Inspection on 19/07/06 for Cuerden Grange Nursing Home

This inspection was carried out on 19th July 2006.

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 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

Cuerden Grange Nursing Home 07/03/06

Cuerden Grange Nursing Home 05/09/05

Cuerden Grange Nursing Home 02/02/05

Cuerden Grange Nursing Home 06/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Cuerden Grange Nursing Home 414 Station Road Bamber Bridge Preston Lancashire PR5 6JN Lead Inspector Mr Patrick Rooney Unannounced Inspection 19th July 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 Cuerden Grange Nursing Home DS0000025554.V299445.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. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cuerden Grange Nursing Home Address 414 Station Road Bamber Bridge Preston Lancashire PR5 6JN 01772 628700 01772 628700 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) Mr Keith Lowe Mrs Diane Margaret Dillon Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability (6), Terminally ill (4) of places Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 46 service users to include: up to 46 service users in the category of OP (old age, not falling within any other category) up to 6 service users in the category PD (physical disability) aged 40 to 65 up to 4 service users in the category TI (terminally ill) The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 7th March 2006 2. 3. Date of last inspection Brief Description of the Service: Cuerden Grange is situated at the edge of the residential area of Bamber Bridge with easy access to local amenities. The motorway network is nearby and the towns of Chorley, Preston and Leyland are all within a convenient distance. The home offers pleasant garden areas accessible to those with mobility difficulties. Cuerden Grange Nursing Home is registered for elderly persons with a variety of care needs. The accommodation is set out on two floors, the first floor being accessible by passenger lift and staircases. The first floor accommodates service users who require nursing care and the ground floor is designed for service users requiring personal care. A high percentage of places are provided in single accommodation, although a double room is available for married couples or those preferring to share facilities. Although only a few bedrooms have en-suite facilities, a number of toilets and bathing facilities are located in convenient positions throughout the home. The homes fees range from £360 to £425 per week for residential and from £465.50 to £530 per week for nursing. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit and took place over a seven-hour period. A pre inspection questionnaire was completed by the registered manager. The inspector consulted care records and spoke to most of the residents living at the home. He discussed their care with them and visiting relatives. Comments received from residents and relatives were positive and were complementary about the care they receive. The inspector toured the building, spoke individually to staff who were on duty. Discussions were held with the manager. Records and policies and procedures were read. Questionnaires were issued to residents and relatives. What the service does well: Staff at Cuerden Grange work well together as a team and provide a good standard of care for residents. Staff are provided with good induction and training to ensure that they are able to provide sensitive care, which respects individual resident needs. Residents commented: “They can’t do enough for you”. “Marvellous home this, they’re very kind and helpful”. “Will I always be able to live here because I like it.” “ The staff are always very cheerful and always respect your choices.” “Everything is marvellous here they are very kind and you can put your trust in them”. Another said “ They are good to you here and help you when you want, I am able to choose what I want to do. Routines are relaxed and there was a good atmosphere in the home. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 6 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. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome group is adequate. There are assessment systems in place, however they are not fully completed. EVIDENCE: Assessments for four resident were looked at, these contained basic information including skin viability and nutritional risk assessments. Some of the risk assessments were not completed correctly and final scores differed from scores in the main body of the assessment. This could have important implications, as on one assessment the final score should have shown a high risk when in fact only a medium risk was indicated. It is important that all assessments are completed fully and that the information is correct for a good care plan to be implemented, which covers all aspects of care including medical, personal care and social care. At the time of the visit the manager told the inspector that the assessment and care planning system was being reviewed and improved. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 9 Cuerden Grange Nursing Home DS0000025554.V299445.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome group is adequate. Care is delivered in a sensitive manner respecting resident’s dignity and privacy; however recording of care plans needs some improvement. Medication policies and procedures are good. EVIDENCE: Four residents care plans were looked at, these were incomplete and items identified on assessments were not followed through. Care staff spoken to had not read care plans, which were mainly left in the hands of nursing staff to record on. Two residents whose assessments had shown high risk regarding to tissue viability and nutrition did not have follow up actions recorded on their care plans, there were no weight charts or instruction regarding nutrition. While some daily recording is carried out on resident’s files, at the time of the visit it was noticed that other daily recordings are maintained in a communication book. Recordings in this book are about individual residents and are recorded together. To maintain confidentiality of recording all Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 11 recordings regarding residents should be recorded on individual pages, which are then fed in to resident’s files. The manager accepted that care plans needed to be improved and said that she is introducing a new assessment and care-planning process, which will ensure care needs are better identified and recorded. Residents said that they are happy with the care they receive and that staff are kind and helpful and provide support when it is needed. Comments from residents were: “They can’t do enough for you”. “Marvellous home this, they’re very kind and helpful”. “Will I always be able to live here because I like it.” “ The staff are always very cheerful and always respect your choices.” Medication policies and procedures were looked at and records kept examined. Only those staff who are qualified to give out medication may do so. Records of medication dispensed were completed correctly and correct amounts of drugs were seen in the medication trolleys. A blister system is in use and they are colour coded for different times of the day. Unused medication is disposed of in special “doop” containers and taken away by an accredited disposal service. Records of disposals are kept. The home continues to have an arrangement with a nurse clinician from the local health authority, who carries out a regular review of resident’s medications. This has led to good monitoring of individuals medications and changes made when necessary. It is interesting to note that since this system was begun that there are no residents in the home being prescribed drugs such as Temazepam. Cuerden Grange Nursing Home DS0000025554.V299445.