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Inspection on 24/05/05 for Charlotte Grange Residential Care Home

Also see our care home review for Charlotte Grange Residential Care Home for more information

This inspection was carried out on 24th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

Residents spoken to liked the staff and felt they worked hard to improve things for them in the home. One resident described the staff as, "a great bunch, they`re all canny". One relative visiting a family member said, "staff can`t do enough for him, no complaints at all". All residents` files examined contained a copy of a full care management assessment as well as the managers own pre-admission assessment.

What has improved since the last inspection?

Progress on the redecoration and refurbishment of the home continues with new carpets and furniture being evident throughout.

What the care home could do better:

Care planning and risk assessment documentation needs to be reviewed and where possible the signature of the resident or their representative needs to be recorded on the care plan to indicate their agreement and understanding, where this has not been possible staff should make a note on the care plan to indicate that they have discussed the care plan with them. Social activities are limited in the home in the absence of a dedicated activities co-ordinator. This has an impact up on the staff workload.

CARE HOMES FOR OLDER PEOPLE Charlotte Grange Flaxton Street Hartlepool TS26 9JY Lead Inspector Bill Drumm UNannounced 24 May 2005 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. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Charlotte Grange Address Flaxton Street Hartlepool TS26 9JY 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) 01429 860301 01429 222472 Community Integrated Care Ms Julie Cowen CRH 46 Category(ies) of OP Old age (24) registration, with number DE Dementia (12) of places PD Physical disability(10) Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 10 people with a physical disability who are 55 years of age and over.10 people with a physical disability who are 55 years of age and over. The home may accommodate one named individual under 55 years of age on a short-term basis, until this accommodation is no longer required. Date of last inspection 18th October 2005 Brief Description of the Service: Charlotte Grange is in a quiet residential area in Hartlepool and is owned by Community Integrated Care (CIC) and is registered to provide care and accomodation for up to 46 people with the categories of dementia (12), Old age not falling within any othere 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. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This un-announced inspection took place on Tuesday 24th May 2005 and was carried out as part of the annual inspection process. The inspection took place over 6 hours. During the inspection time was spent talking to residents, staff and two relatives. The manager was unavailable on the day of the inspection, the senior member of staff on duty was the Senior Support Worker for the home. A number of records were inspected and the inside of the building was looked at. Discussions with residents, staff members and relatives on the day of the inspection showed that there had been continuous improvements in the management, care delivery and environment within the home. Discussion with the Senior Support Worker confirmed that further improvements are also planned for the continued refurbishment of the home as well as the care planning / risk assessment documentation. The manager of the home was spoken with on the day following the inspection and was able to give some verbal clarification on a number of issues raised. What the service does well: What has improved since the last inspection? Progress on the redecoration and refurbishment of the home continues with new carpets and furniture being evident throughout. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 6 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. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. Residents are admitted to the home following a comprehensive assessment of need undertaken by a person trained to do so. This will help to ensure that residents’ needs are met following admission to the home. EVIDENCE: An inspection of a number of residents’ files contained a copy of a comprehensive care management assessment of needs in addition to the manager’s pre-admission assessment. Information from relevant health care practitioners was also present on individual case files. Daily records for each resident are maintained and changes in need are identified. Each resident has their own service user plan of care although it was difficult to see how these linked to the original care management assessments. Risk assessments on residents’ files were not regularly updated or reviewed. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Limited progress has been made on improving arrangements to ensure that the health and personal care needs of residents are identified and met. These shortfalls have a potential to place residents at risk. EVIDENCE: All residents files examined followed the same structure and contained an assessment, care plan, risk assessment reviews in addition to the daily log. It was not clear how the individual plan links to the original assessment, preadmission assessment or the activities for daily living documentation. In addition a number of risk assessments were out of date and had not been reviewed for some time. No evidence was found of “Waterlow Scores” being measured and reviewed to help maintain the skin integrity of residents. Case files were found to contain individual residency agreements although these need to be reviewed to provide the correct contact details for the CSCI. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 10 The home has a comprehensive policy and procedure for the handling and administration of medication, and the home uses the “Boots” blister pack system. The home currently has no residents who self medicate. Discussions with residents and visitors on the day of inspection confirmed that the personal privacy and dignity of residents are maintained. One relative commented that “nothing’s too much trouble, the home always has a good feel to it”. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. The range and choice of activities available in the home are limited and impacts upon staff workloads as there is no dedicated activities coordinator. There has been continued improvement in the fabric of the building with many areas newly decorated and re-furbished which enhances the home for the benefit of all who live there. Visiting arrangements and links with the local community are good residents are free to receive visitors at any reasonable time. EVIDENCE: Discussions with the staff on duty, residents and visitors showed that activities within the home were limited. The home does not employ a dedicated activities co-ordinator, staff are therefore responsible for organising activities in addition to carrying out their caring tasks. One relative spoken to said she was always made welcome by the staff and that she “pops in” whenever she wants. During the inspection a number of visitors were present at the home and were observed to be made welcome. Observation of the interaction between staff and visitors was positive. Residents spoken to confirmed that they were Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 12 supported to make decisions about their own lives and lifestyle. However, residents’ involvement in the care planning and risk assessment process needs to be clearly documented and regularly reviewed. Residents spoken to commented on how much they liked the food at the home and looked forward to mealtimes. Menu’s looked at were found to be balanced and interesting although followed a two week cycle. