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Inspection on 15/12/09 for Littleport Grange

Also see our care home review for Littleport Grange for more information

This is the latest available inspection report for this service, carried out on 15th December 2009.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents we spoke to told us that staff treated them well and there were enough of them around to meet their needs. One commented: ‘staff are wonderful, even the kitchen staff come and talk to me’. Residents have genuine choice in what they eat with 3 options for lunch every day. They also have access to varied and frequent activities to help keep them entertained and stimulated.

What has improved since the last inspection?

The manager has worked hard since the last key inspection to address shortfalls identified in care planning, medication administration, cleanliness and the recording of residents’ valuables and requirements made in relation to these have now been met.

What the care home could do better:

Residents must be much more actively involved in planning and reviewing their care so they have a real say in decisions about how they are to be cared for. Residents need to be given opportunities to discuss their preferences about end of life issues. These should then be recorded so their wishes can be respected.Littleport GrangeDS0000024311.V378680.R01.S.doc Version 5.2 Hand written additions to the printed MAR sheets (medication administration records) should be signed dated and checked by a second person for accuracy and the date on which liquid bottles of medication are opened should be recorded. Residents should be provided with greater opportunities for trips and outings so they get a chance to experience leisure activities and stimulation outside the home where they spend almost all their time. A review of how mealtimes are managed must be undertaken so that residents eat in a pleasant environment where they have the assistance and equipment they need to eat their food. Care staff should receive training in food hygiene so that they are able to prepare snacks and food for residents when kitchen staff are not available. Staff must have a greater understanding and knowledge of the adult protection systems in their local area and the part they play should the need arise. Information about safeguarding should be made more easily available around the home so that residents and their visitors know who to contact if they want to raise concerns. Signage and orientation aids should be improved around the home so that residents and visitors can find their way around more easily. Residents must be able to lock their bedroom doors so that their privacy and security can be maintained. They must also have access to a lockable facility in their room so they can store money, valuables and medication safely. Staff should not be employed until a full CRB disclosure has been received by the home so that residents can be fully protected from unsuitable staff. A formal record should be kept of all supervision with staff, which is signed by both the supervisor and supervisee to show that they agree with what has been discussed.

