Care Home: Cranlea

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What the care home does well Cranlea provides a homely and pleasant environment for the people who live there. Each person has their own flat with en suite facilities. They are able to personalise their flats with items of furniture and other personal effects. The atmosphere in the home was pleasant and relaxed and good relationships exist between the staff and the residents. Friends and family are encouraged to visit and participate in any events taking place. The staff members receive good training to help them meet the individual needs of the people living in the home. The care plans address the individual needs of the people living in the home and are evaluated on a regular basis. This helps to ensure the staff have up to date information to care for the people living in the home. The people living in the home are consulted to ensure they are involved in making decisions about their daily living requirements. There is a robust recruitment and selection procedure to help ensure that people are protected from abuse. Regular audits are carried out by management to help ensure standards are being met, and that people living in the home receive good outcomes. The manager is committed to providing a good service for the people living in the home and has experience in dealing with dementia. Comments received from the people living in the home include:`I`m very happy and settled`. `This is the best home I`ve ever been in`. What has improved since the last inspection? CARE HOMES FOR OLDER PEOPLE Cranlea 1 Kingston Park Avenue Newcastle Upon Tyne NE3 2HB Lead Inspector Anne Brown Key Unannounced Inspection 10:00 3rd and 8th July 2008 X10015.doc Version 1.40 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 DS0000000439.V368083.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 Older People. 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. DS0000000439.V368083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranlea Address 1 Kingston Park Avenue Newcastle Upon Tyne NE3 2HB 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) 0191 271 6278 0191 2869670 lisamchugh@anchororg.uk keri.sherwood@anchor.org.uk Anchor Trust Mr Robert Lyall Care Home 39 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (39) of places DS0000000439.V368083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places: 39 2. Dementia. Code DE, maximum number of places 10 The maximum number of service users who can be accommodated is: 39 19th September 2007 Date of last inspection Brief Description of the Service: Cranlea was purpose built in 1987 as a residential care home. The care home provides en suite single accommodation for 39 older people over two floors. There is a large lounge, conservatory and dining room on the ground floor. There are a number of quiet seating areas, an additional lounge and two dining rooms on the first floor. The home also offers a small library, a telephone kiosk and hairdressing facilities for residents. There are communal toilets located on each floor and residents have the use of four bathrooms, two of which are fitted with bathing aids. Cranlea is in Kingston Park, which is to the north of Newcastle. There is good access to local shops, churches, a GP surgery and public transport. The home does not provide nursing care. Fees range from £407 to £475 per week. The home provides some information about the service through the service users guide. A copy of the last inspection report written by the Commission for Social Care Inspection is available. These help enable people to make a decision about whether the home would be suitable for them. DS0000000439.V368083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. How the inspection was carried out Before the visit: We looked at: • • • • • Information we have received since the last key inspection on 8th May 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The provider’s view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The visit • • An unannounced visit was made on 3rd July 2008. A further visit was made on 8th July 2008. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We sent questionnaires to the home to issue to ten people who live in the home, ten members of staff and ten relatives. Ten were returned from people living in the home, six from members of staff and three from relatives. We told the provider what we found. DS0000000439.V368083.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? An activities organiser has been appointed. She has introduced some new activities and is hoping to develop these further. Live entertainment is provided on a regular basis. Short trips take place to shopping centres and local places of interest. Some people living in the home had enjoyed recent trips to South Shields and Beamish. A summer fayre has been organised in August. DS0000000439.V368083.R01.S.doc Version 5.2 Page 7 Comments included:‘I love playing bingo’ ‘My mother really enjoys playing bingo’ ‘I enjoyed going to Beamish’ Surveys have been issued to the people living in the home to find out their views about the décor and menus. People have been able to choose some new chairs for the communal areas and 12 flats have been refurbished. There is a programme in place to refurbish all the remaining flats and the communal areas. The manager has been registered with the Commission and has experience in caring for people with dementia. The registration of the home has been varied to include 10 places for people with dementia. Staff have received training to help ensure their needs are met. Comments include:‘Good response from manager to recent concerns’. ‘We are beginning to see the benefits of change made by Robert, the new manager. We believe that he is committed to bringing about significant changes to the environment and quality of care for residents.’ What they could do better: Since the last inspection more activities have been introduced to the home and outings have taken place. However more alternative activities should be introduced to meet the individual needs of people who are unable to join in the activities provided, or where they do not like them. More opportunities need to be provided to take people out of the home to venues of their choice. Comments included:‘I would like to get out more. I have only been out to attend a doctor’s appointment’. ‘There is too much bingo and I don’t like that’ ‘There is lots of bingo and games. Lots of people like these but I don’t. I would like to go out more’. ‘More activities’ DS0000000439.V368083.R01.S.doc Version 5.2 Page 8 ‘Lack of activities to meet individual needs’. The manager should review the staffing levels in the home to help ensure staff feel able to meet the individual needs of the people in the home at all times. He should also ensure that staff feel that the lines of communication are working well, to ensure needs are fully met. 