Care Home: Crossways Care Home

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What the care home does well Crossways Care Home provides an excellent standard of care. Each person`s individual needs and preferences are assessed and included in their plan of care. Staffing numbers ensure that people have some individual time with staff as well as group activities. There are opportunities to go out to the theatre and other places of interest at times. There is a robust recruitment procedure and staff are well supported by the manager and owner. There is a good training programme to ensure that staff have the knowledge and skills they need to do their job well. People who returned surveys praised the dedication of staff and said that they receive the care that they need. What has improved since the last inspection? The range of activities provided in the home has been improved and includes a film afternoon each week. The menus have been reviewed and more choices of meal provided following people`s suggestions. Risk assessments have been updated and reviewed. What the care home could do better: The pre-admission assessment process must include detailed information to show how a decision was made that the home would be able to meet the needs of each person and that the home is only admitting people in line with their current registration. The owner said that she would make sure this process is recorded in more detail. The communal toilets and bathrooms are in need of refurbishment and the owner said that this work is due to be carried out in the next twelve months. Key inspection report Care homes for older people Name: Address: Crossways Care Home 2 Sunte Avenue Lindfield Haywards Heath West Sussex RH16 2AA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Annette Campbell-Currie     Date: 2 0 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Crossways Care Home 2 Sunte Avenue Lindfield Haywards Heath West Sussex RH16 2AA 01444416841 01444453830 crosswaysresidentialhome@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Crossways Healthcare Limited Name of registered manager (if applicable) Mr Pramod Bucktowar Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 25 The registered eprson may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the hoem are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Crossways is a care home registered to accommodate up to twenty-five older people. The registered provider is Crossways Healthcare Limited and the manager has applied to be registered with the Commission. The property is a large detached house, with accommodation provided over three floors. There are nineteen single and three double bedrooms, eighteen of which have en-suite facilities. Communal areas include a Care Homes for Older People Page 4 of 25 Over 65 25 0 Brief description of the care home lounge, dining room, quiet lounge and a garden area at the rear of the house. The home is located in the village of Lindfield, near Haywards Heath, close to local shops and amenities, with easy access to local rail and bus stations. The current fees are between £345 and £720 per week. Care Homes for Older People Page 5 of 25 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 star. This means that people who use the service experience excellent quality outcomes. The previous key unannounced inspection took place on 10th April 2007, at that time the home was assessed as providing excellent quality outcomes for people living there. Since then there have been two annual service reviews (ASRs) that showed that people continued to experience excellent quality outcomes. We (the Commission) carried out the site visit over four hours. The manager was on leave and the owner assisted with the inspection. There were twenty-two people living in the home at the time of the visit. The manager completed an annual quality assurance assessment (AQAA) when we asked for it. This contained the information we requested to help us in planning the site Care Homes for Older People Page 6 of 25 visit. We sent out surveys to find out what people think about the home. Sixteen people living in the home completed surveys, some with the assistance of relatives. Three health or social care professionals and fifteen staff also returned surveys. The comments that people made have been used to help make an assessment of the service. We spoke with five people living in the home and four members of staff including the cook and the administrator who also arranges activities in the home. We saw the communal areas of the home, the bathrooms, sluice room, laundry room and five bedrooms. We read the following documents: the case records for four people, the complaints policy and recording system, samples of policies, menus, staffing rotas, samples of medication records and storage, the recruitment records for two care staff appointed in the past twelve months and risk assessments for the home. The outcomes for people have been assessed in relation to twenty-one of the thirtyeight National Minimum Standards for Care Homes for Older People; including those considered to be key standards to ensure the welfare of people living in the home. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed before they move to the home. Evidence: The manager said in the AQAA that each person has an individualised pre-admission assessment to make sure the home would be able to meet their needs. People are given the opportunity to visit the home before they make a decision about moving there. The people who returned surveys indicated that their care needs are being met. We looked at the case records for four people living in the home. There were copies of pre-admission assessments completed by the manager. A more detailed assessment had been carried out when the person moved in. It was not clear how a decision had been made about whether or not the home could meet each persons care needs and that the home is only admitting people whose needs fall within the category of their registration. The owner said that she would discuss this issue with the manager to ensure that pre-admission assessments and the decision making process is clearly Care Homes for Older People Page 10 of 25 Evidence: documented. The home does not provide intermediate care however respite care is provided. