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Crawshaw Hall Medical Centre and Nursing Home Good

We are carrying out a review of quality at Crawshaw Hall Medical Centre and Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.
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Inspection report

Date of Inspection: 28 May 2014
Date of Publication: 24 June 2014
Inspection Report published 24 June 2014 PDF

Food and drink should meet people's individual dietary needs (outcome 5)

Not met this standard

We checked that people who use this service

  • Are supported to have adequate nutrition and hydration.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 28 May 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members and talked with staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People who used the services nutrition and hydration needs were not appropriately met.

Reasons for our judgement

We spoke with the person who was working in the kitchen on the day of our inspection. We were told they were covering for the usual cook for the week. We were told there were two cooks to cover shifts.

We spoke with the staff member who prepared the meals and asked how they ensured food was served to people who used the service safely and at the appropriate temperature. We were told they followed the manufacturer’s guidance. We spoke with the provider about our concerns in relation to recording temperatures of storage equipment and food. We were told they would ensure all staff who covered kitchen duties were trained in the correct policy and procedure to ensure people living in the home received food that had been checked and monitored appropriately.

We looked in the kitchen, and saw supplies of fresh and frozen goods in the home. We were told deliveries were received up to three times per week and there were no budget restrictions for supplies. We asked about the menu choices for people living in the home. We were told people would be asked about their choice of meal for the following day and would be offered alternative to the menu if they so wished. People living in the home we spoke with told us they were offered alternatives if the food was not to their liking. One person said, “(Named Owner) gets me what I like it is excellent, fantastic. If I wanted a snack they would get it for me” and, “The meals are very good we are given choices and options”.

Family members we spoke with told us they were happy with the quality of food in the home and people’s specific needs were being met for example, one person told us a pureed diet was provided to their relative and this was presented in an attractive way.

During the lunch time period we undertook a Short Observation Framework for Inspection (SOFI) in one of the dining rooms to see how people’s nutritional needs were being met by staff. A SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. . We saw people were offered food that met their needs for example some people were observed to be eating a pureed diet.

There were 19 of the 22 people living in the home seated in the dining room and they were being supported by six members of staff. We saw some people were being assisted with their meals by the staff. We observed two staff members who were feeding people engaging in very little meaning full conversation with the people they were assisting. Neither person was informed of their meal choice or the drink they were offered.

One person living in the home was not given an explanation relating to what was being offered on their utensil as the food was given to them. On one occasion this person turned their face away from the food. We saw that no communication took place to identify their specific needs. We observed another person was offered food with no gaps to allow them to empty their mouth between mouthfuls of food or drink.

We observed a third person living in the home who was independent with their meal. We saw this person had protective wear over their clothes during lunch. We noted their face and protective clothes were soiled with food. Staff did not approach this person to offer support or a drink during the time of our observation.

We observed a member of staff assisting a person in the lounge with a drink. We observed the staff member was sat on the arm of the person’s chair. We observed that no meaningful conversation took place. This meant we could not be confident people living in the home were assisted to discuss their views or wishes in relation to their hydration needs

We looked in four people’s care files. We saw evidence of care planning and nutritional risks assessments in place. We saw evidence of involvement from appropriate health professionals for example the speech and language therapy team in the care files we looked at. However in one file we saw staff had noted referra