Care Home: Crompton Court Residential Care Home

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What the care home does well The registered manager has been in post for over 13 years and continues to provide an effective leadership role and offers a well managed home that consistently meets alot of the standards and offers a good standard of care. The service continues to employ longstanding members of staff who offer great stability to the home. The manager also organises weekly surgeries so that anyone can go and see her to discuss anything. We received 11 staff surveys which overall were very positive about working at Crompton court and comments made included, "We have supervision every 8 weeks and appraisals once a year." "The management and all the staff here in Crompton Court worked well to give excellent service to service users." "CRB, pova and references were taken before I was employed." "All usefull information was given to me on my induction so that I could work in a safe environment." "I get supervision. My manager will make sure that I am happy at work and I like the job I am doing." "I feel I have the right support in everything." "preadmission assessments are completed before any clients enter Crompton Court and daily hand overs are given." "All the training that I attended to are relevant not only to my role as a carer but for myself to, because it is applicable to our daily living." "There is good practice of open communication in Crompton Court. Vital information about the clients needs are passed onto the care staff." We received 3 comment cards from health care professionals, comments were mostly positive and included, "Occasionally have concerns that less experienced staff call us inappropriately, but always on side of caution." "As a professional more places for the clients I would like to refer would be good." "I have never witnessed any inappropriate care and residents seem generally happy with care when I see them." "Excellent communication and information is the normal." "Care is of an excellent standard, advice is always sought when necessary if there has been a change in presentation." "I feel that all the staff are caring, polite, approachable and always willing to help and advise in any way possible." We received 3 comment cards from people at the service and their families which were all very positive. Some comments included, "As far as I am concerned everything is running extremely well." "I find Pat the manager a very caring person who I feel I can approach." "The staff are great, very warm, caring and friendly." "The manager Pat is always available to speak to." "Never had to complain." "all staff go out of their way to support residents." Regular checks are made on the safety of the building and equipment to make sure the service is a safe place to live. Everyone living at Crompton Court have their own bedroom and en suite toilet. The service has produced good information about the home which they give to people who are thinking about moving in. They have procedures in place for assessing their needs including trial visits to help people make a choice about Crompton Court. What has improved since the last inspection? The service is meeting the vast majority of the national minimum standards . In a number of respects these standards are being exceeded. The manager continues to look at ways in which the service can be exceeded. The commission have received just one complaint about the service following the last inspection which was fully investigated by the regional manager. There has been no cause for any visits to the service since its last routine inspection. The staff were very enthusiastic to talk to and proud of working at Crompton Court and they all felt they worked well as a team and always strived to make things better for the people who live there. The manager had developed guidance and files for each person who acts as a "key worker". These files were a good example of what the manager had done to develop the staffs roles in supporting people living at Crompton Court. The guidance helped them in getting to know each person, get to know about their life and things important to them and helping support them in what they want to do in the future. What the care home could do better: To review the use of turning charts and fluid balance charts to ensure they relate to the care advised in care plans necessary to show what support a person needs. To look at whether any adaption can be provided for the nurse call system for one person unable to use their hands. To make sure steps are in place to give this person the right support while in their room while they are unable to call for assistance. To review when a specialised chair/ equipment will be provided for one person as a matter of priority so they can then be supported to come out of their bedroom. To provide specialised training on activities to help staff develop their skills in arranging activities to suit everyone at the service. To provide an activities budget and increased hours for the activities organiser to help her further develop initiatives and access to a regular programme of activities. To provide a regular programme of day trips out. To provide feedback to peoples suggestions and requests for a large screen television, sky tv, a nintendo wii game. To update social care plans so they offer up to date support when a persons condition changes. This will help to make sure that they are still included in supporting them with their social needs and requests. To provide specialised training for catering staff regarding special diets including diabetic, gluten free and pureed diets. This will help staff in developing appropriate menus and presentation for puree meals. To review the storage and reasons for the use of frozen food stuffs with catering staff. To provide feedback to everyone at the service regarding any plans or development ofthe environment including the window frames, the wooden frames on the ground floor corridor and lounge. To review the odour in one bedroom and take necessary actions to get rid of the smell in this area. To remove all linen that is ripped and ensure that it it is repaired or replaced providing a good standard throughout. To look at the current use of the ground floor lounge and review whether day space can be developed to produce a large facility so everyone can see the television. To make sure that everyone at the service has updated information regarding their fees and has an up to date contract and terms and conditions with these details. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Crompton Court Residential Care Home Crompton Street Kirkdale Liverpool Merseyside L5 2QS     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: Diane Sharrock     Date: 0 5 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. 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 35 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 35 Information about the care home Name of care home: Address: Crompton Court Residential Care Home Crompton Street Kirkdale Liverpool Merseyside L5 2QS 01512981959 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Care Homes No 2 Ltd Name of registered manager (if applicable) Mrs Patricia Conder Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies 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 categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 34 Date of last inspection Brief description of the care home Crompton Court is registered to provide care for up to 34 older people. The home is purpose built. The accommodation is provided on two floors with access to the first floor from stairs and a passenger lift. The home has thirty-two single and one double bedroom. All rooms have an en-suite toilet and a wash hand-basin. There is a conservatory, large dining room and a lounge situated on the ground floor. There is a further lounge on the first floor. Residents have access to a shower room and a Care Homes for Older People Page 4 of 35 care home 34 Over 65 34 0 Brief description of the care home bathroom on the ground floor and 2 bathrooms on the first floor. Assisted bathing facilities are available in 2 bathrooms. There is a private enclosed garden with seating. Parking is available at the rear of the home. The home is situated in the Vauxhall district of Liverpool, close to local amenities, road and bus routes. At the time of this inspection, the weekly fees for the home ranged from 307.55 pounds to 451.00 pounds. Additional charges are made for hairdressing and chiropody. A service user guide and a statement of purpose, which describe the services offered at Crompton Court is made available to new people, their relatives and professionals before they choose to live at the home. A copy of the most recent inspection report can be obtained from the manager. Care Homes for Older People Page 5 of 35 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: The quality rating for this service is three stars. This means the people who use the service experience excellent quality outcomes. We gathered information for this inspection in a number of different ways. We carried out an unannounced site visit over two days the 4th/5th March 2009. This took place over eleven hours and included reading records, meeting people and looking at the building. We spent time looking at the support the people living at Crompton Court receive. This included looking at the support they get with their daily lives, care plans, medication, money, activities and environment. We met the 9 people who live at Crompton Court Care Homes for Older People Page 6 of 35 and all the staff on duty. We also spoke throughout the visit to the manager. We reviewed any information we had received about Crompton Court following our last key inspection. The manager completed a self assessment form called an (AQAA) which we sent to her before our visit. We used the information in this form and the other information we had to help plan our inspection and write this report. A selection of comment cards were also sent before this visit to staff, health professionals and people who live at the service. We have received 11 surveys from staff, 3 from health professionals and 3 from relatives and people who live at Crompton Court. What the care home does well: The registered manager has been in post for over 13 years and continues to provide an effective leadership role and offers a well managed home that consistently meets alot of the standards and offers a good standard of care. The service continues to employ longstanding members of staff who offer great stability to the home. The manager also organises weekly surgeries so that anyone can go and see her to discuss anything. We received 11 staff surveys which overall were very positive about working at Crompton court and comments made included, We have supervision every 8 weeks and appraisals once a year. The management and all the staff here in Crompton Court worked well to give excellent service to service users. CRB, pova and references were taken before I was employed. All usefull information was given to me on my induction so that I could work in a safe environment. I get supervision. My manager will make sure that I am happy at work and I like the job I am doing. I feel I have the right support in everything. preadmission assessments are completed before any clients enter Crompton Court and daily hand overs are given. All the training that I attended to are relevant not only to my role as a carer but for myself to, because it is applicable to our daily living. There is good practice of open communication in Crompton Court. Vital information about the clients needs are passed onto the care staff. We received 3 comment cards from health care professionals, comments were mostly positive and included, Occasionally have concerns that less experienced staff call us inappropriately, but always on side of caution. As a professional more places for the clients I would like to refer would be good. I have never witnessed any inappropriate care and residents seem generally happy with care when I see them. Excellent communication and information is the normal. Care is of an excellent standard, advice is always sought when necessary if there has been a change in presentation. I feel that all the staff are caring, polite, approachable and always willing to help and advise in any way possible. We received 3 comment cards from people at the service and their families which were all very positive. Some comments included, As far as I am concerned everything is running extremely well. I find Pat the manager a very caring person who I feel I can approach. The staff are great, very warm, caring and friendly. The manager Pat is always available to speak to. Never had to complain. all staff go out of their way