Inspection on 02/10/07 for Grassington House

This is the latest available inspection report for this service, carried out on 2nd October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Grassington House 15/12/05

Grassington House 16/09/05

Grassington House 01/02/05

Grassington House 06/07/04

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

CARE HOMES FOR OLDER PEOPLE Grassington House 50 Prince Of Wales Road Dorchester Dorset DT1 1PP Lead Inspector Andrea East Unannounced Inspection 10:00 2 October 2007 nd 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 Grassington House DS0000056436.V345749.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. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grassington House Address 50 Prince Of Wales Road Dorchester Dorset DT1 1PP 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) 01305 267968 neill1@onetel.com Mrs Marion Jennifer Franklin Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Grassington House has one bedroom which may accommodate two service users; this is bedroom 5. 15th August 2006 Date of last inspection Brief Description of the Service: Grassington House is a care home, which provides accommodation and personal care for up to eleven people in the category of old age (OP), not falling within any other category. Mrs Marion Franklin is the registered provider and manager of the service. Her sister, Mrs Sally Drake who jointly owns Grassington House, and her husband, Mr Franklin, support her with management tasks and other general duties. The home is established in a large Victorian semi-detached house situated in a residential area of Dorchester, close to the town centre and local amenities. The accommodation is available over two floors, and bedrooms situated on the first floor can be accessed by a two-person passenger lift. During 2005 the home was extended and accommodation reorganised, this has ensured that there are eleven single bedrooms, one bedroom that can be used as a double room, to accommodate two people, a ground floor laundry and a spacious conservatory. The home also has a front lounge and a separate dining room. There are two assisted bathrooms on the ground floor. The home provides a range of services including; hairdressing, chiropody, dental care and access to the community nursing service. The rear garden is enclosed by walls and fencing and has been developed and planted with shrubs and flower borders. There is also a paved terrace and a patio with garden furniture. To the front of the premises there is an off the road parking area for visitors’ convenience. The range of weekly fees for the home ranged from £440 to £450. The information about additional charges was provided as part of the home’s inspection site visit. The home’s service users guide and a copy of the last inspection report could be found in the home’s office and was available on request. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection site visit was carried out over a day. A range of documents including staff and individuals’ files, policies, procedures and the home’s service users’ guide were examined. People were spoken to in the home’s lounge and in private rooms and members of staff were also spoken with. The home’s manager and owner were present throughout the inspection. Feedback about the home was also received by post in survey questionnaires provided by the Commission and in discussion with visitors to the home. Mrs Marion Franklin is the registered provider and manager of the service. Her sister, Mrs Sally Drake who jointly owns Grassington House, and her husband, Mr Franklin, support her with management tasks and other general duties. What the service does well: The service had good pre-admission processes that ensured that those people considering moving into the home, were welcomed and were well informed before coming to the home. This also included a discussion with the person or their advocate about their assessed needs and how those needs would be met. The team of staff, management and owners provided an excellent standard of care that was based on individuals’ assessed and changing needs. Individuals’ needs were clearly set out in a range of documents that helped staff to consistently care for people in the way they wished to be cared for. The home provided a range of activities and stimulation for the people using the service. This included supporting people to carry on with past hobbies and interests and to join in with the local community and the many events in the home, such as coffee mornings, attending clubs and church. The home was well maintained, clean, tidy and personalised to provide a good standard of accommodation. Staff employed in the home, were praised by those using the service and their advocates, being described as “kind, caring and always helpful”. The staff were trained, competent and showed a keen interest in making sure those people using their service were well cared for. The management approach in the home was excellent as the management and staff team actively sought to involve those using the service to take part in the day to day events in the home. The manager, owners and staff team worked together to develop quality - monitoring processes, policies, procedures and Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 6 practices, to ensure the health safety and welfare of those people living and working at the home. What has improved since the last inspection? What they could do better: 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. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 7 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 Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 8 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people using the service were confident that their care needs had been assessed and that their needs could be met, right from the start of their stay in the home. The services provided did not include intermediate care. EVIDENCE: Two files holding a range of information were examined. Both files held preadmission assessments on people’s, needs, preferences and details of how people wished to be cared for. People said that they had been offered the opportunity to visit the home before moving into the home on a more permanent basis. