: What has improved since the last inspection? What they could do better: There are requirements relating to the environment that have been outstanding from previous inspection. Therefore, the home should review the length of time it takes for approval of funding and then ordering of basic equipment and building work, thus ensuring items are in place and work undertaken to meet the needs of service users within reasonable timescales. The home should have its own identify and ethos, and therefore giving the appropriate service to the residents and recognised that they are younger adults and their needs will differ from the people living in the adjacent Kilncroft home. The links with the Kilncroft service should be limited. The home should use at all times the Croft Unit entrance, have it’s own visitors book, health and safety records. The home should also look into the possibility of holding the food budget, and encourage residents to take more of an interest in the catering. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 6 The home should find the floor space for an office to store all the home’s records and an area for staff to write reports, hold team meetings and private interviews/meetings. The recording of daily information needs to be reviewed and a system put in place that enables clear communication between staff. The staff team should have specific training for working with younger adults with a pre-senile dementia and mental health issues. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 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 Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 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 & 3 At the present time prospective service users could not be assured that their assessed needs would be fully met within the home. EVIDENCE: The home has not had any new residents since the last inspection. The home is registered for younger adults with a pre senile dementia type illness, but the evidence of care practices tend to reflect a home for older people. For example there is a lack of meaningful activities for younger adults and residents have a very sedentary life style. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 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) 6,7,8,9 & 10 Residents have little input into the decision making about their lives in the Croft Units. Care planning is limited and does not clearly identify the full needs of the residents. EVIDENCE: Care planning is undertaken, but the information is written in standard statements and are repetitive on most plans. The Deputy Manager has the responsibility of care for the units, and she reviews and updates the care plans, but there was no evidence of input from other staff members. Statements were made in care plans, that certain residents like to have a bath, however all bathing is on a rota system and there are no opportunities for bathing as an enjoyable activity. Also the care plans stated that resident should be encouraged to maintain their independence, but there was no evidence that this was a priority. The overall ethos of the home is that things are done to the residents, and not supporting residents to maintain their independence. One care plan stated that the residents enjoyed cooking, but there was no facility available for her to do this. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 10 Residents were interviewed, however due to their conditions were reluctant to speak to the inspectors, they all greeted the inspectors and were friendly but did not have an opinion on the service. Three residents spoken with did say that the staff were nice and helpful. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 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) 11,12,13 & 14 The residents have a sedentary lifestyle that does not reflect their age or status. EVIDENCE: The home is a separate registration from the Kilncroft which is adjacent, but there is cross over in the areas of management, catering and at times staffing. This is not appropriate as the two homes are for different clients groups and this should be reflected in the running of the homes. On the arrival to this inspection the inspectors went to the main entrance, after some time the door was opened, but it was evident that the main entrance to the home is not used. The home does not have its own visitor book and the inspectors had to sign the visitors’ book from the Kilncroft. The Croft Units does not have its own identity and is reflected throughout the home. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 12 The activities undertaken by the residents are very limited, and the staff stated it was difficult to motivate the residents and the main activity consisted of going to the shops on a rota system. The rota was crossed referenced with individual care plans and was not consistant. The main activity after lunch for eight residents was to lie on their beds, two had gone out to the shops. The inspector asked the staff how long do resident lie down for, and was told they are called just before teatime at 17.00, which is over 4 hours. However, care plans stated that the residents have interests, but little evidence that these were encouraged. Staff informed Inspectors that there is an O.T. book, but this was not found on the day. When Inspectors saw this on the second visit it had been recently completed. On the day of the inspection lunch was observed, and found to be sterile experience. The uncooked food is collect from Kilncroft and cooked in one of the Croft Units kitchens by the staff. The meal was plated and placed on the tables and residents called to eat. The meal was over in 10 minutes and the staff were standing by ready to remove the plates. There was very little interaction between residents and staff. The overall evidence is there is a lack of meaningful activity throughout the home, and the staff need appropriate training to encourage and engaged residents in appropriate lifestyles. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 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) 18,19 & 20 Residents receive adequate personal and healthcare support, but the routines of the home limit personal preferences. EVIDENCE: There are no residents that administer and control their own medication, and during this inspection the giving of medication was seen and a trained staff member carried this out and the recording was in order. As stated earlier the home has set routines, and procedures that are not conductive for a home for younger adults and there is a need to for the care practices to be reviewed and staff have training in how to work with this client group. The home is embroiled with Kilncroft and care practices, which are satisfactory when working with elderly people with dementia are not acceptable for younger adults, but practices and skills are being transferred between these homes. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 14 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) 23 Residents have little interest in the home, their care or surroundings. Staff are aware of Adult Protection procedures. EVIDENCE: The home has detailed complaints policy and procedures. Since the last inspection there have been no complaints made. The majority of the staff team have received relevant training on protecting vulnerable adults from abuse. The Residents that were interviewed stated the staff were nice and helpful. The local vicar was visiting a resident and he confirmed that the home was friendly and he was always welcome, but his understanding was Kilncroft and the Croft Units were the same home. The manager has a good understanding of the implementation of Protection of Vulnerable Adults (POVA) register. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 15 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) 24,27 & 30 The home is clean and safe for residents, but the environment of the units are not homely. The kitchen/diners and bathrooms are very basic and do not promote residents’ independence. EVIDENCE: The home is clean and all bedrooms were inspected and were found to be adequate and some are personalised by the residents and their families. There are still building works to be completed, which have been outstanding from previous inspections, which includes replacing a bath, shower, and for the kitchens to be repaired and an oven to be replaced. The home needs to be professionally redecorated, as there are areas that are worn and need repairing. The home needs to review the smoking policy, as most residents smoke and the home can become very smoky, one resident needs to be is physically support with her smoking, and this takes place in the kitchen area. The home needs to reinstate its own main entrance and encourage residents and visitors to use this entrance to establish that the Croft Units are a separate establishment and has its own identify. The practice at present for all to enter the home through Kilncroft is not acceptable and could be intrusive to Kilncroft residents. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 16 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) 32,34 & 35 The home has an appropriate induction programme, which is undertaken by all new staff, but there is a lack of skill training to meet the assessed needs of this client group. EVIDENCE: The issue of appropriate training for staff was a requirement from the last inspection. There is training planned throughout the year for staff in all the mandatory areas including the control of infection, and COSSH. The majority of the staff are undertaking NVQ training and the staff interviewed during this inspection confirmed that they have had basic training and limited training for dementia. The manager discussed the new initiative of ‘Diversity therapy plans’ for each resident. The key workers should note in the individual care plan if a certain activity interest the resident. However, on further inspection it was found this was not taking place in the Croft Units. The manager would be looking into why this initiative was not taking place. It was evidence throughout this inspection that the staffs’ skills in writing care plan is limited. Supervision was discussed, and the staff confirmed that they received regularly supervision with the deputy manager. Supervision files were not seen during this inspection to confirm the frequent or quality of the supervisions. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 17 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) 37, 38 & 42 The health and safety of residents living in the home are protected. However, the ethos of the home does not promote residents’ self confidence and independence. EVIDENCE: There was no system in place for handing over information to other staff. The health and safety record keeping within the home is generally of a good standard, and are located in the main office in Kilncroft, and they were found to be in order during the inspection on the 2nd May 2005. During this inspection the inspectors asked about the risk assessment for smoking for residents and staff, and they were informed that one resident is supported to smoke by a member of staff sitting opposite and handing the cigarette. There was no risk assessment in place for this activity, or alterative apparatus to assist the resident. The health and safety of staff needs to be reviewed regarding the passive smoking whilst supporting a resident. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 18 As stated throughout this report, the home lack its own identify and ethos, and therefore not giving at time the appropriate service to the residents. The links and involvement with the Kilncroft service should be limited. The home should use at all times the Croft Unit entrance, have it’s own visitors book, health and safety records and floor space for an office to store such records and an area for staff to write reports. The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 1 1 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 1 2 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 x 2 3 Standard No 11 12 13 14 15 16 17 1 2 2 2 x x x Standard No 31 32 33 34 35 36 Score x 1 x 3 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Croft Unit Score 2 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 1 x x x 3 x H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 20 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 YA2 Regulation 14(1)(a) (c)15 See Schedule 3 (1)(b),(3) (q) 12, 18(1)(a) Requirement The Registered Manager must ensure that the home can meet the assessed needs of prospective service users based on specialist needs and risk and/or required treatment programmes. The Registered Manager must ensure that the home has the capacity to meet the assessed needs of individuals admitted to the home. To also ensure Staff have the skills and experience to deliver the service and care. The Registered Manager should ensure tht the staff have the appropriate training in writing care plans and the information to enable positive outcomes for all service users, which include treatments and rehabilitation. A more imaginative and extensive range of activities must be introduced, based on individiual needs of residents. The Registered Manager must ensure that residents are given the opportunity, information and assistance to make decisions about they own lives. The Registered Manager must Timescale for action Immediatel y. 2. YA3 Immediatel y 3. YA6 15(1) See Schedule 3 (1)(b) 01/08/05 4. YA7 12(2) Immediatel y 5. YA8 24 (3) 01/08/05 Page 21 The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 6. YA9 YA28 13(4) 23(2)(i) 7. YA11 YA12 16(2)(m) (n) 8. YA13 16(2)(m) 9. YA14 16(2)(m) (n) 10. YA18 12(4)(a) 11. YA24 YA29 13(4)(a) 23(2)(n) 12. YA27 23(2)(d) ensure that the residents are encouraged and supported to participate in the day to day running of the home, to include menu planning. The Registered Manager must ensure action is taken to minimize risk and hazards in connection with the smoking of residents, and the passive smoking of staff. It is required that the Registered Manager must ensure that staff help and support residents to find appropriate day activities that are more fulfilling to the individual. This was a requirement from the last inspection 18/1/05. It is required that the Registered Manager must enable staff to support residents to become part of, and participate in the local community in accordance with assessed needs and the individual care plans. This was a requirement from the last inspection 18/1/05. It is required that the Registered Manager must ensure that the staff support residents to access, and choose appropriate leisure activities. It is required that the Registered Manager must ensure that residents preferences are recognised and complied with and are flexible, this to include time for having a bath and the rotas to be reviewed. The Registered Manager must ensure that the areas of the home outlined in the report should be repaired or replaced. This was a requirement from the last inspection 18/1/05. Work is required to upgrade the bathrooms and shower room to 01/08/05 01/08/05 01/08/05 01/08/05 01/08/05 01/08/05 01/08/05 Page 22 The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 13. YA32 YA35 18(1)(a) (c) See Schedule 2(4) 14. YA37 8,9 15. YA38 12(5) become more acceptable, with comfort, warmth and modern facilities. This is a requirement from the last inspection 18/1/05. The Registered Manager must 01/08/05 ensure that the staff have the competencies, qualities and training required to meet service users needs and have a comprehensive knowledge of this client group.This was a requirement from the last inspection 18/1/05. It is required that the person 01/08/05 responsible for the day to day running of the home is competent and experienced to run the home and meets its stated purpose, aims and objectives. The Registered Manager must 01/08/05 ensure that the home has a clear ethos and there is a clear direction and leadership which enables staff and resident to understand and are able to relate to the aims and purpose of the home. 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 Good Practice Recommendations The Croft Unit H59-H10 S21241 The Croft Unit V222770 120505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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