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. DS0000000439.V368083.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000000439.V368083.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5. Quality in this outcome area is good. Needs are assessed prior to people moving into the home, to help ensure their needs can be met. People are able to visit and spend time in the home to decide whether they want to move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People have their needs assessed be care managers and staff in the home prior to moving in. The person using the service and relevant people who know them are involved in this process. This helps to ensure the home can meet their individual needs. Copies of these assessments were available on the case files that were examined. DS0000000439.V368083.R01.S.doc Version 5.2 Page 11 People are able to visit the home and spend time there so they can decide whether the home can meet their needs before they make a decision to move in. One person who had recently moved in, and their relative, confirmed that assessments had been carried our and they had visited the home and spent time there before they moved in. DS0000000439.V368083.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. People are well supported by staff, and care plans show the amount of care and support that is provided. There are good arrangements in place to ensure that the health needs of the people living in the home are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of care plans was examined. The staff continue to work hard to improve the care plans, which were well organised and evaluated on a monthly basis. Most staff had received training to complete the care plans and one member of staff said they were looking forward to doing this training in the near future. DS0000000439.V368083.R01.S.doc Version 5.2 Page 13 The care records showed that people living in the home have access to external health care services. GPs are regularly consulted for advice and treatment. People are supported to use chiropody and optical services in the community. The staff on duty were aware of the individual needs of the people living in the home. They were observed to be treating them with respect and good relationships were observed. People are able to access their own bedrooms at any time and can choose how to spend their time. All staff were observed to be respecting peoples’ privacy and dignity. There are comprehensive policies and procedures in place for dealing with medications. A random sample of medication records was examined and some discrepancies were apparent. The manager was aware of this and was taking appropriate action. Audits are carried out by the manager and deputy manager on a monthly basis. The manager stated that new storage cabinets are currently on order. Senior management were also undertaking an investigation into a recent medication issue. The senior management confirmed that all staff dealing with medications had received appropriate training. DS0000000439.V368083.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. A range of activities and events are provided in the home for the residents to enjoy and they are able to make personal choices. Friends and family are encouraged to visit and participate in any events taking place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last key inspection an activities organiser has been appointed in the home. She has introduced some new activities and is hoping to develop these further. Activities taking place in the home are displayed in the various locations in the home. Activities include bingo, crafts, board games, carpet bowls, manicures and sing a longs. Representatives from local churches visit on a monthly basis. DS0000000439.V368083.R01.S.doc Version 5.2 Page 15 Live entertainment is provided on a regular basis. Short trips take place to shopping centres and local places of interest. Some people living in the home had enjoyed recent trips to South Shields and Beamish. A summer fayre has been organised in August. The activities organiser is currently gathering items of china and memorabilia to turn the small upstairs lounge into a tea room. A record of those participating in various activities is not recorded and no entries are made on individual care plans. One relative felt there should be more individual activities to meet the needs of people who could not join in some activities provided. Comments include:‘There is too much bingo and I don’t like that’ ‘There is lots of bingo and games. Lots of people like these but I don’t. I would like to go out more’. ‘More activities’ ‘Lack of activities to meet individual needs’. ‘I love playing bingo’ ‘My mother really enjoys playing bingo’ ‘I enjoyed going to Beamish’ ‘Lack of activities to meet individual needs.’ ‘The staff encourage my mother to sit in the lounge which I think is good, it stops her being isolated’. Visitors who were present during the inspection said they were made welcome and could call at any time. The people living in the home said they could choose what they wanted to do and where to spend their time. A furniture ‘road show’ had taken place so people living in the home could try out and choose new furniture. People had also been asked to choose the décor for their bedrooms and communal areas. DS0000000439.V368083.R01.S.doc Version 5.2 Page 16 Menus have recently been reviewed and the people living in the home were consulted about the choices available. During the lunchtime staff were offering a choice to people and the atmosphere was relaxed and unhurried. The tables were appropriately laid. One lady said it was her job to fold the napkins which she liked doing. She also said she liked to help with the dishes. Comments included:‘The food is very good, I eat too much because it is so nice’. ‘I like all the food that is given to me’. ‘Too much food’. ‘I would like more flavouring in the food – I think it is sometimes bland’. ‘We have sandwiches too much’. DS0000000439.V368083.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. A complaints procedure is in place and people living in the home are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The case files contain information about the complaints policy and procedure. The surveys returned by the people living in the home and relatives all stated they knew how to make a complaint. Four people who were spoken to said they knew how to complain but had no reason to. One relative said ‘good response from manager to recent concerns’. A complaint and two safeguarding issues have been appropriately dealt with since the last inspection. The majority of staff have attended training on safeguarding adults. There is a programme in place to ensure this training is available for all staff. The staff on duty were aware of the procedure to follow if they observed any bad practice taking place. DS0000000439.V368083.