Inspection on 21/10/05 for Christopher Grange (Rhona House)

This inspection was carried out on 21st October 2005.

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) 02/03/06

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 21st October 2005 10:10 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.V260815.R01.S.doc Version 5.0 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.V260815.R01.S.doc Version 5.0 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.V260815.R01.S.doc Version 5.0 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 4th December 2004 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.V260815.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over a period of five hours. The records relating to the needs of the service users, and the actual care given were inspected including records relating to medications were inspected. The staff records were inspected to ensure that all checks had been made to ensure the protection of the service users. A tour of the home was made to evaluate the level of provision for the service users. Service users and staff were spoken to, to gather additional information regarding the care provided. What the service does well: What has improved since the last inspection? 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. Christopher Grange (Rhona House) DS0000025095.V260815.R01.S.doc Version 5.0 Page 6 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.V260815.R01.S.doc Version 5.0 Page 7 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): 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 has recently been reviewed and updated to reflect the changes within the home. A copy of this, and the Service User Guide are issued to all prospective service users and are available from the home on request. 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 initial plan of 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. Christopher Grange (Rhona House) DS0000025095.V260815.R01.S.doc Version 5.0 Page 8 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.V260815.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10 The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: Individual care plans are prepared for each service user. The format for the care plans has been regularly reviewed to ensure that all necessary information is recorded. Some care plans have not yet been set into the new format, although the information recorded provides staff with the information they need to provide the appropriate level of care to the service users. The records completed by the staff give full information regarding visits to and by GP’s and other health care professionals. The services of the Tissue Viability Nurses are sought whenever necessary and all recommendations and requirements are recorded. The manager has now implemented a strict monitoring system for ensuring that medications are ordered, stored, administered, recorded and disposed of. Only three designated members of the staff team hold responsibility for the Christopher Grange (Rhona House) DS0000025095.V260815.R01.S.doc Version 5.0 Page 10 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. A comprehensive record is held of all medications being received into or leaving the home. 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. Christopher Grange (Rhona House) DS0000025095.V260815.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. 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. 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.V260815.R01.S.doc Version 5.0 Page 12 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. 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.V260815.R01.S.doc Version 5.0 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 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.V260815.R01.S.doc Version 5.0 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 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 programme of redecoration and improvements continues to be undertaken with all rooms being bright and welcoming. Furniture is in good condition and replaced as necessary. It is planned that the corridor and lounge will be redecorated before Christmas and new flooring is planned for the corridors. Recliner chairs and flat screen televisions have been provided in rooms designated for the care of those who have a terminal illness and a new electric profiling bed has been given to the home as a gift. Christopher Grange (Rhona House) DS0000025095.V260815.R01.S.doc Version 5.0 Page 15 New assisted bathing facilities have been provided since the last inspection and this has proved to be very popular with the service users. Blinds have been fitted to windows throughout the home to further enhance the environment and to further promote privacy for the service users. 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.V260815.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. 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. There are currently some vacant positions that the home is actively recruiting to fill. In addition to the nursing and care staff, the home employs designated catering, laundry, domestic 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. All necessary checks are made on staff prior to them commencing at the home to ensure the protection of service users. 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 a local college in order achieve accreditation for in service staff training. Christopher Grange (Rhona House) DS0000025095.V260815.R01.S.doc Version 5.0 Page 17 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. Two of the nurses have completed formal training and achieved qualifications in Palliative Care and a further two staff are currently working towards this. One of the managers within Christopher Grange is responsible for identifying training needs and arranging for the training to be undertaken. Christopher Grange (Rhona House) DS0000025095.V260815.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 All safety measures were in place to ensure the protection of service users. Staff training continues to provide a high level of care for the service users. 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.V260815.R01.S.doc Version 5.0 Page 19 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.V260815.R01.S.doc Version 5.0 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 X 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 4 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 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.V260815.R01.S.doc Version 5.0 Page 21 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. Standard Regulation Requirement Timescale for action 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.V260815.R01.S.doc Version 5.0 Page 22 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.V260815.R01.S.doc Version 5.0 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!