Inspection on 26/10/05 for The Croft Unit

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 12 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 12/05/05

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 Inspection 26th October 2005 11:30 The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 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 Unit DS0000021241.V249240.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 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 Unit DS0000021241.V249240.R01.S.doc Version 5.0 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 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) Parkcare Homes (No. 2) Limited Mrs Valerie Riedel Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of residents accommodated must not exceed twelve (12) The people accommodated will be between the age of forty five and sixty five on admission The people accommodated will have a pre-senile dementia Date of last inspection 12th May 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 Limited, which in turn is owned by Craegmoor Healthcare Limited. The home is registered for 12 service users. The home has local shops and amenities close by, and is approximately one mile form the centre of Hastings. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection took place between 11.30 and 14.30. The overall focus of the inspection was on meeting with the manager and reviewing the progress of the requirements from the previous inspection. A full tour of the home was undertaken. Time was spent meeting the manager, inspecting a number of records, policies, procedures and other documentation. Some resident and staff on duty were spoken to during this visit. As this report was made following the second unannounced visit, and does not cover all the standards, therefore for the reader to make a judgment about the home, it is recommended that a copy of the last inspection report of the 12th May 2005 also be obtained to have a clearer picture of the home. What the service does well: What has improved since the last inspection? The manager and staff have endeavoured to meet the requirements, and improved the service’s ethos and environment. Many areas of the home have been re-decorated and new furniture has been purchased, including the refurbishment of one of the kitchens, and new windows have been installed. The manager has purchased a distance learning recourse package in Dementia care, and a communication book has been started to aid staff and residents for the introduction of Person Centred Planning (PCP). However, staff need more training in how to record significant conversations with residents, which will help to develop outputs and activities. The menus have been revised and weekly menus are to be introduced to encourage residents to have more of an interest and input with the food, the preparation of the meal, and mealtimes. Since the last inspection the registered manager has successfully been awarded her Registered Manager’s Award (RMA). The Croft Unit DS0000021241.V249240.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 Unit DS0000021241.V249240.R01.S.doc Version 5.0 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 Unit DS0000021241.V249240.R01.S.doc Version 5.0 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): 1,4 & 5 The home has endeavoured since the last inspection to establish that this is a home for younger adults. Staff are involved in training to give them the knowledge to ensure that the residents assessed needs and aspirations are met. EVIDENCE: The manager and staff took on-board the constructive criticism and have started to review the home’s practices and procedures, with the reviewing of the assessed needs of all the residents through the introduction of Person Centred Planning (PCP). The new person to take up residence did so after the manager carried out a full assessment, he and his care manager visited the home, and he had a week trial stay, and there is an on-going six weekly review of the placement. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 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): The home has a more flexible approach to the changing needs and personal goals of the residents, the manager and staff are encouraging residents to have more input into their home. EVIDENCE: Since the last inspection the manager and staff recognise that this is a separate unit from Kilncroft (the adjacent home for older people) and that the expectations and intended outcomes for the residents are based on consultation and participation. The culture of doing things for has started to change to supporting to do things. This was evident in the areas of personal care, there are guidelines and a rota for bathing to monitor personal hygiene, but residents can have a bath whenever they want to. Also one bathroom has been decorated in a style that is very welcoming and homely (with the other bathroom to be decorated soon). There is more consultation and conversation with residents, and a communication book has been introduced for staff to record any conversation that could inspire further outcomes. Unfortunately following discussions with the staff, they are unsure what to, and how to record such conversations. This was discussed with the manager and she will be discussing this with staff. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 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): 15,16 & 17 The resident continue to have a sedentary lifestyle, but the manager and staff are committed to improve the service offered to the residents, and following the last inspection have reviewed the ethos and care procedures of the home to reflect this, however, there is still a long way to go to engage residents in meaningful activities and personal development. EVIDENCE: The home is a separate registration from the Kilncroft, which is adjacent and for many years there has been a cross over in the areas of management, catering and at times staffing this has not been appropriate and following the last inspection the manager and staff have endeavoured to change this. The management has undertaken to review all the care practices and has started to change the ethos of the home. The residents have had a sedentary lifestyle and have been reluctant to change, however the home is introducing Person Centred Planning and staff will have training in this area. The catering within the home has also been reviewed and now has a weekly menu with more choice and variety, suggestions and input from the residents is also encouraged. There has been an increase in the residents eating out and having take away meals. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 11 The home encourages family contact, but unfortunately most the residents have loss contact or wish not to have contact with their families, and this is respected by the staff. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 12 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): 21 At times of illness and death the residents can be assured they will be handled with respect and their wishes are upheld with dignity. EVIDENCE: Sadly, one of the resident has recently died, he had returned to the home from hospital and was receiving palliative care. The resident had no known family and therefore the home ensured his last wishes regarding his funeral was undertaken. From the care plans the inspector could ascertain that his care was respectful and comforting and all the staff attended the funeral, the manager stated that over the years they (the staff) had become his family. