Care Home: Cresta Lodge

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What the care home does well Cresta Lodge provides residents with a quality service in a comfortable and homely environment. The providers, manager and care staff are committed in giving a friendly and professional service. Comments received by CSCI from residents and visitors/relatives were very positive about the care and support that is provided. Clear guidelines are recorded in care ensuring that care staff are able to provide a person centred care and support package. Residents bedrooms are decorated and personalised to meet individual tastes and preferences. The training programme and individual training records show that courses are organised throughout the year to include regular updates and refreshers. What has improved since the last inspection? A new large medicine storage cupboard has been added which provides more appropriate space. The hallways have been attractively redecorated with new lighting and curtains. New lounge chairs have also been purchased. All cleaning materials/chemicals are stored in a locked cupboard. What the care home could do better: It is recommended that the home seeks more detailed assessment information from healthcare professionals regarding prospective residents with dementia care needs prior to their admission. CARE HOMES FOR OLDER PEOPLE Cresta Lodge Bungay Road Poringland Norwich Norfolk NR14 7NA Lead Inspector Andy Green Unannounced Inspection 13th November 2007 11:00 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 Cresta Lodge DS0000066516.V354821.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. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cresta Lodge Address Bungay Road Poringland Norwich Norfolk NR14 7NA 01508 492775 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) Cygnet Care Limited Mrs Sally Margaret Eickert Care Home 27 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (27) of places Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Twenty seven (27) older people may be accommodated, up to eight (8) of whom may have a diagnosis of dementia. Total number not to exceed twenty seven. 15th July 2006 Date of last inspection Brief Description of the Service: Cresta Lodge is a large extended bungalow situated in the village of Poringland which is approximately 3 miles from Norwich. There is a regular bus service. The home is supported by local GP surgeries and district nursing services. The home can accommodate 27 older people, 8 of which may have dementia care needs. There are 19 single rooms, 9 with en-suite facilities and 4 double rooms all with en-suite facilities, 2 lounges with views of the garden, and a central dining room all situated at ground floor level. There are offices on the first floor. There are extensive, accessible gardens to the rear of the property, with smaller garden areas to the front and to the side. Cars can be parked in the drive at the front of the property. Email : info@chevingtonf9.co.uk The fees range from £410 to £450 per week. The most recent CSCI report is clearly displayed in the Statement of Purpose situated in the entrance hall and further copies can be made available to residents and their relatives upon request from the home’s office. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection carried out an unannounced inspection of this service on 13th November 2007. We met with the manager, providers, members of staff, visitors/relatives and a number of residents during the inspection. A variety of records were inspected including care plans, risk assessments, staff files, organisational policies, medication records and health and safety records. A tour of the premises was also undertaken. Additional information was supplied by the home in the completed AQAA (an assessment document completed by the home). What the service does well: What has improved since the last inspection? A new large medicine storage cupboard has been added which provides more appropriate space. The hallways have been attractively redecorated with new lighting and curtains. New lounge chairs have also been purchased. All cleaning materials/chemicals are stored in a locked cupboard. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 7 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 Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 8 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): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home produces information to ensure that prospective residents can decide if they wish to live in the home. EVIDENCE: The Statement of Purpose is reviewed and updated to ensure information regarding the home and its services are accurate. A detailed Service User Guide is also made available to residents. The home continues to receives assessment information from the local authority and for those individuals who are self-funding the manager and senior care staff carry out a needs assessment using the home’s own assessment form. There have been no significant changes to the assessment process since the last inspection. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 9 Prospective residents and their family/relatives are encouraged to visit the home as part the assessment process to ensure that the residents need’s can be fully assessed. The home is fully occupied at present and there is a waiting list. Prospective residents are informed when a place becomes available in the home. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive appropriate health and personal care to meet their assessed needs. EVIDENCE: Four of the resident’s files were seen. Detailed information regarding the person’s history, health and social care needs are recorded. The manager stated that the care planning process has recently been reviewed and is now presented in a more person centred approach. There are clear guidelines for staff stating how care and support is to be delivered to meet assessed needs. Risk assessments are in place including mobility and falls prevention. Daily care notes were seen which accurately record the care and significant events occurring during the resident’s day in the home. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 11 Changes in care are clearly documented with evidence that reviews are carried out on a monthly basis to monitor changing needs. Reviews are completed by key workers and monitored by the manager. Where there have been significant changes a new sheet with the updates is inserted to ensure that the care plan remains current and up to date. Residents continue to have access to a variety of healthcare professionals including district nurses, dentist, optician, chiropodist, care managers, GPs, and a psychologist. All healthcare visits/appointments are recorded in individual resident’s care plans. Medication records are recorded accurately. A new large medicine storage cupboard has been added which provides more appropriate space. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff provide support to ensure that residents have access to activities appropriate to their needs. EVIDENCE: The home has a cheerful and comfortable atmosphere and residents were socialising with each other, relatives visitors and staff on duty. A lively domino session was in progress, in one of the lounges, involving the home’s oldest resident who has reached the marvellous age of 105. The home continues to provide a range of activities including music entertainment, bingo, art and craft work, exercise sessions and religious services. Christmas events and parties are being organised. A hairdresser also regularly visits the home. The manager stated that day trips continue to be organised and a number of residents have been to a local garden centres and pub lunches during the last year. The home has contact with local churches and two residents attend services. Residents are also able to spend time in their bedrooms if they so wish. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 13 There is a varied range of nutritious meals provided throughout and residents are offered choices to the planned menu. Snacks and drinks are also available at all times during the day. Meals can be taken in the resident’s bedroom if they prefer. Residents met during the inspection confirmed that the meals provided in the home was of good quality and that choices are made available on request. A residents meeting is held every three months where issues regarding food, activities and any other changes to the services provided can be discussed and actioned. Minutes are taken and made available to residents. Residents were complimentary about the services they received and felt appropriately supported by a friendly and caring staff team. Comments received from relatives and visitors met during the day were positive and they felt that their relative lived in a safe and comfortable home. A relative confirmed that they were always kept informed of any changes or significant events. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 14 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints procedure to ensure that residents are protected from abuse and have their complaints acted upon appropriately. EVIDENCE: The home has a clear complaints procedure to ensure that any concerns or safeguarding adults issues are dealt with and actioned appropriately. There was evidence in place to show that appropriate action is taken regarding complaints or concerns. A relative met during the inspection confirmed that she would not hesitate in contacting the manager/senior staff if she had any concerns. Staff confirmed that they receive updates regarding training in the protection of vulnerable adults and it was clear from conversations that staff would have no hesitation in reporting any incidents of abuse or neglect to the manager or senior staff member on shift. It was observed that care staff spoke to residents in a friendly, social and respectful manner and knocked on bedroom doors before entering. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 15 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): 19,20,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides appropriate premises and accommodation to meet the resident’s needs and preferences. EVIDENCE: The home is well presented and maintained and is free from unpleasant odours. An ongoing programme of maintenance ensures that the home and the gardens remain in good order and repairs are carried out in a timely manner. Since the last inspection decoration has been carried to the hallways including improved lighting and new curtains. Chairs in the sitting room have been replaced and there are plans to redecorate the lounge areas in the new year. Appropriate door closures have been fitted to all bedroom doors and all non- fire resistant doors have been replaced with fire doors. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 16 New appliances have also been purchased in the last year including a washing machine, tumble dryer, carpet cleaner and a fridge. Residents and relatives confirmed that the accommodation provided was comfortable, homely and could be arranged to meet their individual needs. Residents are encouraged to personalise their bedrooms with additional furniture, television, music systems, photographs and paintings. This was clearly evidenced in the bedrooms viewed during a tour of the premises. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and processes ensure that residents are protected from harm. EVIDENCE: The home is fully staffed including 5 carers in the morning, 4 carers in the afternoon and 2 carers at night. The manager is available during the day and also provides on–call. There are also separate catering/kitchen staff, cleaners, laundry staff, gardener and maintenance person. All staff are issued with contracts, job descriptions and clear details of their areas of responsibility. Three members of staff’s files were seen and they contained appropriate information including their application form, two references and evidence of satisfactory POVA/CRB checking. One of the organisation’s training co-ordinators arranges updates in mandatory and client specific courses. This includes POVA moving & handling, first aid, fire safety, dementia, medication and infection control. A clear training programme is in place which identifies training that has occurred with dates for refreshers. Two members of care staff were interviewed and they confirmed that they received ongoing training throughout the year. NVQ training is well established in the home and a number staff are working towards NVQ at either level 2 or 3. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 18 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): 31,33,35,36,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that residents receive a good and safe standard of care. EVIDENCE: The manager is experienced and skilled and provides a clear and supportive style of management. She has completed the Registered Managers Award and is near to completing NVQ 4. She receives regular support from the providers of the home. Both of the providers were involved in the inspection and they are clearly committed to providing a quality service for residents. One of the providers carries out monthly management visits and in depth quarterly visits to review the care and services provided in the home and action any issues that may arise. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 19 Staff members spoken to confirmed that they felt well supported by the manager and senior care staff in the home and that they were able to freely raise any issues or concerns. Residents and one of the relatives confirmed that they found the management in the home to be responsive to any issues or queries that they have raised. Recorded supervision sessions are in place to monitor the staff’s practice and development needs. Evidence of regular sessions were seen to achieve at least 6 meetings throughout the year. Health and safety records are kept including water temperatures. The fire records were satisfactory and there are contracts in place for the servicing of hoists and fire safety appliances and up to date checks were seen. All cleaning materials/chemicals are stored in a locked cupboard. The electrical system in the home is also protected by a circuit breaking device to ensure resident safety. Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 20 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 3 X 3 X X 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 3 13 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 3 X 3 Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cresta Lodge DS0000066516.V354821.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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