Inspection on 23/05/07 for The Crossings

This inspection was carried out on 23rd May 2007.

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

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

Other inspections for this house

The Crossings 01/02/06

The Crossings 11/10/05

The Crossings 07/01/05

The Crossings 30/11/04

The Crossings 03/02/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 The Crossings 108a Aylesbury Road Wendover Bucks HP22 6LX Lead Inspector Catherine Kane Unannounced Inspection 23rd May 2007 16:00 The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 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 Crossings DS0000023083.V333286.R01.S.doc Version 5.2 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 Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Crossings Address 108a Aylesbury Road Wendover Bucks HP22 6LX 01296 625928 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) Turnstone Support Limited Mrs Dawn Humphris Care Home 4 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 residents with learning disabilities and/or physical disabilities Date of last inspection 1st February 2006 Brief Description of the Service: The Crossings is registered to provide 24-hour residential care and support to four people with learning and physical disabilities, who transferred from the NHS Manor Trust to the Community in September 2001. Accommodation is a detached bungalow, which aims to provide a family style environment for the service users. Service users have their own rooms and shared social areas. There is a well-kept, safe and accessible garden to the rear of the property and car parking to the front. It is situated in a residential area and close to local amenities. Nursing support is provided as needed from the Community Learning Disability Team and District Nurses attached to the local GP Practice. The home is owned and managed by the Turnstone Support Group Ltd., which is a registered charity. The fees for this home are £1,628.13 per week. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 4.00pm on Wednesday, 23 May 2007. The inspector was in the service for two and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The manager was not present at the time of the inspection visit but spoke with the inspector by telephone. One new member of staff and an agency staff member were on duty for the afternoon shift. A senior care staff member who was on-call came to the home to assist with the inspection process. The inspector spoke with all four residents. The inspector saw staff and some residents take part in afternoon activities, prepare for their evening meal and saw how staff help residents look after and take their medicines. She also looked at residents’ care plans and other records kept in the home and made a tour of part of the premises. The inspector would like to thank the staff team for their assistance with the inspection. She also thanks residents who made her feel very welcome in their home. What the service does well: The home has a friendly, relaxed atmosphere with positive relationships between residents and staff. Staff had a very good understanding of residents’ support needs. Meals provided are good. Personal care and healthcare support provided in this home are excellent. The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. The home was organized and well managed. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 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 Crossings DS0000023083.V333286.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. The admission procedure is good although not tested, as there have been no new admissions to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection there have been no new admissions to this home. At the time of the inspector’s visit there were no vacancies at this home. Generally, admissions would not be made to the home until a full needs assessment has been undertaken. The home would then be able to confirm that they can meet the needs of the individual through the service they deliver. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is excellent. The care planning system in place to provide staff with the information they need and for assessing risk is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed two residents’ care plans. These were easy to understand, written in plain language and using picture formats, considered all areas of the individual’s life including health, personal and social care needs. The plan is regularly reviewed and includes comprehensive risk assessments. During the visit the inspector observed residents in the company of staff who were very attentive to their comfort and wellbeing. Staff took time to explain to residents what they were doing, asked their permission before entering their bedrooms and before providing access to their care plan files to the inspector. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 10 From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13, 15, 16 and 17. Quality in this outcome area is good. Opportunities for people who use this service to take part in a variety of interesting activities are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the inspector was in the home during the afternoon and early evening. She spent this time with all four residents and the staff on duty. None of the four residents had verbal communication skills. However, with the help of staff who know them well and good clear information in care plans the inspector got a good idea about some things that were important to them. Residents take part in house meetings. Many activities provided in house were based on what residents prefer to do in their leisure time and take into account their personality, interests and need for either stimulating activity or tranquillity; these included watching TV, The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 12 listening to music, listening to stories, sensory activities, and helping with baking or cooking. While residents do not attend traditional day services, they have frequent outings to visit friends and days out to pubs, meals out, picnics and rambles and visits to garden centres. Daily records seen confirmed this. The relative of one resident returned a survey where they indicated that the home always keep them up to date with important issues affecting their relative. They said, “The care at The Crossings is excellent.” The inspector was in the home when a staff member supported by a resident was preparing the evening meal. Residents have their meal together in the dining area. The meal was freshly cooked chicken stir-fry followed by fruit and jelly. Each resident has special dietary and support needs at mealtimes and clear guidelines for staff were seen. Regular drinks and snacks are available and a varied menu is provided. