Care Home: Cranhill

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What the care home does well Residents needs are really well met. Residents are very satisfied with the overall care and service they receive. Residents can do a good variety of social and therapeutic activities both in and out of the home. Meals are really tasty and well balanced and are served to residents in a relaxed way. The environment is of a really high standard and residents really enjoy living there. There are effective systems used to monitor the quality of the care in the home. The home is well run and is run in the best interest of the residents. What has improved since the last inspection? This is not applicable. What the care home could do better: We did not set any requirements at the inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cranhill Weston Road Bath Bath & N E Somerset BA1 2YA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Melanie Edwards     Date: 1 9 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 26 Information about the care home Name of care home: Address: Cranhill Weston Road Bath Bath & N E Somerset BA1 2YA 01225422321 01225482637 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Charles Otter care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 31 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Cranhill Care Home is situated in a suburban area of Bath and provides nursing care for up to 31 residents. There is easy access to Victoria Park nearby, also to other local venues and shops by car. The building is an older converted property providing single rooms on three floors with lift access. Communal space is in three areas and residents also enjoy the forecourt/terrace area in front of the home. Currently the maximum 0 Over 65 31 Care Homes for Older People Page 4 of 26 Brief description of the care home charge for a room is around eight hudred pounds a week . Care Homes for Older People Page 5 of 26 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: three star excellent 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: We met twenty of the twenty six residents living at the home. We also met a number of visitors. We saw the lunch being served to residents. We spoke to the registered nurse on duty, five care assistants and a cook about their roles and responsibilities, training needs and what they do to support the residents. We saw residents being helped with their needs by staff. We looked at a selection of records relating to the daily running and management of the home. We saw a copy of the statement of purpose, the service users guide, three care records , three care plans, menus, activities records, the complaints log, the staff Care Homes for Older People Page 6 of 26 duty rota, training information,recruitment information, the fire book and fridge freezer temperature records. We looked at three residents care records and care plans. We saw the majority of the environment. The only areas that we did not see were a small number of bedrooms. We found the home was operating within the required conditions of registration which we impose. The conditions of registration set out the type of care, the needs of residents as well as the numbers of residents who may stay at the home. 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 set out 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 8 of 26 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 9 of 26 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. Residents assessed needs are well met by the home. People have the information they need to make an informed choice about living at the home. Evidence: To find out more about what information is available for prospective residents and their representatives to find out about the home, we looked at the statement of purpose and the service users guide. The residents have their own copy of the service users guide so they can find out about life in the home. We saw colour photographs of the home to show what daily life is like at Cranhilll. We saw in the service users guide information about the service provided, qualifications of the staff and the accommodation that residents can expect. The statement of purpose includes the philosophy of the home and how the service aim to meet residents needs. The complaints procedure is in the service users guide so that people know how to Care Homes for Older People Page 10 of 26 Evidence: complain if they need to. All of the residents we spoke to made comments of very high satisfaction about the care they receive and how they feel their needs are met. One resident told us the,care really is excellent, another person said,they really look after us really well and we were also told,you wont find a better home then this. All of these comments help to show that residents feel very satisfied with how their needs are being met. We looked at the nursing assessment records of three recently admitted residents to find out how well residents needs are assessed. We found the assessment records were informative and showed the residents had been consulted with to find out about their range of physical mental and social needs. We found the assessment records linked well to the information in the care plans and showed a detailed assessment of the residents needs had been done. The care plans had been written based on the information in the initial nursing needs assessments. Care Homes for Older People Page 11 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are very well met and care plans clearly demonstrate how they are met. Residents are treated with real respect and their privacy is upheld. Evidence: Every resident who we spoke to was really satisfied with the care and support from the staff. Examples of comments made by residents included,its excellent they couldnt do more for us, the staff are so attentive they really do their best and if I need anything I only have to ring my bell and they will come. We also met visitors who were all happy with the care and attention given to the residents they visit in the home. We saw up to date information in the care plans