to support residents. Regular checks are made on the safety of the building and equipment to make sure the service is a safe place to live. Everyone living at Crompton Court have their own bedroom and en suite toilet. The service has produced good information about the home which they give to people who are thinking about moving in. They have procedures in place for assessing their needs including trial visits to help people make a choice about Crompton Court. Care Homes for Older People Page 8 of 35 What has improved since the last inspection? What they could do better: To review the use of turning charts and fluid balance charts to ensure they relate to the care advised in care plans necessary to show what support a person needs. To look at whether any adaption can be provided for the nurse call system for one person unable to use their hands. To make sure steps are in place to give this person the right support while in their room while they are unable to call for assistance. To review when a specialised chair/ equipment will be provided for one person as a matter of priority so they can then be supported to come out of their bedroom. To provide specialised training on activities to help staff develop their skills in arranging activities to suit everyone at the service. To provide an activities budget and increased hours for the activities organiser to help her further develop initiatives and access to a regular programme of activities. To provide a regular programme of day trips out. To provide feedback to peoples suggestions and requests for a large screen television, sky tv, a nintendo wii game. To update social care plans so they offer up to date support when a persons condition changes. This will help to make sure that they are still included in supporting them with their social needs and requests. To provide specialised training for catering staff regarding special diets including diabetic, gluten free and pureed diets. This will help staff in developing appropriate menus and presentation for puree meals. To review the storage and reasons for the use of frozen food stuffs with catering staff. To provide feedback to everyone at the service regarding any plans or development of Care Homes for Older People Page 9 of 35 the environment including the window frames, the wooden frames on the ground floor corridor and lounge. To review the odour in one bedroom and take necessary actions to get rid of the smell in this area. To remove all linen that is ripped and ensure that it it is repaired or replaced providing a good standard throughout. To look at the current use of the ground floor lounge and review whether day space can be developed to produce a large facility so everyone can see the television. To make sure that everyone at the service has updated information regarding their fees and has an up to date contract and terms and conditions with these details. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 35 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 11 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is given to anyone thinking about moving into Crompton Court. This makes sure that the service is the right place for the person to live and that their needs and be met. Evidence: We looked at records showing what happens when a new person comes to live at the service. Staff completed very detailed assessments to make sure that they identify what care and support a person needs and whether they can provide that at their service. These assessments including detailed tools used for assessing someones pressure areas, and continence assessments. We spoke to people at Crompton Court who said they had been made to feel very welcome and helped to settle in because the staff were so good to them. One health professional talked about the good reputation the service has and how they felt the standards were really good. Care Homes for Older People Page 12 of 35 Evidence: Good information is given to any new person wanting to stay at Crompton Court, including the option of having a trial visit to the service. This makes sure that crompton Court is the right place for the person to live in and and that their needs can be met. The manager has developed a residents guide and a statement of purpose which are available to anyone. The guides include good levels of information on the purpose of the home and the facilities on offer and the manager has been able to have this information transferred onto a CD to help some people who are partially sighted to get the same information. We met some visitors during our visit who advised they can visit at any time and are always made to feel welcome and are always offered refreshments when they visit. They were more than happy with the service and felt that the atmosphere was always really good. Care Homes for Older People Page 13 of 35 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of the people living at Crompton Court are identified so that staff can support them to meet those needs, choices and all aspects of daily living. Evidence: Detailed individual care plans were available for each person, we looked at three of them. As an example of good practice the staff had developed written consent forms for people to sign if they agreed to having their picture taken for their care file. This helped show how staff respect each persons choice and rights in being given the option of having their picture taken. Staff had also developed these plans to include lots of different assessments such as, pressure area assessments/weights/manual handling/use of bed rails and bed wedges. These assessments showed what actions the staff take to help keep people comfortable and safe while living at Crompton Court. The records also showed good relationships and contact with members of the multi disciplinary teams, such as the doctors, district nurses and specialist staff at the Care Homes for Older People Page 14 of 35 Evidence: hospital which helped staff to support people in the right way with their medical needs. District nurses help the staff to get the right equipment such as air flow pressure reliving mattresss and specialist beds which help to keep people comfortable and lessen the risks of pressure sores developing. We received 3 comment cards from health care professionals. comments were mixed but mostly positive and included, Occasionally have concerns that less experienced staff call us inappropriately, but