Care Home: Crown House

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What the care home does well The home provides staff to look after the residents who are recruited thoroughly and receive comprehensive training. The staff, the manager and the provider are committed to the care of the residents and look after the residents in a dignified, caring and considerate way. The home provides an excellent environment that is safe, comfortable, clean and well decorated for the residents to live in. The residents are given a good choice of fresh, in season food for their meals that are presented well. The residents` views are taken into consideration and put into place to make sure that their choices are met. The residents receive activities that suit their needs and take into consideration their previous interests. Visitors to the home are made very welcome and families are communicated with about changes to the resident. What has improved since the last inspection? There were no requirements or recommendations made at the last inspection on 5th September 2006. Some of the bedrooms have been redecorated and had new soft furnishings. The roof gardens have had the addition of a water feature and bird tables and the kitchen has been redecorated and had some new equipment. The residents now have the option of Sky television in their rooms. What the care home could do better: We have not made any requirements or recommendations at this visit. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Crown House Crown Walk High Street Oakham Rutland LE15 6BZ     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: Anthea Richards     Date: 0 1 0 9 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 25 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Crown House Crown Walk High Street Oakham Rutland LE15 6BZ 01572770301 01572770250 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Michael Waycot,Mrs M Waycot care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: No additional conditions of registration apply. Date of last inspection Brief description of the care home Crown House is a care home providing personal care and accommodation for up to twenty-two older persons. The accommodation is sited on the first floor above a shopping arcade, having originally been a hotel. The home can be reached by the stairs or by the passenger lift. There is no parking available at the home but there are car parks nearby and it is served by public transport. There are twenty single rooms and one shared room all having full en-suite facilities. 0 Over 65 22 Care Homes for Older People Page 4 of 25 Brief description of the care home Crown House benefits from two roof gardens providing seating. Information as to the facilities and services offered is available to prospective service users upon request; alternatively these are located in the reception area along with copies of the Commission of Social Care, Inspection Reports. The maximum weekly fee is £ 495.00, which was provided on the day of the site visit, and is detailed within the homes documentation. Additional costs for individual expenditure such a Chiropody, and hairdressing services are payable, the amount being dependent upon the services received. 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: This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we [throughout the report the use of we indicates the Care Quality Commission], spent five hours reviewing information received by the Care Quality Commission [CQC] since the last annual service review on the 10th September 2008. The visit took place on the 1st September 2009 and lasted seven hours. During the visit we checked all the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to two of the residents. Care Homes for Older People Page 6 of 25 To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and visiting families. With their permission the residents bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit we spoke with the manager, the provider, the residents, the staff and families visiting the home. We also spoke to a district nurse visiting the home. We looked at the Annual Quality Assurance Assessment (AQAA) that the home had sent to us when we asked for it. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –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. The residents needs are always assessed before moving into the home and they have good information to help them make the right choice about the home. Evidence: The residents and the families spoken with, told us that they had received a Statement of Purpose and a service user guide. The residents spoken with confirmed that they had had a visit from someone from the home and had the information that they needed to make a decision. They told us that they were able to visit the home for a meal or for a longer stay to make sure that they would like the home and that it was suitable for them. The Statement of Purpose and Service Users Guide gives people the information that they need to know about to help them make a decision about the home. All of the residents case tracked had thorough, completed pre admission assessments in their care plans. These had been completed by the manager or a senior member of staff. Care Homes for Older People Page 10 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. The staff are very aware and responsive to the needs of the residents and they give excellent, individual care, with privacy, dignity and respect. Evidence: The two case tracked records were found to contain individual evidence of the care being given to the residents and reflected the care that they needed. We spoke with many residents and families who all told us that they received the care that they needed and that they were happy that they received it. The residents and their families told us that they had been involved with the care planning and the regular reviews of them and had signed them. The care plans are based on individual needs and identify their interests and wishes. We spoke with a district nurse who was visiting the home and she told that she was very happy with the home. She told us that they have a good relationship with them, that the residents are well looked after, that they are referred to her as soon as they should be and that her instructions are carried out. The home has worked with the Care Homes for Older People Page 11 of 25 Evidence: district nurses and the doctors and have completed training to allow people in the home, where possible, to be cared for by them until they die. We saw a medicine round being carried out and the staff spoken with were aware of the receipt, storage, administration and disposal of medicines. The manager completes an audit of the medicines and the medicine charts to make sure that they are correct. There were no controlled (dangerous) drugs in the home at that time but the staff were aware of the storage and documentation requirements for them. There is a policy and risk assessment in place for people who look after their own medicines. Comments received included: I am very happy in the home, I came for respite for five weeks and stayed for good. the doctor is always called when I need him She has come alive since she moved from the other home Home is excellent, couldnt fault it Care Homes for Older People Page 12 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. The home provides sufficient activities for the residents to enjoy and take part in and meets their spiritual and nutritional needs very well. Evidence: Activities in the home include flower arranging, newspapers, nails, hairdressing, card games, board games, discussions and outside entertainment such as singers. The staff were seen to be undertaking individual