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26. Quality in this outcome area is good. The home has a programme to improve the decoration, fixtures and fittings, which will provide a more comfortable and pleasant place for people to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection 12 flats have been redecorated. There is a programme in place to redecorate the remaining flats and the communal areas in the home. People living in the home have been consulted about the colour schemes. DS0000000439.V368083.R01.S.doc Version 5.2 Page 19 The people living in the home have access to a pleasant garden where garden furniture is provided. Each person living in the home has his or her own bedroom with en suite facilities. Most people have personalised their rooms with items of furniture, pictures, ornaments and photographs. The people who were spoken to said they liked their rooms and the home was always clean and comfortable. 10 surveys returned by people living in the home said it was always fresh and clean. All areas in the home were homely, comfortable and free from offensive odours. DS0000000439.V368083.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. There are enough staff, who have been properly recruited, trained and supported, to meet the needs of the people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection the manager, a team leader, four care assistants, an activities organiser, one administrative assistant, two domestic assistants, a chef and a kitchen assistant were on duty. The home also employs a handyman on a part-time basis. Some staff felt there were times when staffing levels did not allow them to spend quality time with the people living in the home. One member of staff commented that staffing levels are ‘at times more than what is required’. A policy and procedure supporting the recruitment and selection of staff is in place. A random sample of staff files was examined and these confirmed that Criminal Records Bureau checks are received prior to staff being employed by DS0000000439.V368083.R01.S.doc Version 5.2 Page 21 the home. Photographs of each staff member have been placed on their personal files. The deputy manager has recently attended a training course on recruitment and selection of staff which she had found very useful. Job descriptions and contracts of employment have been issued to all staff members. A training plan was in place for mandatory health and safety and specialist training for this year. Training and development records are kept for all staff. The deputy manager has also completed a training analysis on the needs of the people living in the home to help ensure staff are competent to meet their individual needs. The staff on duty felt they receive plenty of training to help them care for the people living in the home. One staff member said she felt the training on ‘Dining with Dignity’ had been very useful when assisting people to eat. The manager stated that all staff are to receive training on equality and diversity in the near future. There is a programme in place to ensure staff achieve a National Vocational Qualification (NVQ) Level 2. One staff member said she was looking forward to enrolling for this training in the near future. The people living in the home confirmed that they enjoyed good relationships with the staff. The home has experienced a high staff turnover since the last key inspection but this has now settled and the staff team are committed to providing a good quality service. DS0000000439.V368083.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. The home is managed by a competent person and is run in the best interests of the people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has recently become registered with the Commission. This means he has been vetted and found to be competent and of good character. Since the last inspection a meeting has been held with the people living in the home and the minutes were available for inspection. The manager has found it DS0000000439.V368083.R01.S.doc Version 5.2 Page 23 is more effective to have smaller discussions with groups of people, as they are more confident to pass an opinion. Surveys have also been issued to people asking their views on the food and the décor in the home. Surveys are also to be issued to people living in the home and their relatives about all aspects of the care provided. Most of the staff team felt they worked well as a team but two felt there was a lack of communication. Policies and procedures are in place for dealing with the money held on behalf of the people living in the home. The staff in the home do not act as appointee or agent for any residents. Appropriate signatures and receipts are retained for all transactions and separate records are held for each person. The manager and deputy manager carry out monthly audits on the care plans, finance system and medication system. A compliance review carried out by the area manager, national care specialist, home manager and deputy manager took place in April this year. This helps to ensure standards are being met and improvements made where necessary. Policies and procedures are in place to help ensure the safety of the people living in the home and the staff. Accidents are recorded and analysed on a monthly basis. Tests are carried out on fire safety equipment, water temperatures and kitchen equipment. The tests carried out on the fire safety equipment were not recorded in one place making it difficult to find. All staff receive regular health and safety training. Dates have been set to update this training when necessary. DS0000000439.V368083.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 DS0000000439.V368083.R01.S.doc Version 5.2 Page 25 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. 1 Standard OP12 OP13 Regulation 16(2)(m) and (n) Requirement The registered manager must ensure that activities are provided to meet the individual needs of the people living in the home. They must be enabled to engage in community activities according to their preferences. Timescale for action 31/10/08 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. 2. 3. 4. 5. Refer to Standard OP12 OP27 OP30 OP31 OP38 Good Practice Recommendations A record should be kept stating when people living in the home participated in activities to help ensure individual needs are being met. The registered manager should review the staffing levels to help ensure staff were able to fully meet the needs of the people in the home at all times. All staff should receive equality and diversity training to help ensure staff are competent in these issues. The registered manager should ensure that there are clear lines of communication between the staff team. Records of tests to fire safety equipment should be DS0000000439.V368083.R01.S.doc Version 5.2 Page 26 recorded in one place to ensure they are clear and easily identified. DS0000000439.V368083.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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