always on side of caution. Often seems short staffed when I visit. As a professional more places for the clients I would like to refer would be good. I have never witnessed any inappropriate care and residents seem generally happy with care when I see them. Excellent communication and information is the normal. Care is of an excellent standard, advice is always sought when necessary if there has been a change in presentation. I feel that all the staff are caring, polite, approachable and always willing to help and advise in any way possible. The plans were detailed and regularly reviewed and gave enough information to show how their personal and medical needs would be met. They covered a diverse range of needs of everyone living at the service, including pressure relief, immobility, diabetes and poor appetite, regular weighing and monitoring. We discussed one plan were staff had not always recorded what care they had given with supporting someone with their fluid, pressure care and social support. Staff were able to verbally give an account of how they supported this person but some of the plans had not been developed to show how the persons needs had changed. Staff advised they were waiting for the supply of a specialised wheelchair which will ultimately help staff to safely support this person in getting out of their room and mobilising within the service. There was no date of when this would be supplied or whether the company could supply the necessary chair and equipment. During our visit the staff recognised a review was needed and carried this out almost immediately so the care plan was more reflective of the support needed to be given while they were confined to their bed until the necessary equipment and chair was supplied. These plans overall, provided staff with good guidance and were appropriate instructions as to the support people require in a range of environments and situations to enhance their life, especially when they wanted to get up and have a bath and have assistance with their personal care. The manager explained that they had developed one bathroom that wasnt used into a store room which left 3 functioning bathrooms for the service. She felt the reduction in bathrooms did not affect peoples choices and it didnt restrict them in having access to a bathroom when they wanted. Care Homes for Older People Page 15 of 35 Evidence: We looked at the storage and procedures of managing medications and they were found to be well maintained and safely managed. One person was supported in managing their own medication to help continue with their own independence for as long as they wished. Staff had developed good auditing of the management of medications which helps to keep up the good standards already achieved in providing a safe system. Staff had also introduced a few good practice initiatives such as the use of tabards advising people they were giving medications out and to try not to disturb them. They had also started using dose alert forms as bookmarks to remind them if someone was asleep or not ready for their medications so they could go back when they had woken up. This was an example of how the staff try to research and introduce new ideas for the benefit of everyone at Crompton Court. We received 3 comment cards from people at the service and their families prior to our visit which were all mainly positive and we chatted to 9 people during our visit. Some comments included, As far as I am concerned everything is running extremely well. I find Pat the manager a very caring person who I feel I can approach. The staff are great, very warm, caring and friendly. The manager Pat is always available to speak to. Never had to complain. all staff go out of their way to support residents. In discussions with staff they were able to explain the way in which people living there make decisions and how they are able to decide for themselves, for example staff support people were they choose to have their meal, either in the dining room or in the privacy of their own room. They were very enthusiastic to talk to and proud of working at Crompton Court and they all felt they worked well as a team and always strived to make things better for the people who live their. Some comments from staff included, The management and all the staff here in Crompton Court worked well to give excellent service to service users. preadmission assessments are completed before any clients enter Crompton Court and daily hand overs are given. There is good practice of open communication in Crompton Court. Vital information about the clients needs are passed onto the care staff. Each bedroom and area of the home had access to a nurse cord so people could contact the staff whenever they needed assistance. However one person could no longer use their hand to operate the call cord and we discussed this with staff regarding what they could do so they were able to call staff easily when they needed assistance. Care Homes for Older People Page 16 of 35 Care Homes for Older People Page 17 of 35 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 people living at crompton court are supported so they can choose what they want to do each day. Evidence: People living at crompton court and the staff have regular meetings to discuss the running of the service. We looked at these records which showed good discussions on alot of things, helping to keep everyone informed and included in the developments of their home. We looked at the individual menus displayed on each dining table to help prompt people as to what choices were on offer that day. The chef also explained that staff visit each person daily to offer people choices of what the want the following day which helps in planing the meals served. A cooked breakfast is also available every day if people choose that. The dining room tables were well laid out and had been attractively laid with cloth table clothes, flowers and condiments. There were mixed comments about the food during our visit, some people loved the food and some people were not keen on the food. We noticed that menus are discussed during house meetings so these comments could be explored further within the service. Care Homes for Older People Page 18 of 35 Evidence: We discussed puree diets and it was acknowledged that the whole meal is mixed together rather than mixed individually as advised by the dietitians. The dietitian had emphasised in