This inspection was carried out on 18th August 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.
CARE HOMES FOR OLDER PEOPLE
Autumn Grange Care Home 19-29 Herbert Road Sherwood Rise Nottingham, NG5 1BS Lead Inspector
Susan Lewis Lee West Unannounced 18 August 2005 at 11:00 am 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 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. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Autumn Grange Care Home Address 19-29 Herbert Road, Sherwood Rise, Nottingham, NG5 1BS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0115 841 7475 0115 962 0061 Mr Munchi Khan Nora Gazeley Care home only (PC) Service User Categories 72 Category(ies) of Dementia - over 65 years of age (DE(E)) registration, with number Old age, not falling within any other category of places (OP Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1 Registered Manager must be full time and have full time supernumery hours of work 2 Two Senior Carers to be in charge, one on each unit(two in total) from 08:00-20:00 3 for 72 service users at least 7 (seven) care assistants must be provided from 08:00 - 20:00 Date of last inspection 16/06/05 Brief Description of the Service: The home is located in a quiet residential area of Nottingham (Sherwood Rise) with access to local amenities. The city centre of Nottingham is about 1 mile away and there is a direct bus route to and from the city centre with a bus stop about 300m metres from the care home. A park and ride service is available, about 500 metres from the care home. The home is split into three units, two of which provide up to forty-nine (49) places for people who may have a Dementia related illness (residential, non-nursing). The other unit provides personal care (residential care, non-nursing) for up to twenty-three (23) older people.The home provides a reasonable standard of accommodation for service users. There is a choice of lounges and combined dining room areas, all in reasonable decorative condition. The building is wheelchair accessible with adaptations and equipment appropriate to the needs of the service users. The garden area to the front of the premises has been reconfigured, with an enclosed safe garden being created to enable service users to use. Parking is limited, but on the road parking is available only several metres from the front entrance. The manager has considerable experience in the caring field and the staff team have a sound knowledge of the service user group and of the needs of the individuals who live in the Care Home. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place as result of a serious outbreak of diarrhoea where at least 35 residents were affected. As this inspection took place only two months after the last inspection the requirements left at that time were not looked at. These will be addressed at a future inspection. Only records pertinent to the infection were looked at and no tour of the premises took place. Only senior care staff were spoken with, no residents were spoken with during this inspection. Information for this report was gathered both at the home and via telephone calls to relevant parties involved. People spoken to as part of this inspection were the Environmental Health Officer, Infection Control Nurse, social service representative and the coroner. What the service does well: 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. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected at this time. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected at this time. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected at this time. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected at this time. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected at this time. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 12 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 Residents are placed at risk by the lack of basic food hygiene training. EVIDENCE: All staff files were looked at and out of the thirty files inspected one member of staff had her intermediate food hygiene certificate. Four had up to date food hygiene certificates, which are valid until June 2006. One member of staff’s had run out in January of this year. The rest either there was no certificate on file or what was on file was out of date. The registered person must ensure that all staff who are involved in handling or preparation of food are suitably trained. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 13 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Residents were placed at risk by poor health and safety practice within the home. EVIDENCE: In discussion with the Environmental Health Officer and staff it was apparent that practices in the kitchen were possibly the cause of the outbreak. However at the time of writing this report the outcome for tests carried out on stool samples had not come back from the laboratory. However the Environmental Health Officer is of the opinion that poor hygiene practice with meat is the likely cause. The registered person must risk assess all working practices within the kitchen to ensure residents are not placed at risk. Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 14 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 1 Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 15 N/A Are there any outstanding requirements from the last inspection? 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 30 Regulation 13(3) Requirement The registered person shall make suitable arrangements to prevent infection, toxic conditions and spread of infection at the care home. All staff who handle food must have an appropriate form of basic food hygiene training. Immediate Requirement Within 7 working days of the inspection. The registered person must ensure unnecessary risks to health and safety of residents are identified and so far as possible eliminated, and all parts of the home are reasonably free from hazards to residents safety. Risk assessments must take place for all activities that may present a risk to residents. Timescale for action 2. 38 13(4)a,b Immediate within 7 working days of the inspection. 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.
Autumn Grange Care Home C53 C03 S2190 Autumn Grange V245465 180805 Stage 4.doc Version 1.40 Page 16 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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