Inspection on 28/11/07 for Grange Lea Residential Home

This is the latest available inspection report for this service, carried out on 28th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Grange Lea Residential Home 24/02/06

Grange Lea Residential Home 08/09/05

Grange Lea Residential Home 08/02/05

Grange Lea Residential Home 17/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Grange Lea Residential Home Grange Road Off Wigan Road Bolton Lancashire BL3 5QE Lead Inspector Judith Stanley Unannounced Inspection 28 November 2007 09:15 X10015.doc Version 1.40 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 Grange Lea Residential Home DS0000009287.V337814.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 Older People. 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. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Lea Residential Home Address Grange Road Off Wigan Road Bolton Lancashire BL3 5QE 01204 665903 01204 650112 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) Dr A Joy Kumar Ghosh Mrs Glynis Roberts Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. That within the maximum number of 26 there can be up to 26 OP. Date of last inspection 13th November 2006 Brief Description of the Service: Grange Lea is a privately owned care home that offers care for 26 older people. It is situated off a main road close to Bolton town centre and other local amenities and public transport runs close by. Grange Lea offers accommodation to people who require assistance with personal care and support. Grange Lea is a purpose built two-storey home that offers twenty-two single bedrooms and two double rooms. Six rooms have en-suite facilities. A passenger lift is available to the first floor. On the ground floor there is a lounge and a separate dining room, a smaller lounge is available on the first floor. Bathrooms and toilets are available on both floors. There is a small garden area and a car park; parking is also permissible on the road at the front of the home. The current scale of fees range from £309.88 to £350.00 per week. Additional charges are made for hairdressing, personal toiletries and personal newspapers. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included a site visit and was unannounced and was carried out over a period of 6 hours. Part of the time was spent in the office looking at the information the home holds on the residents (care plans) and other records the home needs to keep to ensure that the home is being properly run. The inspector spoke with the manager, the deputy manager, staff and residents and one relative and observed the lunchtime routine and the morning medication round. Prior to the inspection the manager was sent an Annual Quality Assurance Assessment form (AQAA). This informs the inspector how the home meets the National Minimum Standards, the outcomes for people using the service, what the home does well at and the areas that need to be improved. To find out more about the home comment cards were sent to residents, relatives, staff and other visitors to the home, such as doctors and district nurses. No comment cards have been returned to the inspector. One relative spoken with at the time of the inspection expressed satisfaction about the care his relative received. There has been one complaint made to the manager of the home and Bolton social services had been involved in resolving this. All information and correspondence has been documented and was available for inspection. There had been no complaints made to the CSCI since the last inspection. What the service does well: What has improved since the last inspection? Care plans are now being signed by the resident or by their relative. The range of activities provided and the recording of the activities had improved. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 6 Staff files now contain an updated photograph of the member of staff. A copy of the providers or a company representative’s report is now kept on site. What they could do better: The assistance given to residents at meal times needs to be improved to ensure that residents receive a sufficient and substantial and nutritious diet. Meals need to be served on a dinner plate and not a side plate as several residents had food coming off their plate. The menus must be reviewed to ensure that residents receive a variety and choice and that certain foods are not repeated over and over again for example baked beans. (Since the inspection the manager has contacted the inspector to inform her that menus have been changed). Staff breaks need to be reviewed. It was noted that some staff take their lunch break at the same time the residents are having their lunch. As this is a very busy time and several residents required assistance it would be beneficial if more staff were available and breaks taken at a less hectic time. The lighting in the lounge needs to be improved as the current lighting is insufficient and makes the lounge dark. The chairs, mainly in the lounge downstairs need to be cleaned, the arms were dirty and stained. All stained ceiling tiles on both floors must be replaced, these look unsightly. The corridor carpets on the both floors need to be replaced, as they are looking ‘shabby’ and in some areas had been patched up. At least two of the carpets in bedrooms were heavily stained and in need of cleaning. The dining room carpet needs to be cleaned or replaced as this was stained from dropped food and grease. (Since the inspection the manager has contacted the inspector to inform her that a new floor has been laid in the dining room). Chipped paintwork throughout the home needs addressing. In the interest of good hygiene procedures the home’s cat should not be in the dining room at meal times nor sat on the tablecloth on a table after lunch. