Care Home: The Crescent Care Home

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What the care home does well The Crescent is a family run home which provides care and support to people. People are assessed prior to moving in to ensure that the home is able to meet their needs. People are involved as far as possible with their care. Comments about the food and the social activities were good. Relatives and visitors are welcome at any time. Health and personal care was said to be of a high standard and people living at the home said that they were happy. The staff said that they receive good support from the management and that the atmosphere is relaxed and friendly. What has improved since the last inspection? The service user guide had been updated to make clear the arrangements for coming in at night. The contracts have been amended to reflect the level of fees. Screens have been purchased for shared rooms to enable privacy during personal care tasks. All staff now receive supervision on a regular basis. Quality assurance systems have been developed to seek the views of people living at the home. The fire risk assessment has been updated in line with guidance from the fire safety officer. What the care home could do better: Care plans need extending to reflect how people like their individual needs to be met. The complaints procedure should include the contact details for the local authority. Locks should be fitted to all communal bathrooms/W.C to support people`s privacy. The radiator in the lounge should be covered to avoid any risks to people living at the home. CARE HOME ADULTS 18-65 The Crescent Care Home 7 South Crescent Headland Hartlepool TS24 0QG Lead Inspector Tanya Newton Key Unannounced Inspection 20th November 2008 9:45 The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Crescent Care Home Address 7 South Crescent Headland Hartlepool TS24 0QG 01429 861350 P/F Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Theresa Evans Mrs Claire Morgans Mrs Theresa Evans Mrs Claire Morgans Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide residential care to one named individual with learning disabilities aged over 65 years until such a time as this care is no longer needed. 16th November 2006 Date of last inspection Brief Description of the Service: The Crescent Care Home is a nine bedded home for adults with learning disabilities and is jointly managed by Mrs Theresa Evans and Mrs Claire Morgans. It is located in a large terraced house on the sea front at Hartlepool Headland, overlooking the town walls and pier and is indistinguishable from any other house. This is a heritage and preservation area with much character, but with modern amenities close by. The views from The Crescent, across the harbour and Tees Bay to the Cleveland Hills are exceptional. The Crescent is not a purpose built care home. Its facilities are located on 3 levels and some people are accommodated in double bedrooms. Fees for the service were £495 at the time of inspection. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection was unannounced and carried out between the hours of 9.45am and 4pm. Prior to the visit the home were asked to complete an annual quality assurance assessment (AQAA). This provides CSCI with information about the home. During the inspection time was spent talking to people living at the home, staff and the owners/managers. Records were also looked at. Comments received from people during the inspection have been included within this report. What the service does well: What has improved since the last inspection? What they could do better: Care plans need extending to reflect how people like their individual needs to be met. The complaints procedure should include the contact details for the local authority. Locks should be fitted to all communal bathrooms/W.C to support people’s privacy. The radiator in the lounge should be covered to avoid any risks to people living at the home. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had enough information to make an informed choice about moving into the home and could be confident that their needs would be met. EVIDENCE: The home has a statement of purpose and service users’ guide, which provides people with information about the home. All people moving into the home are assessed prior to admission. This makes sure that the home is able to meet people’s needs. Each person has a contract. Contracts have been updated and are signed by people living at the home. Contracts tell people about the terms and conditions of residence at the home. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In the main people had their health and social care needs met in a planned way based on risk management principles and with regard to choice and preference. Written documents such as care plans should be extended to reflect how this is done. EVIDENCE: All of the case files looked at had a basic care plan in place. Care plans would benefit from some revision to make them more person centred. They should include more task specific detail to reflect how people like their care to be delivered. Risk management strategies are in place to describe how risks can be minimised for people living at the home. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 10 People who were spoken to during the inspection said that they were encouraged and supported to make decisions and choices about all aspects of their lives. Staff said that the service was run in such a way that people were encouraged to be as self managing as possible. Care files showed evidence of input from other health professionals where this was required. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s social needs are supported and mealtimes were relaxed and enjoyable. EVIDENCE: People said that there were a range of activities provided. Some of the people living at the home go out independently. The home is run in a way, which promotes a family atmosphere. Regular meetings are held in the home so that people living there can be involved in decisions. One of the people living there said, “We have resident meetings and are kept informed of what is going on”. People living at the home were able to attend day services, participated in supported employment and went out with family and friends. One of the people living at the home said, “ We go on lots of holidays, I have been all over, on our birthdays we have a party tea and one of the girls makes us a The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 12 cake, it’s lovely” another said “my sister comes to visit, I go out to work and there is lots going on”. The home has a communal lounge for people to share, people living at the home said that they could also spend times in their own rooms. Comments about the food were good. Menus are discussed in meetings and people are able to make a choice. One of the people living at the home said, “We have nice meals”. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In the main people had their health and personal care needs met in a planned way, although written documents such as care plans should be extended to reflect how this is done. EVIDENCE: People said that they were well cared for by staff at the home. The care plans should be updated to reflect the way in which this care is delivered. There was evidence within care plans of input from other health professionals and social care staff. People living at the home said that staff provided care in private and treated them with dignity and respect. The systems to store and administer medication were looked at. Records were signed and medication was being stored safely. Staff had received training in the safe handling of medicines. Records were maintained of all medicines being The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 14 booked into and out of the building. None of the people living at the home administer their own medication at present, but the manager said that people would be supported should they wish to do so. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures were in place to respond to complaints and to protect people from the potential risks of abuse. EVIDENCE: There have been no complaints to the home since the last inspection. The home has a complaints procedure and people living at the home said that they would feel confident in raising any concerns. The complaints procedure should be amended to include the contact details of the local authority. The home has polices on abuse and whistle blowing. The policy on reporting allegations to the local authority was missing. The manager said that she would get another copy. This policy was viewed during the previous inspection of the home. Staff spoken to during the inspection said that they would have no hesitation in reporting poor practice. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In the main people live in a clean and homely environment. All bedrooms used by people living at the home must be fit for purpose. EVIDENCE: A tour of the home was taken. Rooms were nicely furnished and decorated. Bedrooms reflected people’s individual taste. One of the people living at the home is using the attic as a bedroom, this room was meant to be a storage area and its use as a bedroom must cease as it is unfit for purpose. Shared rooms have screens in place to support people’s privacy. Where rooms are shared, people have given their agreement. Not all of the bedrooms have locks on the doors, where these are not in place risk assessments are carried out. All communal bathrooms and toilets should have locks fitted. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 17 The radiator in the lounge was uncovered, although a risk assessment was in place regarding this, it is recommended that the home arrange to have a cover fitted. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are deployed in sufficient numbers and with sufficient skills to meet the needs of the people accommodated. EVIDENCE: Three of the staff’s training files were looked at during the inspection. There is a clear commitment to training and as well as the mandatory training for staff other courses have also been provided, these include courses on care planning, violence and aggression and key working. Two of the four care staff employed had an NVQ and one person has started this award. All of the four family members who work at the home have an NVQ and/or the registered manager’s award. The home plans to provide training on the Mental Capacity Act to all staff. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 19 Recruitment files were looked at. All contained two references, an enhanced police check (CRB) and an induction. This helps to protect people living at the home. There is one member of staff on duty at all times, in addition to this, there is a manager available either on the premises or on call at all times. The staff member spoken to said that staffing numbers were sufficient. They also said that morale was good. The support for staff was described as ‘brilliant’. The manager and staff confirmed that a programme of formal supervision was now taking place. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and ran in the best interests of the people living there. EVIDENCE: The manager is well qualified and experienced to run the home. The home is managed as a family business and four family members are involved. Quality assurance systems were looked at. The home has a newsletter, which informs people of what is happening and summarises the results from surveys. Regular meetings take place for staff and people living at the home. Surveys are sent out to relatives and stakeholders to seek their views. The home has The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 21 an annual development plan, which is based around meeting national minimum standards. Health and safety systems were looked at. There is a designated staff member who deals with health and safety in the home. There are good systems in place for monitoring this. Fire evacuations are carried out regularly and risk assessments are in place to protect people living and working at the home. The certificates for gas, portable appliance testing (PAT) and electrical safety were out of date. The manager agreed to make sure these checks were carried out. Copies of these certificates were sent to CSCI prior to the report going out in draft. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23(2) Requirement The attic must not be used as a bedroom as it is not fit for purpose. Timescale for action 27/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA6 YA18 YA22 YA24 Good Practice Recommendations Care plans would benefit from task specific detail to tell the story in a clear way how people would like their health, social and personal care needs to be delivered. Care plans would benefit from task specific detail to tell the story in a clear way how people would like their health, social and personal care needs to be delivered. It is recommended that the complaints procedure be updated to reflect the contact details of the local authority. Locks should be fitted to all communal bathrooms to support people’s privacy. The radiator in the lounge should be covered to safeguard people. The Crescent Care Home DS0000021731.V373202.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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