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The home has a satisfactory complaints system in place and relatives spoken to were aware of the process and were confident that their concerns would be quickly addressed. The home also has an appropriate adult protection policy and procedure. Staff spoken to were aware of POVA and CIC includes adult abuse / protection amongst its training for staff. EVIDENCE: A complaints policy and procedure is in place. There have been no recorded complaints since the last inspection. Relatives spoken with were aware of the complaints procedure. Reference to complaints is made in the individual residency agreements found on residents’ files however, these refer to the making of complaints to the appropriate care commission and does not refer to CSCI in name, nor does it provide appropriate contact details. The home also provides training for staff in adult protection and POVA. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. Some improvements have been made to the décor of the home and a rolling programme of redecoration and refurbishment has been established. This will help to provide a well-maintained environment for residents. The home is clean, pleasant and hygienic and provides comfortable surroundings in which residents can live. EVIDENCE: Since the last inspection the home has continued with their redecoration and refurbishment programme, a number of corridors and four bathrooms are yet to be updated. Residents, staff and relatives spoken to were delighted with the changes and improvements, which have so far taken place. Relatives spoken to stated that the home is always, “pleasant and clean”. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 15 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) 27, 29 and 30. The procedures for the recruitment of staff are both thorough and comprehensive and offer protection to people living within the home. Discussions with staff members, relatives, residents and an examination of staff rotas indicate that staff are deployed in sufficient numbers to meet the needs of residents. Records viewed and discussion with staff showed that staff are trained and competent to do their job maintaining the safety and well being of residents. EVIDENCE: The home has achieved over 80 of care staff obtaining NVQ level 2 in care, which enhances the skills and knowledge of the staff undertaking the caring role. During discussions staff were positive about training, self-development and improving their skills. Individual records of training were viewed for staff, which were up to date and applicable to the skills needed to deliver the care service to the people living in the home. Staff files examined were found to contain the necessary recruitment checks to ensure the protection of residents. CRB checks and copies of at least two references were present. Residents, relatives and staff spoken to all confirmed that there are enough staff on duty to meet the needs of all residents. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 16 The Senior Support Worker confirmed that there were currently no staff vacancies within the home and staff sickness or holidays, are usually covered by their own “bank” of staff. Where necessary agency staff will be used to cover staff shortages. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 17 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) 33, 35, 36 and 38. The homes’ owners undertake regular Regulation 26 visits to monitor quality standards within the home. Copies of which are, received by CSCI. Service user meetings are held on a quarterly basis although attendance is described as inconsistent. Robust procedures for the safekeeping of residents’ money are in place. Records in general including health and safety are up to date. The health, safety and welfare of residents, relatives and staff is as far as is reasonably practical maintained. Staff supervision has not been undertaken on a regular and consistent basis. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 18 EVIDENCE: Records viewed on the day of inspection confirmed that resident meetings are held regularly. Discussion with the homes’ manager confirmed that service user meetings take place every three months. She further acknowledged some difficulties in motivating residents to attend and participate in these meetings. Records examined confirmed that robust financial policies and procedures exist in order to protect residents’ interests. The home has health and safety procedures in place and it was evident from observations and discussions with staff and residents that these procedures are adhered to. Maintenance and fire records were observed to be up to date and in good order. Evidence within records confirmed that fire drills take place regularly and that the names of all staff taking part are recorded. Records examined for staff supervision indicate that this has not been undertaken on a regular and consistent basis. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 19 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 2 x 3 Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 20 YES 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 OP3, OP7 Regulation 14 15 Requirement The registered person shall ensure that the assessment and of the service users needs and plan of care is kept under review and revised at any time necessary. This is a requirement of the previous inspection. The Registered provider shall ensure that persons working at the care home are appropriately supervised. The registered person shall ensure that the home is kept reasonably decorated and suitable adaptations are made for service users. This is a requirement of the previous inspection. Timescale for action 24/08/05 2. OP18 18(2) 24/08/05 3. OP19 23 24/08/05 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. Refer to Standard OP12 Good Practice Recommendations The home and its residents would benefit from having a dedicated activities co-ordinator to help promote social activities. B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 21 Charlotte Grange 2. 3. 4. 5. OP14 OP15 OP16 OP33 The residents of the home or their representatives should be encouraged to sign their individual care plans to confirm their involvement and agreement. The home should review the frequency at which menus are changed within the home. The complaints procedure within the residency agreement of each individual should be reviewed to refer to the CSCi and provide relevent contact details. The homes manager shoule ensure that residents meetings are held on a monthly basis. Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Charlotte Grange B54 S21740 Charlotte Grange V 219084 240505 Stage 4.doc Version 1.30 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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