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 7 Staff should make sure that attention is given to personal grooming, with specific regard to ladies hair being brushed, removal of ladies facial hair and gentlemen being clean-shaven. The use of communal toiletries must stop. All residents should have their own toiletries in their own rooms, which can be taken into the bathroom when residents bathe. The view from some resident’s windows is unsightly due the building that was demolished at the side of Grange Lea. It is recommended that the appropriate people concerned be contacted to remove the rubbish and debris left behind. The outside garden would benefit from a tidy up and the removal of the burnt out fireworks. The home has a handy man but his hours are split between the providers other homes. The handy man also does the homes shopping. The inspector recommends that this persons time could be better utilised at Grange Lea to keep on top of the maintenance of the home both internally and externally and alternative arrangements be made for the shopping, for example shopping on line. 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. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 were assessed. Standard 6 does not apply, as Grange Lea does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents and their supporters with up to date information about the home that helps them in making a decision about moving into the home and the services provided. EVIDENCE: The home has a statement of purpose and a service user guide. This information is available to prospective residents and to residents already living at the home. The information is clear and concise and informs people of the service provided and the facilities available and about the staff and their qualifications. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 10 All residents have a written contract/terms and conditions regardless of how their care is purchased. The manager showed the inspector the different contracts used. Two residents files were chosen for inspection. A pre admission assessment had been carried out prior to admission to ensure that the resident’s health, personal and social care needs could be met. Assessments are carried out at the most convenient place for the prospective resident, either at their home or in hospital. The assessment provides staff with the information they need to ensure that the individuals care needs can be met and provides the base line of the building up of the care plan. There are several residents at the home that have a diagnosis of some form of a dementia related illness. The CSCI have had recently been notified of three incidents where residents have either hit another resident and in one case where a cup of cold tea was thrown over another resident. All staff have received training in caring for people with dementia, however there may come a point when staff can no longer deal with some individuals and they will have to be reassessed as to whether Grange Lea is the best place for them and can meet their needs. Caring for people with dementia is a specialised area of care and from observations made at meal times the manager and staff need to be more aware of how residents needs can be fully met. (See standard 15). Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide staff with the information they need to meet the needs of the residents. EVIDENCE: Two care plans were chosen for inspection. The information contained in the care plans gave staff information about the care each resident required. A brief social profile is also available that informs staff of the life experiences of the resident’s, this helps staff to get to know the resident better and generate topics of conversation. Other information in the care plan includes risk assessment, for example risk of falls and mobility, nutrition e.g. soft diet, pressure care and moving and handling. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 12 There was evidence to demonstrate in the care plans that outside agencies, such as doctors, district nurses and the chiropodist are contacted and visit the home as required. Through observation it was seen that residents hands and nails were clean, residents clothes were clean and coordinated. The inspector brought to the attention of staff that some ladies hair appeared not to have been brushed and some gentleman required a shave. Some ladies had unsightly facial hair. Staff were seen ensuring the privacy of residents by knocking on doors before entering and making sure that toilet doors were closed behind residents going to the toilet. Staff were heard speaking with residents in a friendly and respectful manner. The morning medication was observed, and the staff giving out the medication was trained and competent in doing so. Residents were given their tablets in an appropriate manner with water to help them swallow them. Once given the tablets were immediately recorded on the individuals MAR sheet (drug sheet). It was noted that several residents had been prescribed a calcium drink instead of the chewable tablets. This was taking residents a long time to drink that volume of liquid and most of the powder had settled at the bottom of the glass. The manager was dealing with this problem and had requested that for the next delivery of medication that chewable tablets are prescribed. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The way meal times are managed is unsatisfactory. Residents were not receiving the assistance they require to ensure their nutritional intake was sufficient. EVIDENCE: Since the last inspection activities within the home and the recording of activities had improved. Activities include, arts and craftwork, residents had been making Christmas lanterns and was making Christmas cards. Other activities included bingo, ball games, quizzes, and one-to-one chats. There is a television and music centre in the lounge. It was noted that at one point during the day the television was on with the sound turned off and the music centre playing. As several residents are confused, having two things on at the same time may add to their confusion. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 14 Visitors are welcome to visit the home at any time; there are no restrictions as to when people can visit. Residents can meet with visitors in any of the communal areas or in the privacy of their own rooms. One visitor was spoken with and was pleased with the care his relative received; he had no concerns. The home encourages residents where possible to maintain links with the local community. The home has regular visits from the Roman Catholic Church who offer residents the opportunity to take part in communion if they so wish. Where possible residents exercise choice of what time they get up in the morning and what time they retire. Due to the mental capacity of some residents they are unable to make choices for themselves and staff need to assist them with some decisions. The menus were available for inspection. It was discussed with the cook and the manager that some of the meals need to be reviewed and a full description of the meals given, for example one day states fish fingers or jacket potato served with baked beans, there is nothing documented what goes with the fish finger. During discussion with the cook and staff, some of the meals are not well received for example cheese salad or cold meat salad. Over the four weekly menu cycle baked beans were served fourteen times, (the manager has informed the inspector that this has been reviewed since the inspection). The desserts at teatime are also repetitive with jelly and ice cream, which is served on two consecutive days and fruit and cream. It may be beneficial that on some days that the heavier hot puddings are served at teatime with the lighter meal. The inspector recommends that the use of packet soups and tinned soup is limited due to the high salt content and homemade soups and broths would be more nutritious. The use of wholemeal bread instead of white bread for sandwiches would provide extra roughage and fibre. It was noted that the menus do not always reflect the food served, however the cook documents what meal people have had. The inspector observed the end of breakfast, with the menu stating that at breakfast residents have the choice of fruit juice, grapefruit, prunes, a choice of cereal or porridge, cooked breakfast, toast and preserves and a choice of drink. Lunch is the main meal of the day and the inspector sat with residents during lunch and observed what went on. The main meal was roast chicken, creamed potatoes, cabbage, carrots and gravy, followed by chocolate sponge and custard or the option of sandwiches. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 15 The hot meal was nicely cooked and was colourful. It was noted the dinner was served on small tea plates and some residents were having difficulty keeping the food on the plate. The inspector recommended that dinner plates might be better. The inspector had concerns that at least five residents hardly ate any lunch and that plates were cleared away. One resident sat for twenty minutes with a plate full of cold food in front of her before it was taken away and she only had a yogurt. Another resident was given two quarters of a sandwich, which was served on white thick bread with ham on one and thick chunks of chicken on the other, no extras as a garnish. The inspector watched the resident attempt to eat the sandwiches with a knife and fork resulting in the food going over the table and floor. The inspector brought this to the attention of the staff. The resident was brought another two sandwiches of which she ate very little followed by a small amount of pudding, which the manager fed to her. This was not enough food in take for this person. Due to the seating arrangements in the dining room staff cannot sit down and assist to feed residents, it was noted that they are stood at the side of them hovering over them. This is not good practice, staff need to be able to sit with residents and offer assistance and encouragement and conversation. Some staff had taken their break during the lunchtime when their time was needed in the dining room. The inspector suggested a few ideas that could improve the mealtime for example having two sittings so that staff have time to sit and feed residents or to have a member of staff sat at each table to assist and observe what is going on and who has eaten what and report back to the manager if there are any concerns. Another member of staff could take the food from the serving hatch, and serve all the residents whilst the other staff sat down. Due to the number of residents with dementia and high levels of confusion the inspector recommends that the home invests in the two books about how to help people with dementia to eat and drink well called Food, Drink and Dementia by Helen Crawley from the University of Sterling and Eating Well for Older People from The Caroline Walker Trust. From checking the care plan of one resident who has moved into Grange Lea from another care home on 02/11/07, she weighed 42.10 kilos and when weighed again on 26/11/07 was 39.9 kilos. The inspector appreciates that the move to another home could have been distressing and contributed to this factor and the scales may be different, however this lady was seen to eat very little during the inspectors observation. If people do not receive a well-balanced and nutritional diet this can also lead to the skin breaking down and resulting in pressure sores and pressure areas. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 16 A lighter afternoon tea is served and residents should have been offered cheese and onion pie and baked beans or egg on toast, followed by fruit flan and cream (which the cook was changing). Suppers are available before residents retire and are offered toast, malt loaf, crumpets and a milky drink or a drink of their choice. In the interest of good hygiene practices the home’s cat should not be in the dining room at mealtimes as it is sitting waiting at residents feet for food and was then observed laying on a tablecloth on the dining table. If any resident wishes to feed the cat perhaps some alternative arrangements should be agreed. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their supporters can be confident that any complaints or concerns will be listened to, taken seriously and appropriate action taken. EVIDENCE: The home has a satisfactory complaints procedure in place. The complaints book was inspected and there was one ongoing complaint, which was being investing by social services. The nature of the complaint was documented as was the outcomes so far. There had been no other complaints made to the manager of the home and no complaints had been made to the CSCI. The home has a procedure in place for responding to any allegations of abuse. A copy of Bolton safeguarding adult’s policy is available for staff to refer to if necessary. All staff had undertaken training in the protection of vulnerable adults. The manager is reminded that the comments made in standard 15 regarding the lack of assistance and nutritional intake for residents could constitute to neglect if not addressed. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24,25 and 26 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Certain areas of the home require upgrading to ensure that residents live in a well maintained home. EVIDENCE: From a tour of the premises, it was evident that certain areas of the home require attention. The corridor carpet on both floors is in need replacing, as the carpet is looking shabby and in some parts damaged. The carpet in the dining room must be replaced, as it was dirty and stained (the manager has informed the inspector that this has now been addressed since the inspection). The paintwork is chipped and looks unsightly and is in need of attention. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 19 In two of the bedrooms looked at the carpets were heavily stained and in need of a deep clean, this was discussed with the manager. Several bedrooms were looked at and were clean and tidy and residents had personalised their rooms with their own possessions brought with them from home. In the main lounge downstairs the arms of the chairs were dirty and needed to be cleaned. The lighting in the lounge is not sufficiently bright enough and extra domestic lighting is required to a recognised standard (lux 150). The bathrooms were suitably decorated, however in two bathrooms there was evidence of communal toiletries, such as bubble bath, block soap, shampoo, razors, a toothbrush etc. Resident’s should have their own toiletries in their rooms and brought into the bathroom when a resident is ready to bathe. On checking the environment it was noted that several ceiling tiles were stained and damaged and these must be replaced. The outside grounds of the home require tidying up due to the autumn leaves and the removal of burnt out fireworks from three weeks ago. In the main systems were in place to control the risk of cross infection, staff were seen using different protective clothing for different tasks. Hand sanitizer is available to use in between hand washing. The home’s cat must not be allowed on the tables in the dining room at any time. The laundry is sited away from food preparation and food storage areas and does not intrude on the residents. There were no offensive odours detected within the home. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good recruitment procedures and checks in place ensuring the protection of residents living at the home. EVIDENCE: The staff rotas were available for inspection. On the day of the inspection the day shift was covered by the home’s manager, deputy manager, three carers, a cook, domestic and a laundress. There was two waking staff on duty throughout the night. Staffing levels on each shift must be constantly reviewed to take into account the changing needs of the residents and the number of residents with dementia. The recommended ratio (guideline only) for caring for people with dementia is one member of staff to five residents. The manager is recommended to limit the number of people with dementia accepted into the home or review the category of registration for the home. Several of the staff had worked the home for some time and this helps provide consistent and reliable care to the residents. From the inspectors’ observations, staff morale appeared to be good and the staff seemed to work well together. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 21 Staff training is progressing well and more than 50 of staff have completed NVQ level 2 or above in care. The staff training matrix shows that staff have completed training in first aid, moving and handling, fire safety, food hygiene, protection of vulnerable adults, infection control and dementia. Some staff had completed training in medication awareness. Staff were able to describe the training courses they attended and confirmed it was relevant to their work. Each member of staff had a training record. A full copy of each members of staff’s employment file is kept at the home in a secure location. The file of the most recently recruited employee was looked at and was complete and up to date. Two other files were also examined and found to be up to date. Files contained a recent photograph, application form, two references, a CRB disclosure and other forms of identification. The manager confirmed that all staff have a contract of which a copy is kept at head office and the member of staff are given a copy. Staff undertakes a full induction programme on commencement in work, a copy of this was seen in the new starters file. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and safety procedures ensure that residents are living in a safe environment. EVIDENCE: The registered manager has a number of years of experience in working with the elderly. The manager has completed the Registered Managers Award and is aware that she needs to complete the NVQ level 4 award. It was evident that the manager is kind and caring person from the way she spoke with residents and in the way they responded to her. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 23 The manager operates an ‘open door’ policy so that she can be approached at any time by residents, relatives or by staff and this was seen on the day of the inspection. The office was well organised so that staff have access to all the paperwork and contact information they need during a shift. The quality assurance systems had improved with the providers monthly visits now being kept on site and available for inspection. Satisfaction questionnaires are completed and the home holds residents and staff meetings. Some of the residents have handed over their financial affairs to their families but keep a small amount of money with the manager for safekeeping. Of the two care plans inspected one resident had no money and this was being dealt with by the social worker and another resident had a small amount of cash, which the manager could account for. Balance sheets and receipts are kept. Staff supervision is progressing well and there was documented evidence of the supervision sessions that had been carried out. A new format had been introduced for staff supervision since the last inspection. Records kept and required by regulation were seen to be in good order and up to date, all records were kept securely stored. Equipment and systems used in the home are serviced and maintained. On the day of the inspection an outside contractor arrived at the home to check the emergency lighting and door guards etc. The following checks had taken place and certificates were available to verify that: Lift serviced - 05/10/07 – the engineer requested that some old equipment left by the previous lift company be removed, the inspector asked the manager to address this matter. Hoists –13/09/07 Water testing – 25/09/07 Electrics – 25/10/07 Gas 16/05/07 Portable appliances – 13/04/07 The home carries out weekly fire checks and has regular fire drills. Any accidents, illness or incidents were properly recorded and the CSCI are informed as necessary. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x 3 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP15 Regulation 16(2)(i) Requirement You must ensure that residents are provided, in adequate quantities, suitable, wholesome, and nutritious food which is varied and properly prepared and available at such time as may be reasonable be required by the service user. You must ensure that the home is kept in a good state of repair externally and internally and all parts of the home are kept clean and reasonably decorated. Specially: * The carpets in the corridors and in some bedrooms. * The chairs in the lounge need cleaning. * Chipped paintwork requires attention. * The outside grounds. This is outstanding from the last inspection with a timescale given of 31/01/07). Timescale for action 11/01/08 2 OP19 23(2)(b) (d) 11/01/08 3 OP25 23 (2) (p) You must ensure that suitable DS0000009287.V337814.R01.S.doc 11/01/08 Page 26 Grange Lea Residential Home Version 5.2 lighting is provided in all parts of the home used by the residents. 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 OP26 OP27 OP31 OP38 Good Practice Recommendations The inspector recommends that alternative arrangements be made for feeding the cat and that the cat is not allowed on the dining table. You should consider if an appropriate amount of handyman’s hours are provided at the home. The registered manager should work to complete NVQ level 4 in care. You should act on the lift engineer’s advice and remove the articles in question left by the previous lift company. Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. Extracts may not be used or reproduced without the express permission of CSCI Grange Lea Residential Home DS0000009287.V337814.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!