their guidance the importance of presentation of puree diets to help people be more tempted in their meal. The staff had various specialised diets to cater for, including gluten free, diabetic and puree meals. They acknowledged that they had not received specialised training for specific diets and this training may help in developing menus to meet their needs. We also discussed the amount of frozen vegetables, potatoes and chips in the freezers and staff felt they had to be used first before they could order fresh supplies of vegetables. This point was discussed with the manager who advised this was incorrect as they are used only when they are waiting for supplies of fresh products. This was identified as a training issue that could be explored and developed further with the kitchen staff. The manager explained that they had a part time activities organiser (14 and a half hours per week,)who develops a regular programme of activities. The posters advertising the activities on offer that week were seen displayed in reception on the notice board. The reception area had an open and accessible area for alot of information to be shared with people. This included a multi faith calender, an orientation weather and date board, lots of information about the service and company including the residents guide and the comments and grumbles book. All of these documents and notices helped to keep everyone informed and included with what was going on within the service. We acknowledged the activities organiser and staff had managed to access and set up various events over the past 12 months which had shown how much they had done with just 14 hours a week and no activities budget. The activities organiser described various initiatives they had developed over the years including weekly visits from schoolchildren who visit regularly and get to know the people living at crompton Court. She explained this had helped them to understand what a care home was and to build up a rapport and understanding of the people living at Crompton Court. Previously the staff had managed to access grants to buy a computer and 3 people had been supported with Learning direct in training and achieving a certificate for their learning skills. The activities organiser explained that she is responsible for developing social care plans for every person living at the service and for maintaining daily records of what activities each person had been involved with. Staff showed great determination and enthusiasm in trying to provide some form of activities for everyone and felt that some people do not like group events so they try and give them 1 to 1 Care Homes for Older People Page 19 of 35 Evidence: support. We acknowledged that with just 14 hours a week this would be difficult to provide on a daily level with just one member of staff. Some daily records described activities over the past week, such as watching the television, general chats, watching a film, 1 to 1 chats and bingo. During day 2 of our visit staff were supporting 4 people in the dining room with flower arranging and we noticed the hair dresser had visited and seen alot of people that day with hairdressing. We noticed that the people we met and chatted to had been supported with their personal care to a good standard. The people we met were well dressed with colour co ordinated clothes. We noticed that some social care plans needed to be changed due to the persons health recently changing. We discussed how staff and key workers could help the activities organiser to keep these records updated so that the support for social care could be changed and updated taking on board the different needs and support needed. We discussed how the daily activity could be displayed so that everyone knew what was planned that day. The staff did this during the visit to help make it clearer amongst all of the information displayed in reception. We discussed training around developing activities and acknowledged there are limited courses on offer, however staff felt they would benefit from specific training on developing activities for people at the service. Staff advised they do regular fund raising and do not have an activities budget supplied by the company. They felt they could untilise alot more activities and arrange alot more if they had an increase in the hours allocated for activities and more funds to set things up. While walking throughout the home the staff had worked hard in displaying pictures of all recent and previous activities. The dining room had an everton display of pictures involving the club and their sponsorship with various activities involving some of the people and staff at Crompton Court. There were lots of pictures of all of the Xmas activities showing the various parties and meals organised by the staff. There was also a dignity at work champions, notice board with pictures of 2 staff. The manager explained this was a new initiative they wanted to get involved with and the staff were due to do training about it so they could help support people further at Crompton Court. We received 3 comment cards from people living at the home Crompton Court. Overall Care Homes for Older People Page 20 of 35 Evidence: they gave mixed comments but they mostly indicated they were happy with the service and facilities at Crompton court. 2 people felt they usually had, activities. Some people said they were happy with activities and some people said they wished they could see more activities on offer each day. Some staff and people living there said they would love there to be regular trips out and they said they would like to get involved and go out alot more. We noticed that the last organised trip out was at Xmas and staff felt that if they had their own minibus they would be able to go out regularly. some felt the weather had affected access to trips out but felt they untilised the garden once the weather was nice enough to sit out. Staff should be commended in what they have already achieved with just 14 hours a week for activities. They showed alot of enthusiasm and vision as to what more they could achieve if they had increased activity hours and an activities budget. Staff felt that routines in the home were flexible so that people were getting up and going to bed when they wanted, and were having their meals and drinks when it suited them. Care Homes for Older People Page 21 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes