Inspection on 21/06/05 for Care ( Stanley Grange)

This inspection was carried out on 21st June 2005.

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

Care ( Stanley Grange) 19/08/07

Care ( Stanley Grange) 04/09/06

Care ( Stanley Grange) 07/12/05

Care ( Stanley Grange) 10/12/04

Care ( Stanley Grange) 22/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Care Stanley Grange Samlesbury Preston PR5 0RB Lead Inspector Helen Lindsey Unannounced 21 June 2005 15:00 st 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Care Address Stanley Grange Samlesbury Preston Lancashire PR5 0RB 01254 852878 01254 851154 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) CARE (Cottage and Rural Enterprises Ltd) Mrs Lisa Kelsall Care Home 42 Category(ies) of LD Learning Disability (42) registration, with number of places Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home is registered for up to a maximum of 42 service users in the category of LD (learning disability). 2) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3) Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. Date of last inspection 10 December 2005 Brief Description of the Service: Stanley Grange is located in a rural setting half a mile from the A 675, which is one of the main roads linking the towns of Preston and Blackburn. Because of its rural setting, access to local facilities such as post office, shops, public house is via the half-mile walk for the service users or an escort is provided from the home. The service does have a number of vehicles, which are available to be used for transport for the service users. Stanley Grange is one of eight communities run by the CARE organisation and provides a range of accommodation and day care facilities for people with learning disability. The residential accommodation is provided in four units: Stables accommodates fourteen service users; Fountains for thirteen service users; Pendle for six service users and Weavers for seven service users. Each of the residential units has communal lounges and dining areas, kitchens, laundry, bath/shower facilities and WC’s. There are also five flats that are used for the service users. Service users live in the flats with agreed support networks, to develop their independence living skills. The Residential units are all separate buildings and are situated around a central garden area along with the community hall, day-care facilities and administrative blocks. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, carried out by one inspectors and started at 3.00pm. It took place over 5 ¼ hours. The inspector returned to the service on 6th July to provide feedback to the registered manager. The inspectors spoke to 16 service users, 5 members of staff and the day services manager. Staff and care records were examined, and a full tour of the premises was undertaken. As part of the inspection process the inspectors used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the service. Since the last inspection there had been one referral through the protection of vulnerable adults procedures. The issues were investigated by provider and appropriate action was taken to resolve the areas of concern. What the service does well: Service users were very positive about the choice and options that are available to them living at Stanley Grange. This included work, education and employment training opportunities, and social and leisure activities. Service users said ‘I have chosen where to go on holiday, I can’t wait’, ‘I like to go for Thai meals’, ‘I’m working at the café, I really enjoy it’ and ‘we have a good laugh here!’. The service also does well in encouraging individuals to develop their daily living skills and independence skills, with the plan to support those who are able to move on to a more independent style of accommodation in the future. Staff training continued to be of a high standard, and this included the induction being done to both the Skills for Care (previously TOPSS) and Learning Disabilities Award Framework (Ldaf) standards. Care as an organisation provided a wide range of opportunities for internal training courses, and there were also external training courses offered. A number of staff also continued to do National Vocational Qualifications (NVQ) at levels 2,3 and 4. This is recognised training for care workers. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: The organisation must put a procedure in place to safeguard against the risk of legionella. The site has not been tested, though a company has been approached to do this work. This issue must be addressed quickly to ensure the safety of all people who use the site. Some décor in the cottages needed to be improved, specifically the bathrooms in Stables, and in Fountains Cottages. The bathrooms, were looking worn, were musty and in some place were getting mouldy. Service users again raised the issue of being limited in their activities off the site of Stanley Grange due to the limited transport available to them, and amount of staff who could drive. Although there had been some improvement in the number of vehicles available this issue should be looked at again, to identify ways of improving the service users experience. Currently service users made comments like ‘its getting a bit boring just hanging about’, ‘ I just have to watch the TV or what ever if I cant go off site’. Staff also confirmed this could be limiting to individuals social and leisure plans. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 7 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. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The admissions procedure for new service users enabled them to make an informed choice about moving to the service, and the process was also clear to ensure the resident’s needs were assessed. EVIDENCE: Service users were involved in the process of assessment before they moved to the service by visiting Stanley Grange, completing a ‘getting to know you’ document which was used along side assessments from social services, and input from families where appropriate, to get a full picture of each individuals needs and agree what service was to be provided. There had been no new admissions since the previous inspection but three referrals were progressing using the above process. Staff spoken to felt that the assessments gave clear information to them about what support individuals needed, and were aware of the importance of helping people to settle in. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7 The health and social care needs of service users were assessed, and then reviewed on a regular basis, ensuring needs continued to be met. Service users were fully involved in this process, where possible. EVIDENCE: Service users spoken to felt they were fully involved in putting together their Independent Personal Plans (IPP’s) and were supported to think about what goals they wanted to achieve in the future. Consultation with the service users and their relatives was ongoing about the future of the service, and family members spoken to felt the development of the ‘family forum’ had made them feel more involved in the consultation process. Service users described their work, education, social and leisure interests that were varied and reflected individual’s interests. One said ‘ I enjoy going out walking, going to church, sometimes, and listening to my CD’s. Holidays had been organised, and service users were looking forward to going on the trip Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 11 they had chosen, one individual said’ I’m going shopping to choose clothes for my holiday’. An issue service users felt was limiting their choices was the transport arrangements. Service users said ‘its getting a b it boring hanging about’, ‘ I would like to do stuff in the evenings and weekends, but have not been able to get out, so I’m finding it frustrating’. Records for individuals IPP’s were seen to be well written, giving clear details of individuals needs, and showing the involvement of service users, family members and other professionals. Where service users needs had changed records were seen to have been updated, and where needs were changing very quickly staff had developed systems to make sure they were up to date every time they arrived in the cottages. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15, 16 and 17 Service users were well supported to maintain links with family and friends, and enabled to make choices and decisions about their day to day life. EVIDENCE: Service users described how they met in a weekly meeting to decide what the menu would be for their cottage, taking into account healthy eating and people’s preferences. Individuals felt they got more choice now meals were cooked in the cottages. One said ‘we enjoy the food’, and another said ‘cooking stuff in units, its better, I enjoy it’. Staff spoken to felt this new arrangement offered more choice to individuals, and allowed healthy options to be available. Records of the menus were seen to offer a wide range of meals, and meals served in the cottages looked appetising. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 13 Individuals talked about the contact they had with their relatives and friends, which included parents visiting Stanley Grange, them visiting their parents, letters, phone calls, texts, and emails. Staff confirmed that where service users were less able to make contact, then staff phoned parents and kept them up to date on health needs and day to day feedback. All service users spoken to felt that the staff were respectful of their privacy and dignity. Service users said ‘staff are doing their job’, I trust them, yes, we got some good staff’ and ‘the staff do a good job, and are a good help’. Service users also described the different household tasks they were involved in. One said ‘we clean our rooms, and sometimes the communal areas and someone volunteers in the kitchen to do the washing up. I do laundry, and ironing, but get support if I need it’. Service users were seen to have keys to their rooms, and staff were observed to offer choices, and respect individuals choices through all the cottages. Staff felt individuals were given the opportunity to spend time with friends, or on their own, and that individuals had responsibilities for housekeeping, dependent on their skills. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 21 Care records clearly identify individuals needs ensuring service users received personal support in a way they preferred. EVIDENCE: Care records were read for a number of service users in each cottage, and were seen to have been written following a person centred approach. Individual Personal Plans (IPP’s) were done annually and reviewed 6 monthly. Goals were identified with each service user, and their progress to achieving the goals was clear. Service users confirmed that they were free to make decisions, for example when to get up, go to bed, have a bath, and what social activities to be involved in. ‘We have fun here’. However a number of comments were made about the limitations for getting out an about due to the limited access to transport. ‘We have not been able to get out much, I find it frustrating’, and ‘I would like to do more stuff in the evenings and weekends’. Staff confirmed that access to transport was limited, and it took efforts on the part of the staff to make sure there was staff that could drive the bus and booking cars. They confirmed it was limiting for individuals. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 15 Records were seen for individuals whose needs were changing and they were well written. Staff spoken to were fully aware of the service users changing needs, and had developed ways to make sure when needed, staff on each shift could be updated. They confirmed they also kept in touch with relatives as much as was needed at times of illness, and fast changing needs. Practice around this area was seen to have an excellent outcome for the service user, making them as comfortable as possible. Other service users were supported to understand issues such as aging and illness, which helped them to cope with different situations either for themselves or other service users. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Policies and procedures were in place to make sure individuals knew how to complain, and to ensure complaints were dealt with effectively. EVIDENCE: All service users spoken to knew who to talk to if they were not happy at Stanley Grange. They also knew of the formal complaints procedure. One said ‘I would tell my key worker if I did not like what people were saying’ another said ‘If I wanted to make a complaint I would talk to …(residential service manager)’ Records of complaints that had been made were clear to understand and showed how decisions had been reached. Staff spoken to were clear about their role in the complaints procedure, and were also given information in their staff handbook about the complaints procedure. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The environment was suitable for the needs of those living in the individual cottages, however some areas needed attention to ensure homely and well maintained surroundings were provided. EVIDENCE: Each cottage was decorated and presented differently, to reflect the tastes of the individuals who lived there. Some areas had equipment to aid mobility and access, especially in bathrooms, and other areas did not need this equipment to be available. A number of rooms, especially the communal lounges had been re-decorated, and they provided a pleasant homely environment that could be used by each person who lived in that cottage. Service users said ‘I like living here’, ‘my room is nice, and everything is where I need it’ and ‘everything works ok here’. A number of maintenance and décor issues were picked up on a tour of the building, and the service manager was informed during the feedback session Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 18 after the inspection. This included the fact that the bathrooms in Stables continued to provide a poor quality environment for individuals bathing. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35 Staff recruitment procedures were clear and robust and training opportunities offered to staff continued to be of a high standard, to ensure service users were supported by staff competent and qualified to do the job EVIDENCE: Service users spoken to said the staff were ‘a good bunch’. That they trusted them, had fun with them and felt they were respectful. Staff records were stored in a clear and accessible format, and every file contained all information required by the Care Home Regulations. Stanley Grange exceeded the standard by asking for 3 references for each member of staff employed. Staff spoken to felt the induction, completed to Skills for Care (previously TOPSS) and Learning Disability Award Framework (Ldaf) standards. Courses included in this induction were first aid, basic food hygiene, moving and handling, and infection control. Other more specialist training courses were offered, and people were also undertaking NVQ qualifications. The training opportunities with care continued to be outstanding. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,40,41 and 42 Effective quality assurance was undertaken at Stanley Grange to ensure the service provided a good quality service in line with its statement of purpose. EVIDENCE: The quality assurance system at Stanley Grange had been in place since February 2005, and managers of units each had sections to complete. This involved getting the opinions of the service users to check they were receiving a good quality of service from Stanley Grange. Staff said they were starting to get used to the documents, and were sure it would be good for the service. A nominated service user was also taking part in quality meetings to represent all the service users. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 21 A family forum had also been developed since the previous inspection, and this was giving them a voice in the consultation process about the service, and its future. A large consultation had taken place with service users last year about their expectations for the future, and this had been part of the process about deciding how to move the service forward. One service user said ‘I am disappointed at the slowness of me moving to more independent living’. Policies and procedures for the organisation were frequently updated to reflect any changes in legislation, and updates were sent out to staff. Staff were also provided with a staff handbook, so they could make quick reference to those policies that applied to them, and those they worked with. Service users confirmed they knew about the policies that were relevant to them, such as complaints, and these had also been written in a more simple form so people with different communication skills could also understand them. Records for the service were held securely to ensure confidentiality at all times. Staff spoken to confirmed they were aware of the procedures for accessing confidential information. Records relating to servicing of equipment on the site were seen. Feedback was provided to the manager where action was needed to ensure documents were current and up to date. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 4 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Care Score 2 x x 3 Standard No 37 38 39 40 41 42 43 Score x x 3 3 3 2 x F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 23 no 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 42 Regulation 13(3) Requirement The registered provider must make arrangements to prevent the spead of infection. specifically in relation to Legionella. Timescale for action 30/09/05 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. Refer to Standard 18 24 24 Good Practice Recommendations It is recommended that extra transport is made available for service users to reduce the limitations faced by living in a rural area. It is recommended that bathrooms in Stables cottage be refurbished. It is recommended that all first floor windows be fitted with a restrictor to promote the safety of service users. Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley, PR7 1NW National Enquiry Line: 0845 015 0120 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 Care F57 F08 S5873 Care V226001 240505 Stage 4.doc Version 1.30 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. 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