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 13 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): These standards were inspected at the last inspection and were met. EVIDENCE: There have been no recorded complaints since the last inspection, also there has been further staff training in the protection of vulnerable adults and this training is on going. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 14 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): 24,25,27 & 29 The home continues to be clean and safe for residents, the manager and staff are endeavouring to make the environment more homely and less institutional. EVIDENCE: Since the last inspection the home has undertaken re-decorating in bedrooms, communal areas including one kitchen and one bathroom, with plans to continue throughout the home to bring up all areas up to the standard of the recently re-decorated kitchen and bathroom. The home must continue to established its own identity by encouraging people to use the home’s own entrance and to stop residents, staff and visitors to the Croft Units going through another home’s hallway. The home should also have it’s own visitors book. The inspector at this visit knocked at the Croft Units door but it was not answered, and there was still no house name to identify the Croft Units. The inspector had to knock at the door of Kilncroft to get access to the Croft Units, and she was asked to sign the visitor’s book in the hallway of Kilncroft. The specialist equipment used by the home tends to be for the aid of walking and the Physiotherapist supports the use, all equipment is regularly maintained every six months or more frequently if required. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 15 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): 36 The home continues to have an appropriate induction programme for all new staff, and now the resident benefit from a staff team who have a new supervision regime, which is formally recorded and take place six times a year. EVIDENCE: Since the last inspection the manager has been investigating training programmes to support staff to work with this client group appropriately. The home continues to use a Diversity Therapy plan to encourage and support residents in certain activities that interest them. It was evident that the staff still needs training to give them the skills and confidence to improve the quality of life for the residents. Craegmoor Healthcare as an organisation has introduced a new supervision format with is called The Personal Performance Agreement, and all the management have had training in this new supervision. The manager and deputy at the Croft Units had started this process with the staff, and they and the staff feel the process is constructive. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 16 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): 39,40 & 41 Since the last inspection the home is working towards improving the ethos of the home and thus encouraging residents to have more of an interest in their home and surroundings. EVIDENCE: The home does not have formal house meetings, as the residents are reluctant to talk in a large group, and live very insular lives, however, the staff are encouraged to have daily 1:1 chats with all the residents. The manager has introduced a communication book for issues and events to be recorded. The staff are unsure how to use this new format, and therefore the manager will be talking about this at staff meetings. All policies and procedures are in order and are regularly reviewed by the manager and the organisation. Record keeping was found at the last inspection now be up to date, which was the responsibility of the maintenance person, who has now left the service. At the present time until the home recruits another maintenance person, the manager is undertaken all the health and safety checks and they were found to be in good order. The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 17 Since the last inspection the registered manager has successfully been awarded her Registered Manager’s Award (RMA). The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 2 2 3 3 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 3 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 X 3 X LIFESTYLES Standard No Score 11 2 12 2 13 3 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Croft Unit Score 3 X X 4 Standard No 37 38 39 40 41 42 43 Score 3 X 2 3 2 X X DS0000021241.V249240.R01.S.doc Version 5.0 Page 19 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 YA3YA2 Timescale for action 14(1)(a) The Registered Manager should 01/03/06 12,18(1)(a) ensure that the home can meet the assessed needs of prospective residents, and to ensure the staff have the skills and experience to deliver the service and care. Since the last inspection 12/5/05 the manager has been working towards meeting these objectives and was much improved at this inspection. 15(1)Sc The Registered Manager should 01/03/05 3(1)(b)12(2) ensure that the staff have the appropriate training in writing care plans and the information to enable positive outcomes for the residents. The residents should be given the opportunity; information and assistance to make decisions about they own lives. Since the last inspection 12/5/05 the manager has been working towards meeting these objectives and was much improved at this inspection. Regulation Requirement 2 YA7YA6 The Croft Unit DS0000021241.V249240.R01.S.doc Version 5.0 Page 20 3 YA12YA11 16(2)(m)(n) 4 YA14 16(2)(m)(n) 5 YA27YA24 13(4)(a) 23(2)(d)(n) 6 YA35YA32 18(1)(a)(c) Sch.2(4) The Registered Manager should ensure that staff help and support residents to find appropriate day activities that are more fulfilling to the individual. Since the last inspection 12/5/05 the manager has been working towards meeting these objectives and was much improved at this inspection The Registered Manager should ensure that staff support residents to access and choose appropriate leisure activities. Since the last inspection 12/5/05 the manager has been working towards meeting these objectives and was much improved at this inspection The Registered Manager should ensure that the refurbishment and re-decorating of the home continues and it of a good standard to be more acceptable, with comfort, warmth and modern facilities. Since the last inspection 12/5/05 the manager has been working towards meeting these objectives and was much improved at this inspection The Registered Manager should ensure that the staff have the competencies, qualities and training required to meet residents’ needs and have a comprehensive knowledge of this client group. Since the last inspection 12/5/05 the manager has been investigating teaching resources for the staff team, and has introduced recording formats. DS0000021241.V249240.R01.S.doc 01/03/06 01/03/06 01/03/06 01/03/06 The Croft Unit Version 5.0 Page 21 7 YA39 24(1)(a)(b) (2)(3) The Registered Manager should 01/06/06 ensure that effective quality assurance and quality monitoring systems are in place to measure success in achieving the aim and objectives of the home, and that staff have the training and knowledge to undertake these tasks with residents. 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 YA41 Good Practice Recommendations It is recommended that the registered manager encourage residents, staff and visitors to use the Croft Units entrance, which should be clearly named. The home to have it’s own visitors book, thus ensuring the home has its own identity and does not intrude into Kilncroft. 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