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is excellent. The personal and healthcare needs of residents are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and see they get to see their local GP and other community healthcare services when needed. Records seen were well maintained. The inspector saw how the home helped residents to access specialist healthcare support when this was needed. One comment card was returned from residents’ GP. They indicated that they were satisfied with the overall care provided in this home. The GP commented, “Always good communication and excellent care of residents”. Residents’ medicines are securely kept in a locked medicines cabinet. The home uses a pharmacist produced medication administration record (MAR). Records seen were neat and well maintained. Most residents’ medicines are supplied in pharmacist produced monitored dose system. Records were kept of staff assessed as competent to administer residents’ medicines. During the The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 14 inspection one member of staff confidently demonstrated how a resident’s medicines are looked after and how residents are helped to take their medicines. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. The home has a protection from abuse policy and the complaints procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager declared that the home has received no complaints in the last year. The Commission has received no information relating to complaints in the last year. Staff have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures. Staff who spoke with the inspector were clear about their responsibilities and were aware of the home’s ‘whistle blowing’ policy. Systems are in place to ensure that residents’ finances are well monitored and protected. The Commission has received no information relating to adult protection issues since the last inspection. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. The home was tidy and clean at the time of the inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The furniture and fittings are modern and domestic in style providing a homelike environment. The comfortable open plan lounge/dining leads to a wellmaintained garden. The home has a programme of repair and renewal and evidence was seen that redecoration of the areas of the home has been planned. Since the last inspection an extension to add a staff sleep in room with shower WC has been built. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This home’s recruitment procedures and training for staff to do their jobs well are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection visit the inspector spoke with two members of staff and an agency member of staff. The home has a core of well-established staff that understand residents’ needs and who they relate well to. One member of staff commented that “morale is great, we all muck in and just get on with it without being asked”. The agency member of staff said, “I really like working in this home, everyone is so friendly”. On the day of the inspection the staff on duty were a new, but experienced, member of staff who had only worked in the home for two days and an agency member of staff who had worked in the home for 10 months. An excellent oncall system proved to function well where the senior care staff responded promptly and was able to come to the home without delay. The staffing rota confirmed that it was planned that an experienced member of staff would have been on duty with the new member of staff and the senior staff member stated that this was due to an unexpected absence. The manager declared in the The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 18 pre-inspection questionnaire that moderate use of regular agency staff to cover explained staff absence in recent months had been used. Full details of the experience, qualifications, induction and training of agency staff used by the home were kept and made available. No staff members have left and one new member of staff has been recruited since the last inspection. The recruitment process is thorough. The staff file for the new member of staff who started two days prior to the inspector’s visit, was not available in the home but still held by the human resources (HR) department at the organisation’s head office. The inspector viewed e-mail confirmation received by the manager from the HR department that all the necessary checks and CRB disclosures were satisfactory for the new member of staff and authorised that they could start work. Arrangements were to be made for staff file to be delivered to the home without delay. The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they have undertaken. This was a comprehensive training programme. Of the eight care staff six staff members have completed a relevant National Vocational Qualification (NVQ). The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is excellent. The home was organised and well managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager, who was on annual leave on the day of the inspection, spoke with the inspector by telephone. She is an experienced manager and qualified nurse and is competent to run the home and meet its stated aims and objectives. She has sound knowledge and experience in care of people with a learning disability and complex healthcare needs, quality assurance systems, equal opportunity issues, development and implementation of the service’s policies and procedures, good people skills, strong leadership of staff, responds to need and provides an excellent role model and manages the service efficiently. She has a strong ethos of being open and transparent in all areas of running of the home and is aware of The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 20 current developments both nationally and by CSCI and plans the service accordingly. The manager is well respected by members of her staff team. The senior care staff member was able to provided details of the quality assurance survey that included the views of residents and their family representatives or advocates that is currently being carried out. The organisation routinely carries out unannounced monthly visits and produces a report of their findings; these were made available in the home for inspection. The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure the home meets relevant health and safety requirements and legislation. Records kept were good and are routinely completed. Where issues have been identified these have been acted upon successfully to ensure residents’ care is not compromised. The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 21 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 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 X The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 22 No 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. Refer to Standard Good Practice Recommendations The Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Crossings DS0000023083.V333286.R01.S.doc Version 5.2 Page 24 - 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. 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