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome group is good. Daily routines are flexible and take into consideration the individual needs and wishes of residents. EVIDENCE: There is a relaxed atmosphere in the home and residents are encouraged to take part in activities they are interested in, staff assist in this. The record of activities showed that various activities take place, including in house entertainment, aromatherapy, games, music, knitting club, visits to shops and local pubs. Visitors are made welcome in the home, during the visit several visitors were seen; they said that they always feel welcome. Resident’s families mainly deal with their finances, personal allowances are kept for some residents by the home these are kept securely and good records maintained of income and outgoings. Residents told the inspector they are happy with arrangements in place. Those who wish to contact local advocacy services are able to do so; information regarding these is contained in the statement of purpose and the service users guide. Residents have access to personal files and evidence of them having signed their care records was seen on the files. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 13 Residents said they are able to choose when they get up and go to bed and where they wish to sit during the day. Their own rooms are personalised and residents are able to bring own possessions around them on moving into the home. A resident said, “Everything is marvellous here they are very kind and you can put your trust in them”. Another said “ They are good to you here and help you when you want, I am able to choose what I want to do.” Residents spoken to say they are offered a good variety of food, which is home, cooked and well presented. Records of food served showed there are a wide variety of meals offered with choices always available. Fresh fruit and vegetables are always available. A new cook has recently taken over and is in the process of reorganising menus. In order to do this there has been consultation with all the residents. Hot and cold drinks are available throughout the day and a supper is offered in late evening. Residents comments are, “ I enjoy the food here we are offered a choice”. “I am a vegetarian and they make me special meals”. “ We are asked what we like to eat”. Cuerden Grange Nursing Home DS0000025554.V299445.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome group is good. There is a policy and procedure for dealing with complaints, which ensures complaints or concerns are listened to and acted upon. Adult protection procedures are in place and that residents are protected from abuse. EVIDENCE: There is a complaints procedure, which is available to all residents and their families, it is contained in the service users guide and is on notice board in the home. Residents said that they are able to raise issues of concern with the staff and manager; resident’s surveys showed that they are aware of the complaints procedure. Adult abuse procedures including a whistle blowing policy were seen; these provide good guidance to staff. Staff spoken to were aware of the procedures and said they would certainly report any matters of concern to the manager. Staff have had training in the protection of vulnerable adults. Cuerden Grange Nursing Home DS0000025554.V299445.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome group is good. The home provides a comfortable well-maintained clean environment for residents. EVIDENCE: The home has recently undergone an extension and refurbishment mainly to lounge areas and provides residents with a good homely environment, which is well maintained. Residents said they are happy with their accommodation and feel comfortable. One resident commented: “It is always clean, they are always cleaning, I am very comfortable“. There are procedures in place to ensure the home is kept clean, including good infection control measures. There are sufficient domestic staff available to maintain standards at all times. The inspector carried out a tour of the building and found it to be well maintained and clean. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome group is good. Arrangements for staffing the home ensure there are sufficient skilled staff on duty to meet the needs of residents. Recruitment procedures are good and ensure residents are protected. EVIDENCE: The inspector spoke to management, staff and consulted rotas and staff records. There is a stable staff group who have the experience and skills to provide care needed. Discussion with staff showed that they are receptive to looking at residents individual needs and showed they know them well. Records show that all staff receive a comprehensive induction and training to carry out their duties. This was confirmed from discussion with staff, who told the inspector that there are always training courses made available to them. There are always trained nurses on duty and more than 52 of care staff are trained to NVQ 2 in care. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 17 Questionnaires received from residents and relatives confirmed that staff provide good levels of support to residents. Rotas showed that there are sufficient numbers of staff on duty to meet the needs of residents. Residents said that staff are very friendly and approachable, they also told the inspector staff do their best for them. Staff files were viewed and showed that all necessary recruitment checks are made including Criminal Records Bureau checks. References are taken up and interviews held. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome group is good. The home is well managed, which ensures residents interests are protected and health and safety issues are promoted. EVIDENCE: The manager is experienced and has achieved the Registered Managers Award. She is well known to residents who told the inspector they are able to approach the manager with any concerns they may have and that these are quickly acted on. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 19 Staff spoken to said there are good lines of accountability and they are confident in the leadership of the home. There are regular relative/residents meetings every six to eight weeks and residents surveys are carried out. Records for these were seen and show that issues about life in the home are raised and discussed. Records were seen regarding accounting for resident’s personal allowances, these were in order. Records of all transactions are well maintained. Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 21 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 OP3 Regulation 12(1)(a) Requirement The registered person must ensure that assessment details are correct and cover all aspects of care required. The registered person must ensure that care plans are correct and that assessed needs are followed through in the care plans Timescale for action 20/08/06 2 OP7 12(1)(a) 20/08/06 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 Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Cuerden Grange Nursing Home DS0000025554.V299445.R01.S.doc Version 5.2 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. 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