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs met by the staff team. The medication policies and practices protect people. Evidence: A standard format is used for documenting care plans and risk assessments. The manager said in the AQAA that each person is included in the care planning process to make sure that the approach is centred on their individual needs and wishes. The people spoken with said that they receive the care they need and several people said the staff are excellent. We looked at the case records for four people. The care plans were detailed with guidance to staff about the way people prefer their care to be provided. Every aspect of peoples daily lives had been taken into account and it was clear that the care plans are kept under review with changes in need documented. Daily records are also kept and staff said that they are responsible for making sure that all key information is recorded. Care Homes for Older People Page 12 of 25 Evidence: There were risk assessments for all aspects of daily life and where a risk had been identified guidance had been provided for staff. Those spoken with said that they have the information that they need to provide a good standard of care. The surveys that people returned also showed that people receive the care that they need in the way they prefer. The owner said that the home has a good relationship with the local primary care team and that people receive the specialist care that they need in a timely fashion. The professionals who returned surveys indicated that the home seeks advice appropriately and follows any guidance provided. A registered nurse is employed on the staff team, although the home is not registered to provide nursing care. The owner said that this persons expertise is very useful and that she provides training and guidance to care staff. The registered nurse ensures that peoples physical needs as well as their emotional and social care needs are appropriately assessed and met. The community nurses provide nursing input when people require this. There are medication policies and procedures in the home and the manager is responsible for ensuring that all guidance is followed by staff. Medication is only administered by staff who are trained and competent to do so. The medication storage facilities meet requirements and the sample of medication records we saw were in order. Staff are provided with guidance about how to protect peoples privacy and dignity as part of their induction and ongoing supervision and training. During the day people were being treated with courtesy and respect and all those spoken with said that the staff are very good. Care Homes for Older People Page 13 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People experience the lifestyle of their choice and are provided with a well balanced and nutritious diet that they enjoy. Evidence: There is an activity programme in the home and a part time activity coordinator. People are given a programme of planned activities each month in large print so that they can choose what they would like to take part in. There is a range of sessions to choose from including: art classes, armchair exercises, music sessions and film afternoons. A newsletter is sent round to people every three months to keep everyone informed of planned events. Peoples interests and spiritual needs are noted in their care plans. Religious services and communion is available in the home and local churches provide support and visitors. Staff said they are able to spend time with people on a one-to-one basis which some people prefer. Records are kept of those attending activity sessions and peoples views are sought to make sure they are receiving the lifestyle they prefer. People are supported to maintain contact with their families and community links. People are encouraged to make some choices in their daily lives for example what Care Homes for Older People Page 14 of 25 Evidence: time they rise in the morning and retire to bed in the evening. The food is of a high standard with fresh, local produce used including fresh fruit and vegetables. There are two choices of meal at lunch time and a vegetarian option. There is also a choice of dessert. People said that they enjoy the food and most people who returned surveys said that they like the food. Special dietary needs are catered for and the cook knows everyones likes and dislikes. The dining room is attractively set out and most people choose to take their meals in the dining room. Nutritional assessments are carried out and peoples weight is checked each month. If a concern is identified the persons fluid and food intake is recorded and monitored. We read completed charts that showed action is taken when there is concern about a persons health and wellbeing. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel that their concerns and complaints would be listened to and acted upon. There are measures in place to protect people from harm or abuse. Evidence: There is a complaints policy and procedure that is displayed in the home and given to each person when they move in. There is a system for recording any complaints that are made; no complaints have been made in the past twelve months. Residents meetings are held on a regular basis and relatives invited so that any issues or concerns could be raised and then would be addressed. The home follows the West Sussex multi agency safeguarding policies and procedures on safeguarding vulnerable adults; there is also a whistle blowing policy available to staff. All staff have completed training in safeguarding procedures and the staff spoken with said that they understand their responsibility to report any concerns they may have. There have been no safeguarding issues reported in the home. Care Homes for Older People Page 16 of 25 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 homely, comfortable and clean home. Evidence: There is a programme of maintenance for the home and the manager said in the AQAA that the requirements of the fire officer and the environmental health officer have been met and that all equipment is serviced as required. The home is comfortably furnished and people spoken with said that they are very happy with their rooms. The gardens are well cared for and provide a comfortable place for people to use in good weather. The communal bathrooms and toilets are in need of refurbishment and the owner said that this work would be carried out as a matter of priority. There are permanent cleaning staff who keep the home in good order. All staff have completed training in infection control. The home was clean and free from offensive odours. The care staff are responsible for laundry duties. Three people made comments in the surveys that we received, that the system for laundry could be improved. The owner said that this matter would be looked at again to make sure that people are happy with the way their clothes are being cared for. Protective wear should be available to staff in areas of the home where there may be a risk of cross infection including the laundry room. Care Homes for Older People Page 17 of 25 Evidence: Care Homes for Older People Page 18 of 25 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 are supported by a team of staff who are well trained and competent. The recruitment procedure protects people living in the home. Evidence: The staffing levels in the home meet the needs of the people living there. The staffing rotas showed that there are usually five people on duty in the mornings and four in the afternoons. At night there are two waking night staff. The staff spoken with and those who returned surveys said that they have the information and support they need to provide care for people living at Crossways. The manager said in the AQAA that there is a robust recruitment procedure in place in order to protect people living in the home. We looked at the records for two recently appointed care staff. Prospective staff had completed an application form and three written references had been obtained. People had not started work until an Independent Safeguarding Authority (ISA) check had been carried out. The owner said that newly appointed staff are always supervised until the full Enhanced Criminal Record Bureau (CRB) check has been received. The records we saw confirmed that this is the case and staff who returned surveys said that their recruitment procedure had been thorough. Care Homes for Older People Page 19 of 25 Evidence: There is an induction programme that meets the Skills for Care standards. There is an ongoing programme of training that includes the mandatory training and specialist topics such as: palliative care, working with people who have dementia or challenging behaviours, managing change and counselling and talking therapies. All the staff spoken with and those who returned surveys said that they have very good training opportunities. Twelve of the eighteen care staff have achieved the National Vocational Qualification (NVQ) in care at level two or above. This exceeds the target of 50 recommended in the National Minimum Standards for Care Homes for Older People. Care Homes for Older People Page 20 of 25 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. People benefit from a home that is well run and their views are sought and taken into account in the planning of the service. Peoples financial interests are safeguarded. There are measures in place to protect the health and safety of people living in the home and staff working there. Evidence: The manager worked in the care team at Crossways Care Home for six years prior to being appointed as manager and has recently applied to become registered with the Commission. Prior to his appointment the owner was registered manager and she said she maintains regular contact with the home to make sure that standards remain high. The manager has achieved the Registered Managers Award (RMA). There are quality assurance systems in the home. Peoples views are sought every six months and the results collated in a graph. Any issues that arise are addressed as soon as possible. A residents meeting is held every 4 months and relatives are invited; written records are kept so that any required actions can be followed up. The Care Homes for Older People Page 21 of 25 Evidence: owners are in regular contact with the manager, staff and people living in the home and monitor the quality of care provided. The owner said that the records of Regulation 26 visits would be held in the home in future. The home does not support people with their finances; this is done by family members or solicitors. There is a system for holding small amounts of money for peoples daily needs. Records and receipts are kept and safe storage is provided. We saw the records that showed peoples money is protected. There are policies and systems for health and safety issues in the home. We saw detailed risk assessments to show that any aspects of risk have been identified with guidance provided about ways to minimise risks. Staff have all completed updated training in health and safety issues. Incidents and accidents are appropriately recorded and there is a system for monitoring incidents so that measures can be put in place where possible. Care Homes for Older People Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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