Key inspection report CARE HOMES FOR OLDER PEOPLE Littleport Grange Grange Lane Ely Road Littleport Ely Cambridgeshire CB6 1HW Lead Inspector Janie Buchanan Key Unannounced Inspection 15th December 2009 09:00 DS0000024311.V378680.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Littleport Grange Address Grange Lane Ely Road Littleport Ely Cambridgeshire CB6 1HW 01353 861329 01353 862878 littleportgrange@btconnect.com 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) Dove Care Homes Ltd Catherine Ann Mary Doswell Care Home 75 Category(ies) of Old age, not falling within any other category registration, with number (75), Physical disability over 65 years of age of places (75) Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Old age not falling within any other category (OP) - 75 Physical Disability over 65 years of age (PD(E)) - 75 Date of last inspection 16th June 2009 Brief Description of the Service: Littleport Grange is registered as a nursing care home for up to 75 older people. At the time of this inspection there were 54 residents living there. Accommodation is provided in a large detached property set in attractive and well-maintained grounds on the edge of the town of Littleport. There are local amenities within walking distance and the city of Ely is a short drive away. The house is on three floors made accessible by two lifts and stairs. There are a number of lounges and dining rooms available to residents. There are 58 single and four large double bedrooms, most with en-suite facilities. There are registered nurses on duty at all times as well as day care and night care assistants, administrators, cooks, housekeepers, bed makers, laundry workers, maintenance man, gardener and full time activities co-ordinator. Fees for the home range between £487.00 and £660.00 per week, a full range of fees is available from the home upon asking. The most recent inspection report is available in the manager’s office for people who wish to read it. Littleport Grange DS0000024311.V378680.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 care home is one star adequate. This means that people using the service receive adequate quality outcomes. For this inspection, we (The Care Quality Commission) visited the home and talked with residents, staff and the manager. We undertook a tour of the building, checked medication storage and recording and viewed a range of the home’s policies and documents. We also had lunch with the residents so we could assess the quality of food and observe how staff assisted and interacted with residents. The home was subject to an additional inspection on 4/11/09 to check that requirements made at the last inspection had been complied with. Some information from that inspection is included in this report. What the service does well: Residents we spoke to told us that staff treated them well and there were enough of them around to meet their needs. One commented: ‘staff are wonderful, even the kitchen staff come and talk to me’. Residents have genuine choice in what they eat with 3 options for lunch every day. They also have access to varied and frequent activities to help keep them entertained and stimulated. What has improved since the last inspection? What they could do better: Residents must be much more actively involved in planning and reviewing their care so they have a real say in decisions about how they are to be cared for. Residents need to be given opportunities to discuss their preferences about end of life issues. These should then be recorded so their wishes can be respected. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.2 Page 6 Hand written additions to the printed MAR sheets (medication administration records) should be signed dated and checked by a second person for accuracy and the date on which liquid bottles of medication are opened should be recorded. Residents should be provided with greater opportunities for trips and outings so they get a chance to experience leisure activities and stimulation outside the home where they spend almost all their time. A review of how mealtimes are managed must be undertaken so that residents eat in a pleasant environment where they have the assistance and equipment they need to eat their food. Care staff should receive training in food hygiene so that they are able to prepare snacks and food for residents when kitchen staff are not available. Staff must have a greater understanding and knowledge of the adult protection systems in their local area and the part they play should the need arise. Information about safeguarding should be made more easily available around the home so that residents and their visitors know who to contact if they want to raise concerns. Signage and orientation aids should be improved around the home so that residents and visitors can find their way around more easily. Residents must be able to lock their bedroom doors so that their privacy and security can be maintained. They must also have access to a lockable facility in their room so they can store money, valuables and medication safely. Staff should not be employed until a full CRB disclosure has been received by the home so that residents can be fully protected from unsuitable staff. A formal record should be kept of all supervision with staff, which is signed by both the supervisor and supervisee to show that they agree with what has been discussed. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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 Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5,6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the home is good ensuring that prospective residents can make an informed choice if it where they want to live. EVIDENCE: The home has an ‘admissions pack’ which gives good information about the services it offers, its history, insurance details, how to complain and a sample menu. It was also written in large print to help residents read it more easily. It has been updated and includes the new contact details for the Care Quality Commission. Residents are also issued with a contract that states the terms and conditions of their stay there, although the contract for those funded by the local authority needs to include more information. We expect the manager to address this and will not make a requirement. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 9 The home obtains appropriate assessments from health and social care professionals about prospective residents’ needs before they are admitted so they can be assured their needs will be met there. Residents are able to visit the home before moving in to assess its facilities and one reported: ‘I didn’t visit but my daughter did, they gave her all the particulars and she then showed them to me’. Another: ‘It felt strange after 12 years on my own, but they made me feel very welcome when I first arrived here’. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans accurately reflect residents’ needs and provide guidance for staff in how to meet them. However, residents are not actively involved in planning or reviewing the care that they receive. EVIDENCE: At our last key inspection of 16/06/09 we found serious shortfalls in the accuracy of residents’ care plans: we made a requirement about this. During our additional inspection on 4/11/09 we found that care plans had improved greatly and had been updated to accurately reflect residents’ changing needs. During this inspection we viewed the care plan for three residents. Information in the plans was generally detailed and residents’ needs in relation to amongst other things, their breathing, sleeping, personal hygiene, mobility and communication had been identified, with the action to be taken by staff to address the needs clearly recorded. We looked at a plan for a resident with pressure sores and saw that her sores had been monitored closely with a Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 11 detailed wound assessment and management plan in place. Resident’s Waterlow scores, moving and handling assessments, nutrition risk and falls risk are assessed every month to ensure their well being is maintained. However there was little evidence that residents had seen their plans, or had been actively involved in the planning of care that affected their quality of life. We talked to one resident who told us she had never seen her care plan, despite being very able to understand and contribute to it. None of the plans we viewed were in a format that was easily accessible by residents and none of the plans we checked contained information about residents’ end of life wishes to ensure that these would be respected. We checked medication storage and a sample of residents’ medication administration records. In general these were in good order, with accurate and complete records made when residents had received their medication. The actual amount of variable dose medication (such as paracetamol) residents had received had been recorded. Temperatures were kept of both the storage area and fridge to ensure medication was kept at the correct heat, and controlled drugs were stored safely. However, we noted that some hand written additions to the printed MAR sheets had not been signed or dated, and the date on which liquid medication bottles had been open had not been recorded. We expect this to be managed by the home rather than make a requirement on this occasion. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to activities to keep them occupied but lunchtimes are poorly managed and residents’ ability to eat food easily is not promoted. EVIDENCE: The home employs an activities co-ordinator who organises a programme of events and things for people to do. Information about forthcoming events is clearly advertised around the home, and residents are also given an events guide. On the day of our inspection a local school choir was at the home singing to residents and there were many events planned for December including carol singing with the Salvation Army, a Christmas Party, bingo, musical entertainment and a theatre production. The home has its own minibus but despite this, there have not been any outings since a trip to Ely Maltings in the summer and more could be done to ensure residents get the opportunity to get out more. There is a good variety of food available for residents with an option of three main courses and three desserts for lunch each day and residents are asked Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 13 every morning what they would like to eat. We took lunch with the residents to observe care practices during this busy time. We noted some serious shortfalls. One resident had badly arthritic hands and had great difficulty holding her knife and fork as a result: she would have greatly benefited from cutlery with built up handles so she could have gripped them better. Another resident also had difficulty using her cutlery and, as there was no plate guard available for her, most of her lunch ended up on the table or on her lap. One care assistant told us this resident usually used her fingers to eat, but the food she had in front of her was Suffolk Hot Pot (a stew like dish) and therefore impossible to eat using her fingers. Another resident hardly touched her food and told us it was because she didn’t like it. Staff cleared her almost full plate away later and did not ask why she hadn’t eaten her food, or offer her something different to eat. A number of residents had been pushed up to sit at the table in their wheelchairs, making it very difficult for them to reach their food easily as they were too far away to reach their plate. We observed one staff member assisting a visually impaired resident to eat: she sat with this resident only for a few moments and did not explain clearly to the resident the food that was being given to her. Lunch was a noisy and unpleasant affair with staff talking loudly to one another, the call bell sounding constantly and trolleys being wheeled in and out. At the end of the meal a trolley was brought right into the middle of the room where we watched whilst slops were noisily scraped from plates into it. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents’ concerns are taken seriously, however staff’s knowledge of safeguarding procedures needs to improve so that all residents can be protected. EVIDENCE: Information about how to complain is available in the home’s admission pack and also on display in the main reception (although residents would not easily see it here). The manager keeps a record of all verbal complaints as well as more formal ones. We viewed the verbal complaints record and concerns such as one resident not having her hair washed, another resident not being got up until late and another about the quality of food had all been investigated and responded to appropriately. The home had also sent a formal letter of apology to a relative who had recently complained about the cleanliness of a bedroom and a slow response to a call bell. The home has a policy in relation to the protection of vulnerable adults, which included the most recent copy of the Cambridgeshire County Council guidelines. It also covered the different types of abuse, who is at risk and possible indicators of abuse. Information about who to contact in the event of an incident is available in the nurses’ office and in the staff corridor but not Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 15 anywhere where residents or their relatives can access it should they wish to raise concerns. When we talked to staff directly about adult protection, their knowledge about safeguarding older people was variable and some struggled to tell us about the different types of abuse, local reporting procedures and other agencies involved in protecting vulnerable adults. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 26. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a comfortable and well maintained home, but they are not able to lock their bedroom doors for privacy and security. EVIDENCE: We undertook a tour of the home which we found to be generally clean, hygienic and free from strong smells. However the home is very large and its layout is quite confusing. There were no signs indicating where important areas like the lounge, dining room and stairway could be found and no signs indicating where to find numbered bedrooms. This can only be confusing for residents who live there and their visitors and we got lost several times walking around the home trying to find the upstairs dining room. Signs written on toilet doors and bathrooms were very small and not easily seen by residents with poor eye sight, as were the names on their bedrooms doors. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 17 Most residents we spoke to though told us they liked the home and the facilities it offered. One resident commented: ‘my room is very much like my old home’. However, none of the bedrooms we inspected had keys available for residents so they could lock their doors for their privacy and security, and none had a lockable space where they could keep valuables, money or medication safely (some rooms had a chest of drawers with a lockable drawer but the key was not available) . Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by trained staff in sufficient numbers to meet their needs. EVIDENCE: There are 15-16 staff on duty each morning, 11-12 staff on duty in the afternoon and 8-10 staff on at night to meet the needs of 54 residents currently. Residents we spoke to told us there were enough staff when they needed and they only sometimes waited for help. One commented: ‘there’s always someone around’. We sat with one resident as she pulled her call bell for assistance: a member of staff arrived reasonably quickly to help her. One member of staff described staffing levels at the home as ‘comfortable’, although reported they were sometimes short at the week-ends. We checked the personnel files for two recently recruited members of staff. These contained suitable application forms, job descriptions, interview notes and references. However, we noted that the home has routinely been employing staff before having received their full enhanced CRB check. Although this is allowed in ‘exceptional circumstances only’ (Department of Health Guidelines), it is not best practice to do so and puts residents at unnecessary risk. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 19 We checked the training files for 3 members of staff. This showed us that staff had received a variety of training relevant to their role. However, there was not enough evidence that some staff had received adequate refresher training in moving and handling people to ensure that they did this safely. We expect the manager to deal with this so will not make a requirement on this occasion. We also noted that care staff do not receive food hygiene training, even though they may be called upon to prepare snacks for residents when the home’s kitchen staff are not available. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home where their views about how it is run are actively sought and where their health and safety is promoted. EVIDENCE: The manager is a registered nurse and has a management qualification equivalent to a NVQ level 4. She has worked hard since the last key inspection to address the shortfalls highlighted at the last key inspection in relation to care plans, medication, cleanliness and the recording of residents’ valuables. Staff we spoke to told us they felt supported by the management team and received regular supervision from them, which they described as ‘useful’. One Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 21 staff member told us; ‘I find out if I’m doing anything wrong’. However, the manager reported that she has stopped recording these supervision sessions. We discussed this with her, and stressed the importance of keeping an accurate and formal record of what was discussed with staff. The home sends out questionnaires to residents, their relatives, stakeholders and staff in order to get feedback about its service. We viewed some of these surveys and noted that respondents’ feedback was closely scrutinised and used to develop an action plan to improve the service. The home holds money for some residents and we checked a sample of cash sheets which showed that written records and receipts were kept of all financial transactions undertaken on behalf of residents. We checked a number of records in relation to health and safety including portable appliance testing, gas safety, fire and water temperatures which showed us that the home regularly services and maintains its equipments to ensure its safety. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 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 3 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 2 3 x x x 1 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 x 3 Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 23 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 OP18 Regulation 13(6),17 Requirement Allegations of abuse must be appropriately recorded and reported to the local authority safeguarding team. This will help to ensure the safety of the residents. It was not possible to assess this requirement on this occasion. Extended timescale given. 2. OP18 01/02/10 18(1)(a),1 All staff must be aware of what 3(6) constitutes abuse and what procedure they should follow if they suspect a resident has suffered any abuse. This will help to keep the residents safe. Timescale of 30/11/09 has been partially met. Extended timescale given. 3 OP7 15 Residents must be actively 01/03/10 involved in planning and reviewing their care so they have a say in how they are to be helped by staff. Residents must be provided with 01/03/10 appropriate equipment and DS0000024311.V378680.R01.S.doc Version 5.3 Page 24 Timescale for action 01/02/10 4 OP15 16(2) Littleport Grange 5 OP19 12(4) assistance they need to eat their food. Residents must be able to lock 01/04/10 their bedroom doors so that their privacy and security can be maintained. They must also have a lockable facility in their room so they can store money, valuables and medication safely. 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 5 6 Refer to Standard OP11 OP12 OP19 OP29 OP30 OP36 Good Practice Recommendations Resident should be given the opportunity to discuss their preferences about end of life issues. Residents should be given more opportunity for stimulation and leisure outside the home. Signage and orientation aids should be provided around the home to help residents and visitors find their away around more easily. Staff should not be employed until a full CRB disclosure has been received by the home. Care staff should receive training in food hygiene in case they have to prepare food for residents when kitchen staff are not available. Written records should be kept of all supervision meetings held with staff. Littleport Grange DS0000024311.V378680.R01.S.doc Version 5.3 Page 25 Care Quality Commission Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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