Care Home: Croft House

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What the care home does well The people like living at the homeThey make choices about activities they want to do.The people like their bedrooms.They go on holidays with staff.The menus are displayed in picture format.The staff like working with the people.They attend lots of training to help them meet the people`s needs.The staff help the people in a kind manner.The staff get very good support from the manager. What has improved since the last inspection? The requirements from the last inspection were met. What the care home could do better: Provide the service user guide in a picture format the people will understand.Ensure all staff receives at least 6 supervisions per year. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Croft House 138 Leicester Road Thurcaston Leicestershire LE7 7JJ The quality rating for this care home is: Two star good 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: Ansuya Chudasama Date: 1 6 0 3 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (20092008) 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 Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Croft House 138 Leicester Road Thurcaston Leicestershire LE7 7JJ 01162368667 01162368661 crofthouse@madasafish.com Voyagecare.com Voyage Ltd care home 6 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: Croft House care home is registered to provide personal care to male and female service users who fall within the following categories: Learning disability (LD) 6. The maximum number of persons to be accommodated at Croft House is 6. Date of last inspection 2 8 0 2 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Croft House is a care home providing care and accommodation for up to seven adults with a learning disability. All seven bedrooms have an en-suite facility The home has its own vehicle so there is good access to the community and its local amenities. Care Homes for Adults (18-65 years) Page 5 of 31 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on the 16th of March 09. We spoke to the manager We spoke to the staff We talked to the people. Care Homes for Adults (18-65 years) Page 7 of 31 We watched how the people and staff did things together. We looked at information about policies and procedures which tell the home how to do things Care Homes for Adults (18-65 years) Page 8 of 31 What the care home does well The people like living at the home They make choices about activities they want to do. Care Homes for Adults (18-65 years) Page 9 of 31 The people like their bedrooms. They go on holidays with staff. The menus are displayed in picture format. Care Homes for Adults (18-65 years) Page 10 of 31 The staff like working with the people. They attend lots of training to help them meet the peoples needs. The staff help the people in a kind manner. The staff get very good support from the manager. Care Homes for Adults (18-65 years) Page 11 of 31 What has got better from the last inspection What the care home could do better Provide the service user guide in a picture format the people will understand. Ensure all staff receives at least 6 supervisions per year. Care Homes for Adults (18-65 years) Page 12 of 31 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Ansuya Chudasama 33 Greycoat Street London SW1P 2QF 02079792000 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 - 03000 616161 Care Homes for Adults (18-65 years) Page 13 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 14 of 31 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the needs of the people can be met by the home. Evidence: The home has a Statement of Purpose and a Service User Guide and these are given to people who are interested in living at the home. Discussion with the manager showed that the guide was being developed further in a picture format that the people in the home would recognise. The home had admitted a new person to the home last May 08. The manager discussed the assessment process they carried out when admitting the person to the home. This consisted of having several visits to the persons home, school and talking to the funding authority about the persons needs. The person had also visited the home for tea visit and met the other people living in the home. A comprehensive assessment was also recorded from the visits. It is a good idea to record the names of all the people involved in the assessment process. All the people in the home have contracts and those seen need to be signed by all parties involved. The home should make the contracts available in a user friendly format that the people in the home are able to understand. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Care Homes for Adults (18-65 years) Page 16 of 31 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 care planning documents are detailed to ensure that the staff have the information needed to meet the needs of the people. Evidence: We looked at one persons care plan in detail and discussed other peoples care needs with staff on duty. The staff had good understanding of the care needs of all the people living in the home. The care plan was written in an appropriate way and included health profiles, risk assessments, behaviour guidelines and other recording charts. All were well written and gave detailed information about the person including their likes and dislikes. The manager told us that person centred planning (PCP) was going to take place soon. The care plans were stored in locked filing cabinets in the office. During the inspection we saw staff talking to people in a friendly and supportive way. They supported people to make decisions and choices for themselves. Risk assessments are in place that enables the people to take risks as part of an independent lifestyle. However the activity section in some of the risk assessments needs to be broken down to a specific activity as discussed at the inspection Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: Care Homes for Adults (18-65 years) Page 18 of 31 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 plan the routines and activities of the home in a way, which meets the choice and wishes of the people. Evidence: Daily records showed that the people attend church services, go to the parks, local shops and visit the local pub. The staff members we talked with told us that the people go to the cinema, country parks, train rides and to the seaside. They also talked about holidays that some of the people had been supported to go on. There were photographs displayed of the people when they had been on activities and holidays around the house. Evidence shows that activities for the people appear to be happening at the home. We observed each person in the home having an activity schedule for the week in widget format. One of the people that was case tracked attended school five days a week. Discussion with the manager stated that this person was leaving school this summer. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: The manager was already looking at organising a planned activity to meet the persons needs. We observed one person being supported by staff to do their laundry and saw pictures of people getting involved with cooking. We were shown a folder for each person and this had pictures that the staff use to find out what activities they want to do. Some of the people in the home maintain contact with their families and go on regular home visits. Friends and families are welcome at the home and the people are able to use the privacy of their room to have private time with their visitors. The lounge provided a homely atmosphere where the people could relax and enjoy a quite moment watching the TV or read a book. The home had picture menu for meals served on each day and this was good. The pictures of the meals seen were healthy and staff had good understanding of the food the people liked. We were also told that the staff encouraged the people to try different food to increase their choices. One person in the home told us that they like the food, their bedroom and the staff. Each persons bedroom seen showed that the home supported the people to pursue their chosen hobbies. For example one persons room had ornaments and Pictures about cows and another person had things to do with trains. We were told that the peoples rooms were being personalised further to meet the peoples needs. We were told that all the people enjoyed using the garden. The garden had a football net and evidence showed that the people enjoyed kicking the ball in the net. The furniture in the garden looked old and worn out. New furniture that met the needs of the people was needed for the garden. It would also be good to have a swing seat for some of the people who would enjoy using this in the summer months. We were told that in the future the people were going to get involved in growing vegetables and there was also discussion about having chickens in the home for the people to look after. The home has house meetings where people have an opportunity to take part in making decisions. Action points are recorded from the meeting for staff to do. Care Homes for Adults (18-65 years) Page 20 of 31 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. The peoples personal and health care needs are met by the home. Evidence: The care plans we saw clearly set out peoples support needs and preferences in receiving personal care. The plans talked about encouraging people to choose what they want to wear and when they get up at weekends. The staff we spoke to were knowledgeable about the people they care for. We observed staff interaction and noticed that they talked to people in a respectful manner and were careful to preserve their dignity. There is evidence in the care files that people are offered support for their physical and emotional health needs. There are records of doctors and hospital appointments, and people have access to district nurse, opticians, dentists, general practitioner, and other health care professionals. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: Care Homes for Adults (18-65 years) Page 22 of 31 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 staff have good understanding of the peoples behaviours to ensure they are protected from any abuse. Evidence: The staff spoken to informed us that they had completed the safe guarding of vulnerable adults procedures training. They had good understanding of this and understood the peoples behaviours to know when they were not happy or were feeling unwell. The complaints procedure was in picture format. The home had received one complaint since the last inspection and this was dealt with satisfactorily. The manager told us that most of the people had their own bank accounts and one person was in the process of opening their own account. The home also had people under the court of protection. One persons finances were looked at in detail and this was satisfactory. The manager and the operations manager monitored the peoples finances. Care Homes for Adults (18-65 years) Page 23 of 31 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 is pleasantly decorated and provides a relaxing atmosphere for the people living at the home. Evidence: A tour of the home showed that the home is clean and tidy. The peoples bedrooms seen are homely and comfortable and individual to the person. All the people have single rooms with en-suite facilities. The communal rooms are furnished in a contemporary style to a high standard. The main corridors are light and airy with pictures on the wall. The small office on the first floor is moving into a bigger room. This will be much better for the staff to access information. (See life style for the garden) The home has a sensory room and a cabin at the end of the garden. The cabin is used for providing a variety of activities for the people. The home has two vehicles so the people are able to access external services. Care Homes for Adults (18-65 years) Page 24 of 31 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 staff receive good training to meet the needs of the people in the home. Evidence: A new member of staff spoken to explained that they had an induction at the home. This consisted of reading policies and procedures of the home, and looking at the peoples care plans. We were also told that new staff had to shadow an experienced member of staff for a number of weeks. This was until they were confident to work on their own. All new staff did the skills in care induction course. The staff member had completed training in food hygiene, infection control, and safeguarding of vulnerable adults procedures. The staff working rota was inspected and showed that the home had increased their staffing levels. The staff told us that there were enough staff on duty to do things with the people. They told us that they enjoyed working at the home and the training provided was very good. The staff recruitment files for three staff were looked at in detail. Evidence showed that the home was obtaining all the relevant information required to safe guard the people living in the home. Records looked at and staff spoken to, showed that not every one was receiving supervision on a regular basis. This needs to happen at least six times a year and needs to be recorded. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: Care Homes for Adults (18-65 years) Page 26 of 31 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 is run in the best interest of the people living at the home. Evidence: The manager has many years experience of working in a variety of different care settings. The manager will be completing the Registered Managers Award in 2009. The manager has also applied to become the registered manager with the Care Quality Commission. The staff told us that they could talk to the manager about any issues and found her to be very supportive. It was also said that her door was always open and she was excellent. The manager told us that regulation 26 visits were being carried out and copies of these were seen. The home carried out Annual Service Review for the people to get their views about living at the home. The manager was looking at ways of developing surveys in an easy to understand format. The Environment Health Officer had visited the home and had given a score of 3 Stars, which was good. The Fire officer had visited on the 2nd of October 08 and the out come from the inspection was good. A contingency plan and emergency fire plan were seen. There was information about the people called about them was kept for emergency situations Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: The fire alarm system was being tested on a weekly basis. The emergency lighting was done on a monthly basis. We were told that fire drill practice was happening on a weekly basis. Both the people and staff on duty were involved with this. The home was sending us regulation 37 notifications and these were dealt with appropriately. The staff had training on health and safety, infection control and food hygiene. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 29 of 31 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 Description 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 Description 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 Adults (18-65 years) Page 30 of 31 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. 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