procedure for responding to concerns and complaints Evidence: Information about how to raise a concern or complaint is made available to the people living at Crompton Court. This is good practice as it helps to increase the opportunities for people using the service now and in the future to have a better understanding of the ways in which they can raise concerns. This policy and guidance is also displayed in reception and contained within the, residents guide. The commission have received just one complaint about the service following the last inspection which was fully investigated by the regional manager. There has been no cause for any visits to the service since its last routine inspection and there have been no safeguarding referrals to the local authority. The manager also organises weekly surgeries so that anyone can go and see her to discuss anything. During our visit it was obvious that the manager always makes herself available to everyone, including, visitors, staff and people living there. The regional manager looks at any records of complaints during their monthly audits and this helps to make sure that all comments are reviewed by both the manager and the Care Homes for Older People Page 22 of 35 Evidence: company representatives. Some of the people we chatted to said they were aware of what to do or who to see if they had any concerns or issues to discuss. They felt they were well supported by staff especially the manager. One person said, Never had to complain. Some of the staff we chatted to described various training that they had attended including, safeguarding and abuse awareness which helped them do their job efficiently. They were happy with the training they had been offered and felt supported with their training needs. All of the staff we talked to described their safeguarding procedures and felt confident of knowing were to go to report any concerns they might have. This helped to make sure they were well trained in knowing how to safeguard the people they support. Care Homes for Older People Page 23 of 35 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. People live in a safe and well maintained home. Evidence: Every bedroom offers a single room with an en-suite toilet. Those people that we chatted to said they were more than happy with the homes facilities including their bedrooms, People said, I have everything I need. The communal areas and corridors on the first floor were well maintained and showed a good standard to the decor achieved offering an attractive environment. The first floor lounge was highly maintained with good quality chairs, fabrics, curtains and carpets. Staff explained this room wasnt really used on a daily basis and was more for training, meetings and occasionally computer work. They felt that most people liked to stay in the smaller lounge downstairs as it was closer to were everyone congregated. The ground floor communal areas were clean and tidy however they experienced alot more wear and tear and this showed in the environment. The wood work on skirting boards and door frames was scraped and some parts chipped in the wood. The ground floor lounge was cramped and full of people sat in chairs arranged around the edge of the room. Some people could not see the television properly from the position of their chair. Visitors went into the dining room to be able to sit comfortable to see their Care Homes for Older People Page 24 of 35 Evidence: relative. This room accommodated 14 people and staff felt that most other people stay in their bedroom. This room could not really accomodate any more people in this room. We discussed why they did not use the top floor lounge and they felt it was due to people choosing to stay on the ground floor. We were advised that the service does not have an ongoing planned maintenance and decorating programme that they could share with people regarding plans for developing their home. However the manager felt that she could request various repairs and decoration via her line manager. The manager had already identified that the windows outside needed repair and this was documented in a meeting dated recently, 1 /3/09. There was no date or response as yet as to what plans will take place around the window frames. The pre inspection survey (AQAA) told us that they are planning to develop more seating areas in the garden for everyone to enjoy. We looked around the service and viewed a sample of rooms. Each bedroom was very clean and tidy and well maintained with attractive and colour co ordinating linen. Just one bedroom had a slight odouress smell that needed to be reviewed. Staff thought it was due to the carpet which they felt needed to be replaced to help keep the room free from odours. We noticed a couple of bed covers/ sheets had small rips that needed to either be repaired or replaced to enhance the standards already achieved in the bedrooms. Some mattresses seen were thin and firm and possibly needed to be reviewed to look at other types of mattress so that people had a varied choice in style of mattress to sleep on. We looked at a sample of maintenance certificates which showed up to date checks as listed in the homes pre inspection questionnaire which helped show what actions were taken to keep the service safe and well maintained. There were various maintenance checks and records to show ongoing and updated checks on eg, water temperatures, in-house fire checks on equipment and systems, fire drills and window restrictors. Crompton Court has their own part time maintenance person who is responsible for alot of checks within the building to help keep the environment safe and comfortable. Care Homes for Older People Page 25 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Crompton court are supported by a well trained staff team who are able to produce a good standard of care and support. Evidence: Records showed that before anyone is appointed to work at Crompton Court they have a series of checks that are carried out. These include obtaining written references and checking with the criminal records bureau (CRB). These checks help to make sure the people living there are safe and that staff are suitable to support them. The manager has developed and produced detailed and well organised personnel files for staff to help show how they are recruited supported and trained while working at Crompton Court. The manager has developed a supervision