Inspection on 17/11/08 for Christopher Grange

This inspection was carried out on 17th November 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Christopher Grange 08/03/06

Christopher Grange 02/11/05

Christopher Grange 04/12/04

Christopher Grange 14/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

CARE HOMES FOR OLDER PEOPLE Christopher Grange Youens Way East Prescot Road Liverpool Merseyside L14 2EW Lead Inspector Joan Adam Unannounced Inspection 17th November 2008 10:00 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 Christopher Grange DS0000025335.V373189.R01.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. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Christopher Grange Address Youens Way East Prescot Road Liverpool Merseyside L14 2EW 0151 220 2525 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) maureendenning@christophergrange.org The Trustees Catholic Blind Institute Care Home 78 Category(ies) of Old age, not falling within any other category registration, with number (78) of places Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 78 service users in the category of OP, to include:* Up to 78 service users in the category of SI (Sensory Impairment) * Four named service user under the age of 65 years may be accommodated in the home Date of last inspection 31st August 2006 Brief Description of the Service: Christopher Grange is registered with CSCI as a care home for 78 older people. Christopher Grange provides accommodation in single bedrooms on four separate units all of which have an en-suite WC and wash hand-basin. Bedrooms are located on the first floor and can be accessed by stairs or two passenger lifts. The home is situated in Liverpool 14 and is in close proximity to local shops and public transport routes. The home is owned by the Catholic Blind Institute and has its own chapel in which a daily mass is held. However, residents are accepted from any faith and local ministers of other religions visit to provide pastoral support. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 1 star. This means that people who use the service experience adequate quality outcomes. This site visit was carried out by two inspectors of the Commission for Social Care Inspection (CSCI) 17th November 2008 over a period of six hours. This was to assess if people’s needs were being met at the home. A tour of the premises took place and included the kitchen and laundry, a majority of the bedrooms on three units and shared areas such as the lounges and dining rooms, shared bathrooms and toilets. The manager, several staff and people cared for were spoken with and their views contributed to the inspection of the home. This visit was just one part of the inspection. Before the visit the home was also asked to complete a self-audit called an annual quality assurance assessment (AQAA) to provide up to date information about services at the home. The previous manager of Christopher Grange completed this form. The new manager in post had identified some issues in relation to fire safety that she had inherited and was in the process of addressing these risks when this visit took place. Other information sent to us by the home and other professionals, such as social services or district nurses, since the last key inspection was also reviewed so that we could plan what we needed to look at when we visited. We made a visit to the home in April to check requirements made at the previous site visit had been met. This is called a random inspection. Feedback was given to the manager at the end of the visit. What the service does well: Individualised care and attention is provided and there is a welcoming, cheerful environment so that people who are cared for feel comfortable and at home. An established staff team works at Christopher Grange which means the people who live in the home know the staff well. Some staff members have been in post for twenty years and said” I wouldn’t work anywhere else it is a really great place to work”. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 6 One resident said, “I have known the staff member for so long they are like my own family”. Plans of care were well documented and reflected each residents’ needs so all staff would know what to do for each person. Meals were varied and reflected each person’s preference. They offered choice and variety. A range of varied activities is provided so that the people who live in the home have enough to do. A good standard of hygiene was seen throughout the home and the standard of décor was good so that people live in a clean and comfortable environment. Residents spoken with said that, “this is a really great place to live”, “ the staff can’t do enough for you and, “the food is very tasty”. Other comments included, “the staff are really nice” and “I wouldn’t live anywhere else”. Staff were seen to treat residents with respect and had an easy and friendly manner. Staff were also seen providing support to residents in a caring and sensitive way. What has improved since the last inspection? What they could do better: All people working at the home should receive regular training in fire safety so they know what to do if there is an emergency. Bedroom doors must not be propped open with wooden wedges, the purchase of a safer way to prop doors open must be looked at to ensure the safety of residents is maintained. The manager must assess the needs and dependency levels of residents to ensure that the staff provided are in adequate numbers to meet the residents’ needs at night. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 8 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 Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 9 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, Quality in this outcome area is good. People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. Residents are assessed before they move in to the home so that they know their needs can be met. EVIDENCE: The care records of two residents who has recently moved in to the home was looked at. The residents had been assessed by the manager before they moved in to the home so that they knew their needs could be met. This information was used to write a plan of care for the resident. Documentation from the previous care home and social services was present in the file. The home does not provide intermediate care so this standard does not apply. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 10 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. People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity and medication management ensures that the residents receive their medicines correctly and that medicines are stored safely. EVIDENCE: Each person living at Christopher Grange has a care plan that details their needs and gives information to staff about how their needs can be met. The care plans of six residents were looked at. A sample was taken from three of the units in the home. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 11 Each care plan contained adequate information to enable care staff to know how to care for each person. Social activities were recorded. Care plans had been reviewed monthly and these reviews were detailed to enable staff to be aware of changes that had taken place. All visits to health care professionals such as GP’s, dentists and opticians were recorded within the care plan. The daily record sheets were written each day by the care staff working at the home and showed day-to-day activities of each resident. During the visit the staff interaction was observed and it was obvious that the staff knew the residents well as there was good banter between staff and people who lived in and visited the home. The staff were attentive to residents needs and helped them when required. The general atmosphere on all the units within the home was warm and friendly. Comments made by residents spoken with were “it is a lovely place”, “the staff are really marvellous”, “nothing is too much trouble”. Medicines are managed well. Policies and procedures are in place for the safe management of medications. The home uses a blister pack system for medication so that staff can see which medicines have been given out each day. All medication administration sheets had been completed. CSCI had visited the home in April to check requirements made at the previous site visit had been met. Some improvements had been made, however, the requirements had been fully met at this visit. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 12 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. People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. Residents’ were able to take part in a range of activities of their choosing and meals and meal times were a positive experience. EVIDENCE: The home has an activities co-ordinator and a wide range of activities are on offer. A mass is held daily in the chapel and is open to all residents who wish to attend. The chapel can also be used by residents and families who wish to sit and have some quiet reflection. Residents spoken with felt there was always plenty to do. A choir had been formed for Christmas. The home has a large entrance known as the “market place” where residents and their relatives were seen to take coffee, tea and cakes. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 13 This area has a piano and we were told that a resident played this on a regular basis. Menus were varied with a good choice of food on offer. Residents spoken with were complimentary about the food on offer. “The food is lovely”, “you get plenty to eat”, were comments made by residents spoken with. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 14 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 good. People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. People who live at Christopher Grange are confident that their complaints are listened to and staff have received training so that they know what to do to protect people. EVIDENCE: There is a complaints procedure in place at Christopher Grange and any complaints made are fully recorded. Complaints made had been fully addressed and people could be confident that their complaints would be listened to. The complaints log books were kept on each unit, the manager said she was to keep all this information in her office to assist her to monitor any concerns that were raised. Staff have received training about safeguarding vulnerable people from abuse so that they know how to deal with any incident or suspicion of abuse. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 15 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. People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The home provides a good, clean and comfortable environment for the people to live in. EVIDENCE: During the visit to Christopher Grange we walked around three of the four units in the home. All areas were clean and tidy and there were no odours present. The home was generally well decorated in a domestic style and each bedroom is well personalised. Bedrooms have been decorated as they become empty and decoration is ongoing throughout the home. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 16 We found that some bedroom doors had been propped open using wooden wedges. This practice was seen on all units and it was discussed with the manager as to the purchase of a safer way to keep doors open. There is a small kitchen on each unit, the worktops were worn and split which made them difficult to clean properly and this is an infection control risk. The small kitchen on the top floor also had worn worktops and these need to be replaced. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 17 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 adequate. People who use this service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. Enough staff are provided during the day so that the needs of people living at the home are met. Lack of training means that staff may not know what to do in case of fire. Recruitment procedures are thorough to make sure that new staff are suitable to work with the people who live at the home EVIDENCE: The staffing rota was looked at and showed there were appropriate staffing levels and skill mix deployed on each shift during the day to enable the needs of residents to be met. However, at night the staffing levels for the home are four waking staff and one “sleep in staff”. It was discussed with the manager that an assessment of numbers, needs and dependency levels of residents needs to be undertaken to ensure the needs of residents are met at night. Three residents spoken with said they went to bed before the night staff come on duty so they are not rushed. The percentage of staff holding National Vocational Qualification (NVQ) Level 2 in care was above 50 . Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 18 Training was in place with regard to moving and handling and safeguarding of adults. Training records showed that no staff at the home had received mandatory training regarding fire safety. This means that staff may be unaware of what to do in the event of a fire. We found that some bedroom doors had been propped open using wooden wedges. This practice was seen on all units and it was discussed with the manager as to the purchase of a safer way to prop doors open which could be de-activated when fire alarms went off. Training for first aid was being accessed by the manager and all staff were to receive up to date training in the near future. The recruitment records of four staff were checked. All the files looked at contained relevant information required to enable the management to be aware that the person could work safely with elderly people. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 19 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): 31,33,35,38 Quality in this outcome area is adequate. People who use this service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. There have been some improvements in medicine management but staff training in fire safety needs to be addressed so that people living at the home are kept safe. EVIDENCE: The manager is a qualified nurse and has many years experience in managing in the caring environment. She has been in post since the end of August and has applied to be registered with CSCI. The manager had identified areas of risk in the home with regard to fire safety such as lack of staff training, a problem that she had inherited. She was in the Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 20 process of arranging for all staff to have this training when the inspection visit took place. She had implemented a new up dated risk assessment with regard to fire safety and was viewing this as a priority. As the manager is new in post we rang her following the visit to ask if she had other records of staff attending fire safety training but these could not be found. Records indicated that the maintenance man tested and checked fire safety equipment. There had been no records of staff members who had undertaken fire safety training since the last inspection and they might not be clear about what they had to do to protect residents and themselves if fire broke out at the home. Staff spoken with said they couldn’t remember when they last had fire prevention training. The last fire drill in the home had been carried out in September 2008. We found that some bedroom doors had been propped open using wooden wedges. This practice was seen on all units and it was discussed with the manager as to the purchase of a safer way to keep doors open was found. Fire alarm checks had been carried out and emergency lighting checks had been carried out on a monthly basis and this had been recorded. Recruitment files looked at showed that all relevant information required to enable the management to be aware that the person could work with vulnerable adults. Routine maintenance checks are carried out on all appliances and services. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 21 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 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X 2 Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 38 Regulation 23(4) d) Timescale for action All staff in the home must 12/01/09 undertake an annual refresher course in fire safety training so that people in the home are protected. Requirement 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 OP27 Good Practice Recommendations It is recommended that the manager assesses the needs and dependency levels of residents in the home to ensure the needs of residents are met at night. Christopher Grange DS0000025335.V373189.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North West Regional Contact Team Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 Christopher Grange DS0000025335.V373189.R01.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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