that showed residents are being well supported with their physical health care needs by GPs, dentists and the chiropodist. We saw the staff on duty helping residents in a very polite and respectful way. The Care Homes for Older People Page 12 of 26 Evidence: staff assisted residents with their needs in a very courteous way. This also included the kitchen staff who served lunch to residents in a very warm and polite way. Our observations of the staff help to show that residents are treated very respectfully at the home. We checked procedures for the giving out and storing of residents medication to find out if the systems are safe. We looked at six residents medication administration charts in detail. We saw a photo of the resident kept with each chart. The medication charts were satisfactorily maintained, legible and contained the signature of the nurse giving out the medication. The reasons for any omissions of medication had also been recorded. We checked the controlled drug record and this was in order. We checked one residents supply of controlled drugs. The records were correct. This helps show medication stock is well organised. We looked at three residents nursing care plans to find out how residents are supported to meet their needs. We found the care plans to be informative and they explained well how to meet the nursing care needs of the person. The care plans set out the actions staff must follow to help the residents to meet their needs. We saw a range of helpful information about the life history of each person and what matters to them including information about families, friends and significant others. We saw that care plans are reviewed and updated regularly. This demonstrates residents needs are being monitored and kept under review. Care Homes for Older People Page 13 of 26 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. The home ensure that residents are provided with a nutritious diet is served to residents in a manner that suits them. There are a good range of social and therapeutic activities put on for residents that they really enjoy. Residents are able to exercise choices in their daily lives. Residents are supported to receive visits from family and friends. Evidence: Each resident is given a copy of the timetable of forthcoming social activities planned to take place. This information is also displayed in the entrance hall. This helps to ensure residents are aware of current activities taking place. Activities that are planned for the near future include drives to places of interest,indoor gardening,arts and crafts sessions, games,musical afternoons and exercise classes. Care Homes for Older People Page 14 of 26 Evidence: We saw a number of residents have visits from their family and friends during the inspection. Visitors said that the staff are welcoming and friendly. The home has a relaxed visiting policy this benefits residents as this means they can keep in contact with family and friends. We saw residents getting up at different times during the morning. The residents we met told us they can do what they want to in the home. We also saw information in care plans where residents had requested that staff of a specific gender care for them. These are good examples of how residents preferences and autonomy are respected in their daily lives. We saw the lunchtime meal being served to residents. This was a choice of home made soup or fruit juice to start the meal, followed by roast lamb with potatoes and fresh cooked carrots and cabbage followed by choices of deserts. We also saw residents who did not want this dish having alternative meals. The meal was tasty and nourishing and was presented family style in serving bowls, so that residents could help themselves. The kitchen assistant who served the meals was very polite, warm and friendly to all the residents . Residents were also observed having lunch with their visitors. This is a really good way for residents to keep in contact with the people who matter to them. Residents commented very positively about the food served at the home. Everyone we spoke to said that the food was, really good. Care Homes for Older People Page 15 of 26 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 complaints will be dealt with effectively. Residents are well protected from abuse. Evidence: We saw a copy of the complaints procedure on the wall by the entrance hall of the home. There is also up to date complaints information in the service users guide. This means people can get hold of the right information to make a complaint if they need to. This helps to make sure residents have the information they need to make a complaint. The complaints procedure includes the up to date contact information for us if a person wants to complain directly. Residents said that they see Mrs Hughes often. We were told she makes time for the residents. The residents we met said they can talk to her,or to any of the staff about concerns they may have. There are residents meetings held in the home. These meetings are a way residents are able to make known any concerns or complaints they may have. There is an up to date policy in place relating to the issue of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. Care Homes for Older People Page 16 of 26 Evidence: The staff we met told us they do regular training in the understanding of the principle of the protection of vulnerable adults from abuse. The staff we spoke to had a good understanding about the subject of abuse and how they protect residents in the home. Care Homes for Older People Page 17 of 26 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. Residents live in a safe, well maintained and very suitable environment which they really appreciate. Evidence: Cranhill is a very spacious building built over four floors that can be reached by stairs or lift. The building is over two hundred years old is situated in the City of Bath. The home is situated in its own large self-contained gardens. Residents spoke of how much they like the views from their windows of the surrounding gardens and a nearby park. The home is near to local shops, a