plan which covered the planned dates for 1 to 1s and appraisals for all staff. This helped show a clear plan making sure that every staff member was supported in their role while working at Crompton Court. Observation of staff and in general discussions with them, showed that they knew the needs of the people they support and know their likes and dislikes and personal requests. Care Homes for Older People Page 26 of 35 Evidence: It was evident they had a good understanding of how to support people and how to make sure their needs are met and their individuality respected and catered for. All staff were seen knocking on each persons bedroom door before entering respecting their privacy. There were various positive comments from visitors and people living at Crompton Court about the staff, including, The staff are great, very warm, caring and friendly. all staff go out of their way to support residents. We received 3 comment cards from health care professionals. comments were mixed but mostly positive and included, Occasionally have concerns that less experienced staff call us inappropriately, but always on side of caution. Often seems short staffed when I visit. I feel that all the staff are caring, polite, approachable and always willing to help and advise in any way possible. We received 11 staff surveys which overall were very positive about working at Crompton court and comments made included, We have supervision every 8 weeks and appraisals once a year. The management and all the staff here in Crompton Court worked well to give excellent service to service users. CRB, pova and references were taken before I was employed. All usefull information was given to me on my induction so that I could work in a safe environment. I get supervision. My manager will make sure that I am happy at work and I like the job I am doing. I feel I have the right support in everything. preadmission assessments are completed before any clients enter Crompton Court and daily hand overs are given. All the training that I attended to are relevant not only to my role as a carer but for myself to, because it is applicable to our daily living. There is good practice of open communication in Crompton Court. Vital information about the clients needs are passed onto the care staff. The Staff rota showed that the home provides 4 staff all day and the manager is supernumerary to the rota.There is also a team of domestic and ancillary staff who help keep the home clean and well maintained. Many of the staff working at the home have been there for several years or more and provide a stable team for the people living there. The manager has supplied various information regarding previous and current training Care Homes for Older People Page 27 of 35 Evidence: for staff in obtaining a care qualification(NVQ). This helps to exceed the basic guideline for at least 50 of staff to have a care qualification. Evidence of the companies commitment to staff training is their commitment in trying to make sure that eventually all staff will have an NVQ qualification at either level 2 or 3. The manager had developed good detailed training records including a large visual training matrix in her office which showed that the staff have received both mandatory and specialist training such as, fire, food hygiene, move and handling, pova and infection control, use of bedrials and bed wedges,medications and care plans. This type of training shows how staff are supported in trying to meet the diverse needs of people living at Crompton court. The manager had also developed guidance and files for each person who acts as a key worker. These files were a good example of what the manager had done to develop the staffs roles in supporting people living at Crompton Court. The guidance helped them in getting to know each person, get to know about their life and things important to them and helping support them in what they want to do in the future. Care Homes for Older People Page 28 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the health and safety of people living there and staff is promoted and protected. Evidence: The manager has been at the service for approximately 13 years and offers a great stability and rapport to everyone at Crompton Court. The manager was seen to have an open and positive management approach with an open door policy, approachable to everyone. There were various comments about the manager and her management style within the service from both the staff, visitors and people living at Crompton Court. Some comments included, I find Pat the manager a very caring person who I feel I can approach. The manager Pat is always available to speak to. The management and all the staff here in Care Homes for Older People Page 29 of 35 Evidence: Crompton Court worked well to give excellent service to service users. The management structure in the service is very good. The registered manager and senior staff have clear responsibilities. The service is effectively managed and any development is in the best interests of the people living there, ensuring a good quality of service is provided. The manager felt she always strives to improve and develop new initiatives if she felt it would benefit people at the service. One example was the dignity of work champions displayed in the corridor. Eventually staff will have training to be the named dignity at work representatives to help support people further. The focus of the service is very much on providing the best to the people living there and responding to their needs. The manager meets with everyone on a regular basis and the minutes of these meetings shows good communication keeping everyone up to date and included with the developments of the home. Some agendas included comments and updates on, eg, occupancy levels, training, (pova), uniforms, Health and safety, media policy, incontinence pads, visitors and Xmas. The home is visited on a regular basis by a representative of the organisation. These visits form part of the quality assurance process and form an opinion on the standard of care provided. These visits are also a requirement of the care home regulations and a report has to be produced to show evidence of these checks. These reports were very detailed and showed regular auditing and monitoring of the standards achieved at Crompton Court. They included information on, eg, interviews and comments made by staff and people