Inspection on 21/01/10 for Stockwell Grange Residential Care Home

There is a good level of satisfaction amongst the people who live and work at Stockwell Grange. People are satisfied that their needs are met and are happy with the support they receive. Staff are happy with the training and support they are provided with. Systems are in place to ensure the smooth running of the home. People living at the home are routinely consulted about the care they receive. Their views and suggestions for change are listened to and acted upon.

What has improved since the last inspection?

Since the last inspection at Stockwell Grange many improvements have been made. All the requirements arising from the last inspection have been met satisfactorily. The home has been totally refurbished to provide a very pleasant and welcoming living environment. Staff rota`s have been reviewed to ensure they best meet the individuals specific needs. The home has been proactive in responding to feedback from the people living at the home to improve the service provided.

What the care home could do better:

The current care plans and assessments are extensive, some are out of date, and in some cases not relevant to the individual. The manager is to review all the care plans and assessments, to condense the documentation and make the file easier to use so that staff have current information to allow them to meet the needs of the people living at the home. Daily entries recorded by staff need some improvement to ensure a full picture of the individual is recorded. Regulation 26 forms completed by the provider need more detail to show what issues were discussed and any actions arising from their visit.

Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for older people Name: Address: Stockwell Grange Residential Care Home Stockwell End Tettenhall Wolverhampton West Midlands WV6 9PH The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sara Gibson Date: 2 1 0 1 2 0 1 0 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 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. 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 Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Stockwell Grange Residential Care Home Stockwell End Tettenhall Wolverhampton West Midlands WV6 9PH 01902751657 01902752353 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Arjan Bhoja Odedra,Mr Vijay Odedra,Daljit Takhar,Jasvinder Takhar,Mrs Shanta Odedra Name of registered manager (if applicable) Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 23 The registered person may provide the following category of service only: Care Home Only (Code PC) to service users of the following gender: both- whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) (23) Dementia (DE) (23) Date of last inspection Brief description of the care home Stockwell Grange formally Greystones provides accommodation and personal care for 19 people over the age of 60 years old. Care Homes for Older People Page 4 of 24 Over 65 23 23 0 0 2 3 0 3 2 0 0 9 Brief description of the care home The lounge and dining areas are homely and comfortable. There are two double bedroom with the remaining all single occupancy and 10 rooms have en-suite facilities. They are all well decorated with many items belonging to service users. The home overlooks Tettenhall golf course and is situated in a private road approximately a half mile from Tettenhall village where there is a good range of small shops and a bus service to the city centre The home provides short stay and introductory stays when the home has a vacancy. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2*. This means the people who use this service experience good quality outcomes. One inspector carried out this unannounced inspection over one day. All the key standards identified by the Care Quality Commission were assessed to evaluate the experiences of care and support received by the people living at Stockwell Grange. Information about the service provided was sought and collated in a number of ways. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home for completion. The AQAA is a self assessment that is filled in once a year by all providers. It infoms us about how providers are meeting outcomes for the people living at the home. We used comments and information in the AQAA to plan our inspection. Care Homes for Older People Page 6 of 24 During the inspection we used a variety of methods to make a judgement about how the people living at the home are being supported. We talked to the manager and the provider who were able to answer questions and provide us with documentation. We also talked to the staff team on duty and to some of the people living at the home. We assessed in detail the care provided to two people using care documentation. We sampled a variety of other documentation related to the management of the home such as training, recruitment, staff supervision, accident and incident recording, and complaints. All this information helped to determine a judgement about the quality of care the home provides. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that the home can support them. This is because there is an accurate needs assessment carried out which they have been involved in. Evidence: The home understands the importance of having sufficent information when choosing a care home. They have developed clear information to help prospective individuals choose a home that will meet their needs and preferences. The information is contained in the homes Statement of Purpose which clearly sets out the homes aims and objectives, and is supported by a Service User Guide that details what services the home can provide, the qualifications and experience of staff, and what levels of service the prospective resident can expect. The documents are clear and easy to understand and can be made available in other formats such as large print and other languages. The service user guide lists the fees charged and any extra charges that may be incurred. Prospective residents are given a copy of the guide, Care Homes for Older People Page 10 of 24 Evidence: and people living at the home also have a copy to refer to if needed. Prospective residents are offered a trial visit and admissions to the home are not made until a full needs assessment has been carried out by the home, or a full assessment is obtained from the referring authority. During the inspection we saw two pre-admission assessments that had been carried out with full involvement of the person and their family. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person is treated as an individual and the home is responsive to their individual needs and preferences but this is not reflected in the documentation. Their right to privacy is respected and the support they get from care staff is given in a way that maintains their dignity. Medication is administered safely at the prescribed time to promote peoples health. Evidence: Two care plan files were looked at. Both files contained an extensive amount of documentation with numerous assessments in place. After reviewing the files we advised the manager that a number of the documents could be condensed to make the file easier to read and easier for staff to use and review monthly. From the care plans seen they all contained the same generic care plans whether they were relevant to the individual or not. For example, one file contained a care plan for challenging behaviour, yet on it is written the individual does not have challenging behaviour, so this can be removed. Care plans need more detail to identify the individuals specific needs, how staff should support the person to meet those needs Care Homes for Older People Page 12 of 24 Evidence: and the outcomes as agreed with the person. Care plans and assessments should be reviewed monthly and changes made where necessary. The two files we saw had not been reviewed or updated for some time. The last evaluation date was October 2009. This shows that staff do not have the information to support people with their current needs. Risk assessments were in place for risk of falls and use of bed guards, again these need further work to ensure staff have the current information to support the person safely. Entries made by staff in the daily records need to be improved to show any issues arising and actions taken to resolve the issue. For example, in one file daily records show that the person had complained of pain for two days, yet there is nothing written to show what action was taken to remedy the pain or follow up to be taken by care staff. A medication round was observed. Only staff who have undergine medication training administer medication. This was done in a safe and appropriate manner. Medication charts were looked at, and all were found to be completed correctly with no hand written entries. Medication is stored safely and appropriately and no issues were identified in this area. People were supported by staff to choose clothing appropriate for the time of year which reflected their individual and personal preferences. Staff were observed assisting individuals in a sensitive manner giving choices about the food they ate, whether they would like a bath or shower, and encouraging people to participate in activities. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a varied social activities programme that meets the needs of people and provides them with activities and interests to improve the quality of their lives. A wholesome and varied diet is offered and special diets are catered for to meet the needs of the individuals. Evidence: The reception area of the home has an information board for the people living at the home. The board displays planned events and activities including games, exercise, crafts, cooking, gardening and quizzes. Dates of residents and relatives meetings are listed along with information on how people can complain if they are not happy with the service being provided by the home. Residents and relatives meetings are held throughout the year and minutes of previous meetings seen demonstrate that staff listen and respond to suggestions made. Family input at the home is good. Family and friends are encouraged to visit and to participate in events and activities. This allows close relationships to be maintained and gives people living at the home a sense of family life. Care Homes for Older People Page 14 of 24 Evidence: Meals are well balanced and nutritious, and choices are offered to those living at the home. For those individuals who need support during mealtimes, staff give discreet assistance. Mealtimes are relaxed and dining at the home is a pleasant experience for all concerned. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to raise concerns or make a complaint are confident that these will be dealt with and their views listened to. Staff have access to the policy regarding safeguarding adults and are to undergo training to ensure they have the knowledge and skills to respond appropriately to allegations of abuse. Evidence: The home has an eay to read complaints policy on display in the home. No complaints have been received in the last six months. The manager operates an open door approach and during the inspection we observed her interacting well with residents and staff in a friendly open manner. Residents spoken with said they had no complaints and would talk to the manager if they had any concerns. Safeguarding Adults policies are clear and detailed. Adult Protection and whistle blowing policies are available for staff to access at any time. Training for staff in safeguarding is due to take place in the next two months. Staff spoken to said they would report any concerns to the manager, and they had a good awareness of adult protection issues. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A homely and comfortable living environment has been achieved for the people who live there so they feel safe and well cared for. Evidence: The home reopened in June 2009 following a total refurbishment. The home now provides spacious, light and airy accomodation. Communal areas are open plan and include a lounge, dining area and sun room. All the areas were warm, well decorated, welcoming and homely. People living at the home spend most of their time in the lounge area. They looked comfortable, well cared for and happy, and were playing a lively game of bingo with the staff. The home is decorated, furnished and fitted to a very high standard. Maintenance issues and repairs are responded to promptly and the general housekeeping is of a high standard, no odours were present, and it was all very clean and fresh. The bedrooms seen during the inspection were spacious and comfortable, and had been personalised with the individuals own photographs and ornaments to reflect their personal taste and gender. Garden areas were tidy and well maintained, and easily accessible to people living at the home. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are well maintained to ensure people living at the home receive competent and safe care from appropriately trained and robustly recruited staff. Evidence: Staffing levels at the home are well maintained to meet the needs of the people living at the home. From talking to and observing staff during the day it was evident that staff morale was good, and the interaction with the people living at the home was excellent. Robust recruitment procedures safeguard the people being supported at the home. Two staff files were sampled and all the relevant checks had been carried out prior to the staff member starting work at the home. New staff undergo an induction programme and work with a more experienced member of staff until they feel confident to work on their own. The staff training and devlopement programme at the home is good. Training in the last year included: Fire Safety, Manual Handling, Food Hygiene, Infection Control and Sensory Awareness. Planned training for the next three months is to include Safeguarding Adults, Mental Capacity Act awareness and Dementia. Over 50 of staff hold an NVQ in Care, and six staff have received training in Safe Administration of Medication. Ongoing training ensures that people living at the home are supported by Care Homes for Older People Page 18 of 24 Evidence: a safe and competent staff team. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is competent and possesses the skills and knowledge to oversee the dayto-day management of the home, and ensures that residents needs and views are responded to. Arrangements in respect of health and safety are good but corresponding documentation must reflect this to prevent the risk of injury occuring. Evidence: The manager of the home is capable, efficient and proactive and has over 22 years experience in care. She is supported by the provider who visits daily and completes a Regulation 26 form monthly identifying any issues. The forms seen require more detail to show the issues discussed, the areas audited and actions to be taken. Staff and resident/relative meetings take place throughout the year and minutes are documented. From reading the minutes it shows that people living at the home are happy with their care. People living at the home have access to their personal monies. Finances are secure Care Homes for Older People Page 20 of 24 Evidence: with receipts and transactions listed. A robust audit trail is maintained. Staff supervisions take place and are well documented, giving staff the chance to discuss care issues, air any concerns they may have, gain feedback and identify any training needs they may have. This further safeguards the people living at the home by ensuring staff have the skills, knowledge and support they need to meet individuals needs. General arrangements for health and safety are satisfactory. Maintenance checks are carried out on schedule and repairs attended to promptly. Documentation must reflect the fact that actions have been taken to remedy any problems. For example, where hot water temperatures are outside the normal range, entries need to be made to show that the issue has been resolved. This will ensure people living at the home are safe from potential risk of injury or harm. Accidents and incidents are documented in the accident book. Two reports were picked at random and the corresponding daily records were obtained. Only one of the accidents had been recorded in the daily records. Daily records are a way staff communicate between themselves, if the entry is not complete, it does not give staff the full picture of the individual and what has hapened to them during the shift. Accidents, action taken and any changes to be made to risk assessments or care plans must be documented in the daily entries to ensure people are safe. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 31 8 The Registered Provider must 30/06/2007 ensure that an application is brought forward to register the Acting Care Manager with the CSCI as a registered manager as a matter of priority. Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care plans and risk assessments need to be condensed. Detailed guidance for staff should be listed to enable staff to meet individuals specific needs. Daily entries written by staff need to be more detailed to give a full picture of the person and include any accidents, incidents or health issues. 2 7 Care Homes for Older People Page 23 of 24 Helpline: 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). 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. 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