activity with residents in the lounge, reading newspapers and talking with them. The lounge was buzzing with conversation between the residents and with a lot of visitors. There are not a lot of activities arranged but there are enough things to do I brought games and cards with me but havent had time to use them Because of the homes close proximity to the town people can spend time in the town shopping and hairdressing. Care Homes for Older People Page 13 of 25 Evidence: Visitors are made very welcome in the home at any time and are always offered refreshment, which we saw on the day and the visitors told us. They have the opportunity of having a meal with their relative in a very pleasant private dining area. The cook plans the meals around the meat and the vegetables that are in season and that are good and available in the local market and butchers. She gives choices of meals and is aware of individual needs and choices. We spent time with the residents during their lunch, which was well presented and served with silver service which they told us that they were enjoying. The staff were seen to be sitting with the residents to help them with their meals and talking with them. Religious needs are catered for by the residents having a monthly service in the home or by visits from a local minister. Care Homes for Older People Page 14 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. There are good systems in place to support and protect residents and staff are aware of the processes. Evidence: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. The policy could be made available in a large print and other languages if it was needed, which makes that as many people as possible could read it. The complaints form was clear and easily followed. The home and the the Care Quality Commission have received one complaint since the last annual service review on 10th September 2008. This was discussed with the manager and the provider on the day of the visit and was resolved satisfactorily. The residents, the families spoken with and the surveys told us that they were aware of how to make a complaint and told us that if they had to make one they were happy that it would be dealt with properly. The staff were aware of how to deal with a complaint and were happy that they would be dealt with correctly. The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that Care Homes for Older People Page 15 of 25 Evidence: they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the manager and the records seen supported this. They were confident that the management would handle any issues correctly. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents and staff are well protected by the policies and procedures in the home that provides a safe and very pleasant environment to live in. Evidence: Crown House is situated on the first floor of a building overlooking the High Street in Oakham, and can be reached by the stairs or the passenger lift. The home has a large lounge and a dining room. There is a private dining room/ lounge where the residents can have quiet time and can have a meal with family or friends. There are mostly single bedrooms with en-suite facilities with one shared room. The whole home was very well decorated and furnished. It was clean and well maintained. There are two lovely roof gardens with pots of plants and chairs and tables for the residents to use. A water feature and bird tables have been added to the gardens for the residents to enjoy. There is a life sized model of a cow on one of the roof gardens, which the residents told us that they loved. The provider told us that a lot of the residents had come from the country so they decided to bring a bit of the country into the home. The bathroom seen was clear of any hazards and clean. It had both a walk-in shower Care Homes for Older People Page 17 of 25 Evidence: and a jacuzzi bath. The kitchen has had a recent EHO inspection and was awarded three stars and was given a good rating. My bedroom is lovely and I have been able to bring my own things in The hot water temperature records were found to be up to date and within recommended levels. 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. The residents are well protected by the recruitment and excellent training practices in the home. Evidence: We looked at two staff files and both of them contained the documents that are required. These include two written references, a Protection of Vulnerable Adults check and a Criminal Records Bureau check. The staff spoken with confirmed that they had received recent training in moving and handling, challenging behaviour, safeguarding of vulnerable adults, first aid, care planning and Equality and Diversity. The records that we saw and speaking with the manager confirmed this. The manager holds a training matrix showing when courses would be held and which staff needed to attend. The residents, the families spoken with all felt that the staff were well trained to do their job and that there were always enough staff to look after them. Couldnt be better, would recommend it to anyone. We saw the induction programme, the basic one takes three days to complete and includes fire, health and safety, moving and handling and infection control. The staff then work through the common induction standards which takes about six weeks. Care Homes for Older People Page 19 of 25 Evidence: 14 of the 15 care staff hold a National Vocational Qualification [NVQ] at level 2 or above. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. 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. The residents views are taken into account and their safety is protected by the practices in a home that is run in their best interests. Evidence: The Registered Manager has worked at Crown House as the manager for 14 years and works very closely with the provider who lives on the premises. She has achieved an NVQ at level 4 and the Registered Managers Award. Both the manager and the provider were available throughout the visit. There are regular meetings held for the residents and for their families, to discuss activities and menus in addition as to how the home is meeting their needs. These were confirmed by the residents and their families and by the minutes that we saw. There is an annual quality questionnaire sent to the residents and their families and the questionnaires that we saw on the visit confirmed this. The families and the residents told us that they had completed the questionnaire. The home additionally sends out questionnaires throughout the year to gain peoples opinions about the Care Homes for Older People Page 21 of 25 Evidence: home such as the food and the laundry. We received very positive comments from the residents and the families at the visit, amongst which were that the staff and the manager were very supportive of them and their relative. We saw the manager and the provider spending time with the residents and the visitors on the day of the visit and they were both very aware of all of their needs. The home does not hold any accounts for the residents for personal money. There was evidence from the staff spoken with and from the records seen with that they are having regular, formal supervision with their line manager. Formal supervision of the staff gives them and their line manager the opportunity to discuss work and training issues and needs. There are regular staff meetings held, confirmed by records held and by the staff spoken with. The areas of health and safety such as hot water temperatures and fire alarm testing were found to be in order. 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 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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