Care Home: Cranford Residential Home

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What the care home does well There is clear information available for new and prospective residents in the home. Residents are admitted to the home following a thorough assessment of need and care plans are drawn up to establish how staff will carry out care and support appropriate to individual need. The atmosphere in the home appeared warm and relaxed and staff and residents interact well. Staffing in the home is stable with minimal turnover and staff rota`s show that there is sufficient staff to meet assessed care needs. Residents said they were happy in the home and comments included: The staff are kind and caring. We like being here because staff are so helpful. Staff do their very best to make us all very comfortable. Staff are kind considerate and aware of our care needs. What has improved since the last inspection? There has been some improvements to the environment to include new fabrics and furnishings. Staff training has been updated and staff support systems improved. What the care home could do better: It was noted from staff personal files that a reference had been received without it being apparent who had sent it. All references must identify who has supplied them and in what capacity they know the person to whom the reference relates to. The homes recruitment and selection policy details the good practice guidelines to be followed to ensure suitable staff are appointment and this must be followed at all times. Care files viewed lacked detailed social history or pen picture of each resident and the manager agreed that this information would assist staff to identify past interests and hobbies and therefore enable them to draw up an activities list to incorporate individual choices. Key inspection report Care homes for older people Name: Address: Cranford Residential Home 637 Warrington Road Rainhill Merseyside L35 4LY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lynn Paterson     Date: 0 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Cranford Residential Home 637 Warrington Road Rainhill Merseyside L35 4LY 01514266308 01514266415 dianejones52@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cranford Care Homes Limited care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Service Users to Include up to 24 (OP) The service should, employ a suitably qualified and experienced manager who is registered with the CSCI. Date of last inspection Brief description of the care home Cranford Care Home is registered to accommodate a maximum of 24 older persons who need assistance with their personal and social care. The accommodation is provided over two floors, the upper floor being accessible via a passenger lift. The home comprises 5 double and 14 single bedrooms none of which have en-suite facility, three communal lounge areas, a dining room and conservatory, which overlooks the rear garden. Fees charged are currently #359.00 - #371.00 per week. 0 Over 65 24 Care Homes for Older People Page 4 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection of Cranford Care Home was carried out by one inspector over a one day period on 8th September 2009. The visit to the premises was one part of the inspection. Other information received was also looked at. Before the visit the agency manager was asked to complete an annual quality assurance document (AQAA) to provide up to date information about the services provided. Questionnaires were provided for people who use the service, relatives and staff to find out their views. Other information that had been provided since the last inspection was reviewed. During the visit various records, policies and care files were looked at and a partial tour of the premises undertaken. A number of people who live at the home were spoken with as well as five staff members and they all gave their views about the service. The manager was able to give clear information about the services undertaken by the home Care Homes for Older People Page 5 of 23 and detailed changes to policies and procedures that had recently been implemented. All information gained from discussions, surveys and document reading were used as a basis for the process of this report. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff provide information about the home and carry out full assessments of need prior to a placement being offered. Evidence: Residents spoken with said they had been provided with clear information about the home prior to them making a decision to move in. They said that before admission they had been visited either in their own home or a hospital setting by either the home manager or another senior member of staff to speak with them about their care and support needs. Staff confirmed this pre admission assessment take place and care files looked at identified that the home use a standard format with which to collect information about the individual and look at individual needs. The manager said that when this process is completed she can then access if the home have the capacity to meet assessed need and if so a placement will be offered. Discussions with people living in the home -BS-MG-LU- identified that this process had occurred prior to them coming to live at Cranford. People said that before they can Care Homes for Older People Page 9 of 23 Evidence: make any firm decision about long term future plans they are admitted on a trail basis to make sure they feel comfortable in the home and that the home has the staff and facilities to meet individual needs Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and health care needs are met overall so that residents are treated with respect and their dignity maintained. Evidence: Documentation examined showed that all residents of the home have a care plan and five plans were examined in detail to check their content. The care plan is sectioned into several parts with each section referring to various tasks of daily life to include personal care, nutritional needs and general or specific health care.The care plans identify what care and support is needed for each resident and how those services will be carried out. The plans are reviewed each month by a member of the care staff and the resident and an changing needs are addressed. One care plan identified that a resident had a visual impairment , another recorded some challenging behavioral patterns. All plans showed that risk assessments had been carried out and the care plan in operation listed how these needs would be managed and met.General observations of care staff carrying out their roles showed that they worked as per the care plan. For example a resident who is being carried for Care Homes for Older People Page 11 of 23 Evidence: for long periods in bed was seen to be provided with the care and support as agreed by the resident and their representative as recorded on the care plan. All staff spoken with demonstrated their understanding of providing care in a way that respects peoples dignity and privacy and observations of staff and residents interactions revealed that they had respect for each other. Medication records and storage systems were well managed at the time of the visit. People spoken with said they were given their medication at the same time each day and staff recorded what they had been given. Records showed that none of the residents were self medicating. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to be involved in some activities and are provided with good meals and a menu of their choice. However the activities programme could be further developed by staff gaining more information about the past hobbies and interests of the people currently living in the home. Evidence: Care plans viewed did not fully identify the hobbies and interests of the people living in the home although in discussions staff were able to identify the likes, dislikes and capabilities of each person. It was suggested that staff drawn up a concise life history of each resident to include past hobbies and interests to enable staff to drawn up a more person centered activities programme. Discussion with residents identified that they were generally content with the daily activities in the home although it was felt that more outings should occur weather allowing. Dominoes appeared to be a favorite activity of the home and residents said it was their choice to play dominoes most days. Observations of the people living in the home about their daily life indicated that they were able to do as they pleased within reason and visitors were seen to be calling at the home throughout the day. Residents said that staff were kind and assisted them to maximize their daily life by enabling them to do the things they wanted to do. For example one resident was very keen to use a computer and gain access to the Care Homes for Older People Page 13 of 23 Evidence: Internet and s/he said that staff assisted this to happen. People living in the home said that they always knew what the daily menu was as it was written on the board in the dining room and staff always reminded them. The general opinion of the meal content and presentation was good and residents said the food was well cooked and plentiful. Observations of residents during lunch time identified that the food was nicely presented and looked extremely appetizing and all residents appeared to be throughly enjoying their meals. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are aware they can complain about any concerns and feel sure the manager would deal with this. Staff are trained in safeguarding so that people living in the home can be assured of protection Evidence: Discussions with residents and information gained from surveys suggested that all residents were aware of the complaints procedure and would know how to make a complaint if they felt it necessary. However no complaints had been received by the home or by The Care Quality Commission since the last inspection.Earlier complaints records do exist and there was evidence that previous complaints had been recorded. A local authority procedure on adult protection is available to the home and discussion with staff identified that they had received training in how to identify abuse and what steps to take if they have any suspicions that abuse is taking place. Staff said that they have also been given information about the Whistle Blowing process and would not hesitate to use it if they felt that staff or other people were dong anything which was detrimental to the people living in the home. Records show that one safeguarding referral had been received by the local authority however after full investigation this was found to be not proven. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continue to develop the environment so that residents can feel safe and comfortable. Evidence: A partial tour of the premises identified that the building continued to benefit from refurbishment to include redecoration and replacement of furnishings. The building has easy access to the front and rear of the property and has ramps, hand rails and other equipment available to ensure the safety and wellbeing of the people living in the home. The home presented as clean and hygienic and free form any unpleasant smells at the time of the unannounced visit. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are consistent and staff are trained and supported to carry out efficient effective care and support to the people living in the home. Evidence: Examination of staff files identified that the home carry out their recruitment and selection processes as per their policy. The manages ensures that all checks are carried out prior to the applicant being offered employment. This includes police checks, proof of identity and the provision of two references. One file examined held all the necessary information however one reference was provided on non headed paper and it was difficult to agree to its authenticity.It was suggested that the manager make telephone contact with the referee to ensure s/he had provided this document and ensure in future that all references are supplied with full detail of who and where they are from. Staff rotas and staff training records confirmed that staff are provided in adequate numbers and skill mix to ensure the safety ad wellbeing of the people living in the home. Discussion with residents identified that they feel the staff are good at what they do and comments included; Staff are always here to help us. We like the staff, they seem to know what we want and when we want it. The staff are wonderful, they out themselves out to help nus. Care Homes for Older People Page 17 of 23 Evidence: They are great, they support us with everything and they always have a smile on their faces. Staff said they get adequate training and are up to date with all the mandatory courses. They say they work well as a team, all get on well together and as staff turnover is very low they are able to get to know each other and the residents and provide a good service. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager communicates well with the staff and residents to ensure the home is run in the best interests of the people living in there. Evidence: The manager of Cranford has her registered managers award and is experienced in the care of older people.She ensures staff receive appropriate training and support to enable them to work with the residents and ensure they provide care and support to maximizes their daily lives. The manager carries our regular health and safety checks and record show that health and safety training is an ongoing process for staff. Documentation examined showed that all essential services are checked on a regular basis and are maintained by qualified and competent people so that staff are people living in the home are protected. Residents say they are kept informed of everything that goes on in the home and are consulted with to see if any proposed changes are acceptable. Documentation seen identified that residents meetings are held as are staff meetings Care Homes for Older People Page 19 of 23 Evidence: and many issues are discussed about the general management and running of the home. All comments received from staff, residents and other people associated with the home were positive and confirmed that the home is run in the best interest of the people who live there. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 It is suggested that staff record a short life history of each resident to include their past interests and hobbies to assist staff when drawing up the activities programme. References should be verified by telephone call from manager to the perosn who has provided reference. 2 29 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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