Inspection on 24/07/07 for Charlotte Grange Residential Care Home

This inspection was carried out on 24th July 2007.

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

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

Other inspections for this house

Charlotte Grange Residential... 04/09/06

Charlotte Grange Residential... 16/11/05

Charlotte Grange Residential... 24/05/05

Charlotte Grange Residential... 18/10/04

Charlotte Grange Residential... 25/06/04

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

CARE HOMES FOR OLDER PEOPLE Charlotte Grange Residential Care Home Flaxton Street Hartlepool TS26 9JY Lead Inspector Mrs Tanya Newton Unannounced Inspection 24th July 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Charlotte Grange Residential Care Home Address Flaxton Street Hartlepool TS26 9JY 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) 01429 860301 01429 222472 charlottegrange@c-i-c.co.uk www.c-i-c.co.uk. Community Integrated Care Ms Julie Cowen Care Home 46 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (24), Physical disability (10) of places Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP, maximum number of places 24 Dementia - Code DE, maximum number of places 12 2. Physical Disability, Code PD, maximum number of places 10 The maximum number of service users who can be accommodated is: 46 4th September 2006 Date of last inspection Brief Description of the Service: Charlotte Grange is in a quiet residential area in Hartlepool and is owned by Community Integrated Care (CIC). It is registered to provide care and accommodation for up to 46 people with the categories of dementia (12), Old age not falling within any other category (24) and Physical disability (10). Internally the home is divided into units with a central forum area at the entrance. Each unit has a lounge and additional seating areas as well as a dining area. Residents can choose to eat their meals in the dining area or in their own rooms. Kitchenettes are provided in each unit where snacks can be made. The home has a central kitchen, which serves all the units. Residents are able to personalise their own rooms and relatives and friends are welcome to visit at any reasonable time. Fees range from £356 - £370 depending on the level of care required. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on the 24th July 2007 over a period of 7 hours. During the inspection, time was spent talking to people using the service, staff, relatives and management. A number of records were looked at and the grounds and building itself were inspected. A number of questionnaires were received from people using the service and other health professionals as well as visitors and a self-assessment form, which the manager completed. Information gathered throughout the inspection maybe included within the inspection report. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to contain the finer details so that all aspects of people’s needs are met. Medication needs to be stored in an alternative area and the home should have a trolley so that medication can be given directly to people. Consideration should be given to employing an activities co-ordinator so that people can enjoy and access a greater range of activities. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 6 The maintenance to the premises should continue and the area, which was odorous, needs to be addressed. The company quality assurance systems needs further development to reflect individual services. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions are well managed and people are provided with information about the home before moving in. The home does not admit people who require intermediate care. EVIDENCE: The home provides information, which is given to people who may want to move in. This provides people with detailed information about the service provided and the key terms and conditions of residence. All people moving into the home have their needs assessed before moving in and are invited to look round the home. Assessments viewed were detailed and contained the relevant information. The home does not provide intermediate care. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health needs are well managed by the home. Systems to store and administer medication would benefit from some improvement. People living at the home say that they are treated well and that the standard of care is high. EVIDENCE: A new format of care plan has been introduced. Care plans were in the main well written. Some needed to include more detail. Care plans provide information, which sets out the way in which the home will meet people’s needs. There was clear evidence of input from other health professionals where this was required. Comments about the care included, “my health needs are well met” and “I am very happy with the care”. The home has been involved in the end of life care package working closely with Macmillan nurses, district nurses and community matrons to enable people to make choices about end of life care. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 10 Medication systems were viewed. Although medication systems were generally safe, medication was being stored in locked cupboards within sluice rooms, a practice which was unhygienic. A discussion took place with the manager regarding this and it was agreed that alternative arrangements would be made to store medication. The home was advised that medication trolleys should be used to administer medication as this system allows staff to take medication directly to the individual before administration. People were asked whether staff treated them with dignity, the following are some of their responses, “Staff are polite and friendly” and “Staff enable mum to make choices, she is well cared for and safe”. One of the staff members said, “We talk to people and tell them what we are doing, we encourage them to be as independent as possible” and “we get to know people’s individual needs”. Staff were observed throughout the day to be speaking to and supporting people in a caring and respectful manner. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In the main there are a range of activities available to support most people’s social needs. Visitors are made welcome to the home and there is a varied menu which people enjoy. EVIDENCE: The home does not have an activities co-ordinator so the staff working at the home provide activities. Views about the social activities available were mainly positive. Activities included dominos, cards, skittles and entertainers who are bought in from outside to sing or play music. The home does not have an activities co-ordinator so staff provide activities. Some people said they would like more opportunities to go out and that this was difficult, as the home did not have its own transport. Some of the comments from people were, “good parties” and “very good effort by staff in activities”. Some people spoken to say that they were supported in attending church. Staff say that they would like more opportunities to be available socially to people living at the home. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 12 Visitors are encouraged and those spoken to said that they were made very welcome. One said, “Friends and families can visit whenever as there are no restrictions on visiting hours and you are always made welcome”. Throughout the inspection staff were observed to be treating people in a kind and dignified manner. People living at the home are encouraged to be as selfmanaging as possible. Comments about the food and the meals provided were also positive, some of the comments included were “it’s all home cooking and the variety is excellent”, “the food is excellent” and “I had a nice lunch today”. The home has a menu, which is updated regularly, special diets, and individual preferences are catered for. A choice of meals is available. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear policies to support staff in managing complaints or allegations. The complaints procedure is made available to people living in the home and to visitors. EVIDENCE: The home has clear policies for managing complaints and allegations. Concerns are dealt with on a day-to-day basis. All staff had received training in the protection of vulnerable adults (POVA). All staff spoken with said they would feel confidant whistle blowing (telling someone) if they saw or heard something inappropriate. All relatives spoken with said that they felt able to approach staff with any concerns. People living at the home said, “I would have no hesitation in telling someone if I had a problem”. The home has received two complaints since the last inspection neither of which was upheld. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is kept clean and in the main free from any unpleasant odour. Rooms are individually furnished. There is a programme of maintenance ongoing to update the home. EVIDENCE: The home is a ground floor property, which is accessible to all people living in the home. It has a range of accessible facilities to support people who have difficulties with mobility. The home is made up of four individual units, each with its own lounge/dining area and kitchenette. The home has an ongoing programme for the maintenance of the premises. Twelve carpets had been replaced since the last inspection. Some areas of the home still require redecoration. There are plans to replace further carpets on a rolling programme in bedrooms and the corridor carpet in the Croft unit is also going Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 15 to be replaced. People’s bedrooms were individually furnished and many had personal items to make them more homely. The home has raised money to revamp the garden, which will include a sensory area. The home has a policy on the control of infection, hand-washing gels are located throughout the home to minimise any cross infection between units. In the main the home was clean and free from odour, one area did smell and the manager is trying to address this. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing numbers support people’s needs. The home has an excellent commitment to staff training and recruitment practices protect people living in the home. EVIDENCE: There are two care staff on duty in each unit throughout the day to provide care for the people accommodated. In addition to this there is a manager and/or a senior on duty. Staff spoken with all said that staffing numbers were sufficient and allowed flexibility and cover between units in the home. Staff recruitment and training files were looked at. Recruitment practices are sound with references and police checks being carried out prior to people starting work at the home. The home provides good-training opportunities for staff, which includes training staff in specific needs, for example blind awareness, stroke and dementia. All staff receive training in the protection of vulnerable adults (POVA), health and safety, palliative care, NVQ 2 and 3 as well as mandatory training in first aid, fire and manual handling. 96 of staff had achieved an NVQ qualification this is commendable. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 17 Comments from other professionals about staff were positive and included, “Working as a community matron the care home staff are always keen to ask us for help and advice for clients. They contact the Older Persons Service regularly for both reactive and proactive care for the benefit of clients. When given advice they always act on our recommendations” and “Staff at the care home anticipate people’s needs, maintaining high standards of care and dignity”. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and relatives and people using the service are regularly consulted about the service they receive. Financial arrangements are sound and health and safety systems and practices protect people. EVIDENCE: The Manager is qualified to NVQ level 4 and in care and management and has gained the registered managers award (RMA). Feedback from people living and working at the home was positive about the management arrangements. People living at the home said, “the home is well run”. All staff said that the Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 19 manager was approachable. Quality assurance systems are in place to seek the views of people living in the home. Feedback is also sought from visitors. The home should develop these systems further to gain information from other stakeholders. The corporate quality assurance system does not reflect individual services. The manager said that people who live at Charlotte Grange are actively encouraged to take control of their own finances. No member of staff takes responsibility for managing peoples finances however the home does provide a safe facility whereby people can request the holding of money. A record of all transactions is maintained and signed by two members of staff. Staff supervisions were not up to date, all staff should receive a minimum of six supervision sessions each year. The home carries out regular health and safety checks to ensure that the premises remain safe. All records for health and safety viewed were up to date. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 21 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 OP9 Regulation 13(2) Requirement Timescale for action 30/09/07 2. OP19 23 Alternative storage facilities for medication must be used and the home should purchase a medication trolley so that medication can be administered safely. The registered provider must 30/11/07 continue with the programme of refurbishment. Redecoration of communal, personal accommodation and carpet renewal. This will ensure that people live in a well-maintained and comfortable environment. This was a previous requirement, which has been met in part. Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 22 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. Refer to Standard OP33 Good Practice Recommendations Quality assurance systems should be further developed to reflect the views and wishes of stakeholders. The corporate quality assurance system should reflect individual services. All staff should receive a minimum of six formal supervision sessions each year. 2. OP36 Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Charlotte Grange Residential Care Home DS0000021740.V344063.R02.S.doc Version 5.2 Page 24 - 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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