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 9 The person in charge on the day of the visit, said that people were welcome to stay in the home on a probationary period, to ensure that they settled into the home and were happy with the services provided. People received information about the services provided, through informal discussion and in a contract of ‘terms and conditions.’ The service user’s guide was also available on request. The home’s Annual Quality Assurance Assessment said that right from the start of the service “we listen to what our residents say and keep them informed of issues that affect them”. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 10 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 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using the service had their health, personal and social care needs fully met and this was set out in an individualised plan of care. Individuals are involved in decisions about their lives, and played an active role in planning the care and support they receive. People were treated with dignity and respect and their privacy was upheld. EVIDENCE: Two files, including a range of information, on people’s needs were examined. Care Plans and assessments were well completed and included information focused on people’s needs and preferences. The assessment process included asking people what name they wished to be called by and what routines they Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 11 wanted to continue with: for example what time people wanted to get up and what time they wanted to go to bed. Assessments also included detailed medical histories, personal safety issues, including any history of falls and any mental health concerns or considerations. The care plans also included a section for the people using the service or their advocate to comment and agree the contents of the care plan. People said that they felt well cared for by staff and that they were asked about how they wished to be cared for. Ongoing daily records such as diaries, communication books, reviews of care plans and daily evaluations showed constant consideration to people’s changing needs. Records also included information on health professionals visits. Surveys returned to the Commission from health professionals commented on the improvements in the care of people’s skin and said “the home looks after people well in a holistic manner” and “we have no concerns or issues to raise about this home”. Medication administration systems in the home were good. Medication was stored safely and administered by staff who knew the medication policy and procedures well. People said that staff dealt with their medication safely and reliably. Medication records examined were well maintained. At the previous inspection it was recommended that the home must record the receipt of all medicines accurately, and the dose given if a choice is prescribed, so that there is a clear audit trail. The owners and manager had implemented a system so that it was much clearer what medications were prescribed and when they were given. The manager said that there had been a medication error that had been investigated and that the home had sought advice from the pharmacist. This had not been reported to the Commission at the time of the incident, as required. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 12 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 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People’ s lifestyle in the home met their expectations and satisfied their needs. People who used the services were able to make choices about their life style, and were supported to develop their life skills. Social, educational, cultural and recreational activities met individual’s expectations. People enjoyed an appealing, varied diet in pleasant open surroundings, at a time that suited them, with attentive considerate support from staff. EVIDENCE: People said that friends and family were welcomed into the home at any time. People also described how relatives and friends were also invited to join in with fundraising events and special celebrations. People were offered the option to take part in a range of activities such as; music and movement exercises, ‘sing a-longs’, various board games, bingo, helping in the kitchen and garden. People also routinely attended events Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 13 outside of the home with visits to the library, local shops, trips to the theatre and garden centres. People described several different occasions when the owners and manager had provided trips out of the home to support people in maintaining past hobbies and interests. A range of documents including risk assessments, care plans and ongoing daily records showed how those people using the service were encouraged to maintain links outside of the home and with families and friends. People said that they were treated as part of a “large family with the benefit of being able to do what I want, when I want to but also have people near” and said “I make the decisions about my care”. Surveys said the staff and owners “can’t do enough for us, they always make that extra effort”. Staff described how people were supported to make day-to-day choices in care, for example; in making sure that people wore their favourite accessories to, people deciding how they wished to spend their time. The people using the service continued to praise the quality of the meals provided and said that they were pleased with the level of choice of menu on offer. Lunch was served as the main meal of the day. Staff said that there was always a choice of menu and people were welcome to have visitors join them for lunch. A menu board detailed what was on the menu for the day and staff reminded people what was for lunch throughout the morning. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 14 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who used the service were able to express their concerns, and complaints and suggestions from those using the service, relatives or other visitors to the home were treated seriously. People were protected from abuse, and had their rights protected. EVIDENCE: The people using the service said that they felt able to talk to all the staff including the manager about any concerns issues or worries. Most of the people spoken too were unable to describe a time when they had raised a complaint as “the staff attend to everything”. Complaints had been noted in the homes complaints book and included details of how concerns had been addressed. The manager/owners and staff had addressed the issues and dealt with the complaints in an open and positive way. Complaints procedures were included as part of the home’s service users guide, so that everyone in the home had access to a complaints procedure and knew how to raise concerns. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 15 Staff records showed that care staff had received training in issues relating to the protection of vulnerable adults. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 16 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home presented as a clean, tidy home, decorated, furnished and maintained to a good standard. EVIDENCE: The lounge and dining areas presented as pleasant, welcoming areas, that the people using the service were observed enjoying, as they were using these areas to socialise in. People were playing dominoes, cards and chatting. The owners and manager had created, reviewed and updated a range of information for staff in policies and procedures including health and safety and risk assessments for the premises. The programme of guarding or protecting Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 17 central heating radiators according to individual risk assessments, which had been highlighted at previous inspections, had been completed as planned. At the previous inspection it had also been highlighted that items stored at the side of the house and small items of furniture in the first floor bathroom should be either thrown away or stored elsewhere. These items had been removed. All areas of the home including people’s individual rooms had been personalised with items of furniture, photographs and ornaments. The home’s Annual Quality Assurance Assessment included details of plans to continue to refurbish and redecorate people’s bedrooms and communal areas. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people using the service, were supported by staff who were trained, skilled and competent. Staff had been subject to rigorous recruitment checks. EVIDENCE: The people using the service described the staff as kind and caring and they said that, “nothing was too much trouble for them”. Surveys returned to the Commission said that the things the home did well was in how staff worked in the home, for example; “staff are always friendly and the staff turnover seems low so clients and the GP team get to know each other.” The manager, owners and staff said that the home continued to support staff to complete a range of training based on the needs of the people using the service. This included training in key areas such as infection control, health and safety and first aid. Staff training records and supervision records for staff showed that staff had completed internal and external training. This included staff completing National Vocational Training in Care at level two or above. A sample of staff files were examined and they included completed application forms, interview notes, proof of identity, reference and police checks. Staff Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 19 files also held details of staff induction into the home, staff supervision and any disciplinary action the home had taken. These records demonstrated the home’s commitment to ensuring that only those suitable to work with vulnerable adults were employed in the home. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 20 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 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People lived in a well managed home, with the management, administration and staff team, working together to provide a stimulating, safe environment that respected and protected people’s rights. EVIDENCE: The home was well managed by the owners, manager and staff team who worked together with the people living at the home to make sure that people received the services they wanted. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 21 One of the owners who also acted as the manager for the home had been working towards her National Vocational Qualification in Care at level Four. This was also detailed in the home’s Annual Quality Assurance Assessment as something that the owner/manager wished to complete in the next twelve months. Surveys said that the home was “run on the basis of a being a family and run for the benefit of the residents”. People said that they felt safe and that what they wanted or were concerned about someone in the home would “always sort out”. Throughout the visit to the home people repeatedly said that the home “was run for them to enjoy their retirement” surrounded “by friends as part of a happy family”. Records required to be kept on the management of the home and the care people received were well completed and regularly reviewed and updated. This included risk assessments for the premises and for individuals’ specific needs. Recommendations and requirements from previous inspections, such as; a staff induction programme that included Skills for Care criteria, a programme of guarding or protecting central heating radiators according to individual riskassessments, updating policies on infection control and a ‘Heat wave’ plan detailing people’s collective and individual needs had been completed. The manager said that people’s finances and personal allowances were not managed by the home. People were supported to manage their own finances with support of relatives and outside advocates such as solicitors. Grassington House DS0000056436.V345749.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 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 4 X 3 3 X 3 Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP31 OP38 Good Practice Recommendations Complete as planned the National Vocational Qualification in Care at level Four. All incidents affecting the well being of staff and the people using the service should be reported to the Commission. Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Grassington House DS0000056436.V345749.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!