at the service, environment checks, analysis of accidents, activities, care plans and finances. We looked at a sample of, resident questionnaires for 2008 carried out by the manager. They were all very positive and contained alot of positive comments and were very complementary about the service and staff. The manager had received a good response and got a total of 33 back from people. The manager explained that they try to organise this twice a year to give people the opportunity to express their opinions about Crompton Court. Within these surveys there was a suggestion that the company should purchased a large screen television for people living there. This point and other suggestion also came up during our visit with people also suggesting that people would benefit from having sky television and a nintendo wii game,( similar to what some people had used with Everton club scheme. There was no maintenance, development plan to show what response had been given to suggestions and requests for a large screen television. We also looked at a sample of staff questionnaires and in total 25 had been received and again they too were very positive about their employment at the service. Care Homes for Older People Page 30 of 35 Evidence: The manager had developed various records to show how health and safety was managed within the service. This included having regular health and safety meetings with nominated people who made sure various risk assessments and risks were monitored and reviewed. We looked at a sample of health and safety risk assessments that covered alot of areas within the service including, catering risks, infection control, coshh sheets, hot water, lifts, clinical waste, manual handling and the grounds, with guides on how to complete a risk assessment. They were all regularly reviewed and updated by staff to show what actions had been taken to reduce risks. The manager had numerous management tools to show how she was safely managing the service including weekly reports that she sent to head office including, training, complaints, analysis of accidents, estates and environment, quality assurance surveys. She also advised that they had a business plan for the company which helps set out the developments of the company for the future. Records and certificates showed that regular checks are carried out on the building and equipment. This includes checking electrical appliances, the gas supply and regular fire checks. These checks help to make sure that the home is well managed and is a safe place to live and work in. We looked at a sample of finances records regarding how each persons money is stored and managed on their behalf. As an example of good practice the company have developed personal allowance contracts. They helped to explain how the company offer to manage their personal allowance and showed a clear process were each person could sign up to agree to have this type of support. The sample of records seen regarding the management of personal allowances were clear and accurate with receipts kept of any money spent on behalf of each person. We noticed that some people had updated contracts which had a breakdown of their fees and contributions and they were signed however one had an old, Highfield contract was not signed and didnt have the fees clear in the contract. The adminstrator had updates to each persons fees and contributions on the services computer but we discussed the need to have clear and up to date documents accessible to the people living at the service. The staff attended to this after day one of this visit and gave an update during our second day to explain what they had done to try and update their finance records. Care Homes for Older People Page 31 of 35 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 32 of 35 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 To review when a specialised chair/ equipment will be provided for one person as a matter of priority so they can then be supported to come out of their bedroom. To review the use of turning charts and fluid balance charts to enure they relate to the care advised in care plans necessary to show what support a person needs. To look at whether any adaption can be provided for the nurse call system for one person unable to use their hands. To make sures steps are in place to give this person the right support while in their room while they are unable to call for assisstance To update social care plans so they offer up to date support when a persons condition changes. This will help to make sure that they are still included in supporting them with their social needs and requests. To provide specialised training on activities to help staff develop their skills in arranging activities to suit everyone at the service. To provide an activities budget and increased hours for the activities organiser to help her further develop initiatives and access to a regular programme of activities. To provide a regular programme of day trips out. Page 33 of 35 2 8 3 8 4 12 5 12 Care Homes for Older People To provide feedback to peoples suggestions and requests for a large screen television, sky tv, a nintendo wii game. 6 15 To provide specialised training for catering staff regarding special diets including diabetic, gluten free and pureed diets. This will help staff in developing appropriate menus and presentation for puree meals. To review the storage and reasons for the use of frozen food stuffs with catering staff. To provide feedback to everyone at the service regarding any plans or development of the environment including the window frames, the wooden frames on the ground floor corridor and lounge. To review the odour in one bedroom and take necessary actions to get rid of the smell in this area. To remove all linen that is ripped and ensure that it it is repaired or replaced providing a good standard throughout. To look at the current use of the ground floor lounge and review whether day space can be developed to produce a large facility so everyone can see the television. To make sure that everyone at the service has updated information regarding their fees and has an up to date contract and terms and conditions with these details. 7 19 8 20 9 35 Care Homes for Older People Page 34 of 35 Helpline: 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 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. 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