Inspection on 02/03/06 for Christopher Grange (Rhona House)

This inspection was carried out on 2nd March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 (Rhona House) 03/08/09

Christopher Grange (Rhona House) 02/08/07

Christopher Grange (Rhona House) 31/08/06

Christopher Grange (Rhona House) 21/10/05

Christopher Grange (Rhona House) 04/12/04

Similar services:

SignHealth

Mere Hall View

Beechfield Lodge

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

CARE HOMES FOR OLDER PEOPLE Christopher Grange (Rhona House) Youens Way East Prescot Road Liverpool Merseyside L14 2EW Lead Inspector Jeanette Fielding Unannounced Inspection 2nd March 2006 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 (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Christopher Grange (Rhona House) Address Youens Way East Prescot Road Liverpool Merseyside L14 2EW 0151 220 25 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) The Catholic Blind Institute Tina Marie Clair Care Home 28 Category(ies) of Sensory impairment (23), Terminally ill (5) registration, with number of places Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 23 Sensory Impairment (SI) aged 65 years and over 5 Terminally Ill (TI) aged 50 years and over To accommodate one named person under 65 years old Date of last inspection 21st October 2005 Brief Description of the Service: Rhona House is part of the main Christopher Grange Home, but is registered separately. Rhona House is currently registered with the National Care Standards Commission for nursing care for elderly persons. A total of 28 beds are available, with five of these being available for the care of terminal illness. The home forms part of the Christopher Grange Home that was purpose built for providing services to visually handicapped people and provides all facilities on the ground floor thereby providing full access to all areas. It is situated in Liverpool 14, close to local shops and amenities. The home is set within a residential area, close to shops and major transport routes. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over seven hours in one day. The records relating to service users were inspected and the initial assessments of service users were good. Some care plans require additional information to be recorded. Staff records were inspected and found to be comprehensive and included all information to ensure the protection of service users. A tour of the home showed that improvements continue to be made to provide a pleasant and homely environment for service users. The lounge is now particularly bright and welcoming and the corridors were still being decorated. Service users spoke highly of the care afforded to them. The well maintained grounds and gardens can be used by service users as they wish. What the service does well: What has improved since the last inspection? What they could do better: Additional information requires to be added to the care plans to ensure that the risk assessments are reviewed and risk management plans put in place. Please contact the provider for advice of actions taken in response to this Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 the following standard(s): 1, 3 Comprehensive assessments are undertaken on all prospective service users to ensure that their individual care needs can be met. EVIDENCE: The statement of purpose is currently being updated to reflect changes in the home. The inspector viewed the draft copy of the document and this was found to be extremely informative and provides excellent information regarding the services and facilities provided by the home. It will be available for current and prospective service users in the very near future. Assessments on service users who are to be accommodated for long term care are undertaken by the manager or own of the qualified nurses. The assessment involves the gathering of information from the service user, family members, GP, social worker and any other person involved in their care. The assessment enables the home to gather information regarding the service users care needs, the equipment that is necessary and any individual preferences. The assessments are detailed and informative. The initial plan of Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 9 care is developed, based on the information gathered at the time of the assessment. The home is registered to accommodate five persons who require care due to their terminal illness, palliative care. Some of these service users have their assessment undertaken by the District Nurse, District Nurse Liaison, Marie Curie or Macmillan nurses. The plan of care is developed to ensure that the needs of the service user can be met. The home does not offer Intermediate Care. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Care plans are generally informative although some require additional information to ensure that staff are given sufficient information to meet service users needs. EVIDENCE: The care plans are currently under review and are being updated to reflect the changing needs of the service users. Some files inspected lacked risk assessments, risk management strategies and plans to meet specific care needs. One service user recently admitted to the home did not have an adequate care plan which may result in an inappropriate level of care being provided. The majority of care plans were detailed and informative and provide staff with all the necessary information to enable them to provide the appropriate care for the individual service users. No accident reports are held on the care files which makes it difficult for accidents to be audited in respect of time and place resulting in a lack of information to be included in the risk management plan. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 11 The daily reports completed by the staff provide details of the specific care given to individual service users. A strict monitoring system for ensuring that medications are ordered, stored, administered, recorded and disposed of has been implemented. Only three designated members of the staff team hold responsibility for the ordering of medications to reduce the risk of mistakes. The medications administration record sheets were found to be accurate and up to date. All medications are securely stored and new storage facilities have been provided since the last inspection. An effective system of disposal of medications is in effect. A comprehensive record is held of all medications being received into or leaving the home. Staff must ensure that the medications room door is locked when the room is not in use. The home is looking to providing facilities for access to specific medications for service users who are accommodated for palliative care. The advice of a pharmacist inspector will be sought to advise the home on specific requirements. All service users are accommodated in single bedrooms, each having en-suite facilities. Personal care is given to service users in the privacy of their bedroom or the bathroom as appropriate. Staff were observed to knock on bedroom doors prior to entering and spoke discretely to service users on personal issues. Policies and procedures have been reviewed and updated and are accessible to all staff. These documents are comprehensive and provide staff with necessary information. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 EVIDENCE: Service users confirmed that the routines in the home were flexible and suited their individual preferences. An activities co-ordinator provides activities and social stimulation with the service user on an individual basis as well as in small groups or with service users from other service users within the Christopher Grange complex. A list of planned activities is displayed on the notice board to give service users the opportunity to choose which activities would suit their individual preferences. The activities available include daily Mass, board games, musical afternoons, library, film afternoon, bingo, reminiscence and exercise to music. The hairdresser visits the home each week. Friends and family are welcomed to the home and may meet with service users in the privacy of their bedroom or in one of the communal areas as the service user wishes. The home provides a room where service users may meet with their visitors in private if they wish. Some service users are taken out by family members or staff, particularly during the warmer summer months. Service users enjoy trips to the shops or to local amenities as they wish. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 13 Service users can choose the time that they go to bed and rise and this information is recorded in their plan of care. Records are held of the name that the service user wishes to be called and of the lifestyle they choose. The meals at the home are good with a wide range of choices available. A menu is provided and service users are asked to select their choice the day before. Meals were seen to be attractively presented and smelled appetising. The main meal of the day is provided at lunchtime and the menu included soup, a choice of two meat meals, a soft diet, a fish meal or a vegetarian meal. Service users are encouraged to take their meals in the dining rooms, however arrangements are made for those who are unwell to eat in the lounge or in their bedroom. The dining room is bright and tables are attractively set. The meals are delivered from a central kitchen in a heated trolley and individually served in the dining room. Ethnic and special diets can be provided on request or following the recommendations of the dietician and the manager liaises with the chef regarding these. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a comprehensive complaints procedure which is included in the statement of purpose and is displayed within the home. The procedure indicates that upon receipt of a complaint to the manager an acknowledgement of the complaint will made within 24 hours and a response within seven days. The procedure states that matters remaining unresolved may be further pursued with the home’s governing body or the Commission for Social Care Inspection. Staff spoken to, during the inspection, were able to confirm that they were aware of the procedure to be followed. Service users spoken to confirmed that they knew whom they could complain to. No complaints have been received by the home since the last inspection. The home has a policy and procedure to be followed in the event of abuse being suspected. Some staff have now completed formal training on abuse and the action to be taken and further training is planned for all staff in the near future. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The décor in this home continues to improve to provide a pleasant and homely environment for the service users. EVIDENCE: The home is on ground floor level and all areas are fully accessible to those who have mobility difficulties or require to use a wheelchair. Handrails are fitted to assist service users. Safety issues are addressed as soon as they are identified to ensure the protection of service users. The main lounge has been redecorated and a fireplace fitted to provide a central focal point for the room. This lounge is now extremely pleasant and has been provided with new armchairs and a sofa. New pictures have been purchased and now hang in the lounge. Service users spoken to commented positively on the improvements. At the time of the inspection, the corridors were being redecorated and those that were completed were bright and welcoming. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 16 Bedrooms have been personalised and are decorated and furnished to a good standard. The home was found to be clean throughout and no offensive odours were present. Policies and procedures relating to the control of infection were in place and were seen to be followed by the staff. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The home provides two qualified nurses on duty during the day supported by six care staff during the morning and four care staff in the afternoon. At night, one qualified nurse is supported by three care staff. Some new staff have been recruited to compliment the current staff team. In addition to the nursing and care staff specifically for Rhona House, the home employs designated catering, laundry, domestic, maintenance and administration staff who work with the Christopher Grange complex. NVQ training continues to be promoted within the home and all staff are encouraged to further their knowledge and understanding. All prospective staff are required to complete an application form prior to attending for interview. Two references are taken and checks are made through the Protection of Vulnerable Adults and Criminal Record Bureau’s. Staff appointed at the home receive an induction and further training to meet the needs of the service users. The home has a number of training videos for staff to facilitate in house training and consultation continues to take place with Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 18 a local college in order achieve accreditation for in service staff training. NVQ training continues and at present, 60 of the staff team have attained this qualification. Training in Palliative Care is being given to all staff and additional training in specific care needs is provided where the needs of the service users identify this as necessary. All qualified nurses have been given two days training at the Marie Curie Centre. Recent training for staff includes moving and handling and abuse and the home is now providing a more structured training programme. Staff meetings are held on a regular basis and provide a forum for information to be disseminated. Regular supervision is given to all staff and annual appraisals are held. The staff records inspected were found to be extremely organised and contained all necessary information including recent training undertaken. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The systems for service user consultation are good with a variety of evidence that indications that service users’ views are both sought and acted upon. EVIDENCE: The Registered Manager of the home is an RGN who has extensive management experience who holds specific qualifications and has undertaken considerable training to provide a high level of care to those service users who are elderly, together with those service users who have a terminal illness. Staff meetings are held on a regular basis and specific meetings are held for nurses, daytime care staff, night staff and general assistants. Comments and suggestion leaflets are available throughout the home providing opportunities for people to comment on the facilities, care and services provided. Verbal feedback is also obtained from service users, Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 20 relatives and other visitors to the home. The manager speaks with service users on a one to one basis to obtain their views and has a good rapport with all relatives. Some service users deal with their own finances and several have their finances dealt with by family members or advocates. The accounts are audited on a regular basis by the finance director. All records inspected were found to be well maintained and up to date. Fire equipment checks are made on a regular basis as required and duly recorded. Records are also held of fire drills and of the staff involved. Risk assessments are undertaken on equipment, staff and service users and risk management strategies were seen to be in place as appropriate. Safety certificates are held and all were found to be up to date. Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 3 X 3 X X X 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 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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 OP7 Regulation 15 Requirement The registered person must ensure that care plans include all necessary information. Timescale for action 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Christopher Grange (Rhona House) DS0000025095.V286446.R01.S.doc Version 5.1 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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