church and the city of Bath. All of the residents we met spoke about how much they like the environment and the history of the building. We saw specialist equipment and adaptations in place throughout the home to help people who may have reduced mobility. We saw most of the bedrooms and all the communal areas. We found rooms to be well decorated and well maintained. We found the environment was very clean and tidy in all the areas we saw. Bedrooms looked personalised and homely as residents have mementos and small items of their own furniture with them in their rooms. We found Care Homes for Older People Page 18 of 26 Evidence: the standard of furniture and fittings was really high and residents told us they like the environment and setting of the home. There is a really good sized dining room and a very spacious lounge next to the dining room. Residents were sitting in communal rooms and looked very relaxed and comfortable in the surroundings. We saw acccessible toilets are located close to the dining room and lounge. We saw that shared bathrooms were very clean and well maintained and were free of any unpleasant odours. The majority of rooms have en-suite facilities and there are bathrooms and toilets located within close proximity to rooms that do not have these facilities. There is also a washbasin in each bedroom. We found that the home was well ventilated and warm with lots of natural light. We saw that the radiators have been fitted with guards where needed. This is to help maintain health and safety so that people do not burn themselves. We found the environment to be really clean. The residents we met told us that a really good standard of cleanliness is always maintained. We saw soap and hand towels available in the toilets and bathrooms this helps reduce the risks of cross infection. Care Homes for Older People Page 19 of 26 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. Residents needs are met by enough competent and caring staff. Residents are protected by the homes recruitment procedures. Evidence: We checked how many staff there are on duty, to see if there are enough staff to meet the needs of the residents. For twenty six residents there is one registered nurse and six care staff on duty in the morning. In the afternoon there is one registered nurse and three care staff on duty. On a night shift there is one registered nurse and two care staff on duty. There are domestic staff on duty most days, a cook and a kitchen assistant,a maintenance person and an administrator. We saw the residents being very well supported by the staff who were on duty. Mrs Hughes works full time and works a range of different hours to fit in with the needs of the home. As we have already mentioned the staff who we saw helping residents with their care needs were really courteous, patient and kind in their manner. We looked at the training records of the staff team to see if staff keep up to date in their knowledge of the needs of residents. We saw good evidence that staff had done training sessions and updating over the last twelve months. Care Homes for Older People Page 20 of 26 Evidence: Many of the care staff we met have completed National Vocational Qualification in care awards to Level 2 or Level 3. This is good evidence that demonstrates care staff are developing the skills that they have. We checked staff recruitment information of the three most recently employed staff, to see if the home carry out the required employment safety checks on staff before they start work. The information we saw was sent to us after the site visit to the home. We saw two written references taken up for all new staff before they start work, Criminal Records Bureau checks and Protection of Vulnerable Adult first checks. This tells us that residents are protected by the homes recruitment procedures. Care Homes for Older People Page 21 of 26 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. Residents live in a well run home. There are good systems used to effectively monitor the quality of service in the home. The health and safety of residents and staff is protected in the home. Evidence: Mrs Hughes is a qualified nurse who has been the matron of the home for over ten years. She has many years of experience caring for people with a range of nursing needs. The residents who we met said they see Mrs Hughes most days and she always makes time for them. This helps to show us Mrs Hughes makes sure she is available for residents. The home employ an external company who specialise in reviewing the quality of care in care services. We saw really recent evidence that a quality review had been done. The home had achieved really good results from the findings of the quality review. Care Homes for Older People Page 22 of 26 Evidence: We found residents records were well maintained, up to date, legible and in order. The records to do with the management of the home were also satisfactorily maintained, up to date and in order. The records we saw had been kept secure in the home and are available to staff when needed. We have referred to other records elsewhere in the report. We did not review residents finance records as the home do not take direct responsibility for residents money. This is made clear to residents when they first come to the home. We found the environment looked satisfactorily maintained throughout. We saw that the kitchen was clean and tidy and in good order. All kitchen staff do regular food hygiene training to ensure they have a good understanding of safe practises for preparing and cooking food. However we advised that it would be beneficial if a record of when the staff take the temperature of cooked food is maintained. This provides good evidence that food is being consistently served at a safe temperature. The staff do regular health and safety training in a range of areas including food hygiene, fire safety and infection control. This helps ensure staff maintain a good understanding of health and safety and this helps keep people safe. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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