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Inspection on 05/09/05 for Cuerden Grange Nursing Home

Also see our care home review for Cuerden Grange Nursing Home for more information

This inspection was carried out on 5th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

The home provides good care to its residents and in many cases is able to nurse individuals back to health. Residents and relatives commented that there is good care provided and staff carry out their tasks with care and consideration.

What has improved since the last inspection?

Recording of care plans is improving and a new system is being put into place which will be easier for staff to use.

What the care home could do better:

There is concern that correct procedures have not been followed for the extensive alterations currently taking place. An application for variation to the service should have been received by the CSCI prior to work beginning.

CARE HOMES FOR OLDER PEOPLE Cuerden Grange Nursing Home 414 Station Road Bamber Bridge Preston, Lancashire PR5 6JN Lead Inspector Patrick Rooney Unannounced 5 September 2005 10:00am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 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 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 CRH Care Home 45 Category(ies) of DE(E) Dementia 1 registration, with number OP Old Age 45 of places PD Physical Disability 6 TI Terminally Ill 4 Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 45 service users to include: 2.Up to 45 service users in the category of OP - (Old age, not falling within any other category). 3. Up to 6 service users in the category PD - (Physical Disability). Age 40 to 65 years. 4. Up to 4 service users in the category TI - (Terminally Ill). 5. 1 named service user in the category of DE(E) (Dementia over 65 years of age) may be accommodated within the overall number of registered places. 6. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 7. 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. Date of last inspection 2nd February 2005 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 people 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 ground floor accommodates service users who require nursing care and the first 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. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and took place over a period of seven hours. The information contained in the report has been gathered by discussion with the manager. Five staff were interviewed separately and the care of ten residents was case tracked from assessment to care plans. These residents were seen privately. Other residents were spoken to during a tour of the building. Questionnaires were distributed and completed by most residents. Completed questionnaires were also received from relatives. Positive feedback was received from all discussions and questionnaires. Residents told the inspector that they are well cared for and that staff are caring and approachable and meet their needs. The inspector carried out a tour of the home and examined records, policies and procedures. Cuerden Grange Nursing home is managed by a registered manager and the owner is in regular contact with the home. The inspector found during the visit that the manager and staff demonstrated a good awareness of the needs of the residents and he observed good interaction between residents, management and staff. What the service does well: The home provides good care to its residents and in many cases is able to nurse individuals back to health. Residents and relatives commented that there is good care provided and staff carry out their tasks with care and consideration. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 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 F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3 All residents receive information about the home and may visit prior to placement. There is a full needs assessment carried out including risk assessments. Some attention is needed to ensure a personal history is obtained. EVIDENCE: The inspector looked at the care records for ten residents, five nursing and five residential. He also spoke to those residents in private. All seen have received full assessments including an assessment of any risks and said that the care they receive is adequate for their needs. Some files contained very limited personal history information. Residents and their families said that they receive a service users guide and information about the home before accepting a place. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8 Residents have a care plan, which they are involved in, and which helps them to reach personal goals. Areas of risk are dealt with in care plans and are agreed with the involvement of residents or their representatives. EVIDENCE: The care plans were seen for ten residents and the inspectors spoke to them about the care they receive. They said that they receive the right levels of support from staff and are enabled to reach their own goals. All care plans are signed by the resident, or their supporters. Any constraints are discussed and agreed. Care files also showed that residents or their supporters sign the record of information held and have access to their records. Residents and relatives survey forms received back during the inspection were positive about live in the home. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 10 One resident said “I enjoy living at Cuerden Grange”. A relative said “ I have always found that the care given to mother has been top class. And staff are very helpful and friendly”. All residents spoken to by the inspector said that staff are friendly and helpful and that care they receive is good. Staff were interviewed individually and demonstrated a good awareness of the care needs of residents. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 Social activities are provided which are varied according to the needs of individual service users. The homes routines are flexible and welcoming to all individuals. Friends and relatives are made welcome when they visit the home. EVIDENCE: The inspector saw a good varied programme of activities for residents, which includes entertainment sessions, outings, and visiting shops. At the time of the inspection there was major building work going on within the home. This has curtailed recent provision of activities, however when work is completed there will be more space. Residents told the inspector that there are always activities available to them if they wish to take part. The home employs staff who’s job is to promote and organise activities. The atmosphere in the home was observed to be relaxed, residents told the inspector that routines are flexible and they able to rise and retire when they Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 12 wish. Mealtimes are flexible according to their needs and wishes and they can take meals privately if they wish. Visiting relatives told the inspector they are always made welcome during visits and said that the staff are always pleasant and helpful. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Arrangements for complaints are good and an effective whistle blowing policy ensures protection of residents. EVIDENCE: The home has a detailed complaints procedure, this was seen by the inspector. In discussion with residents and visitors the inspector found that they were aware of what to do if they had a complaint. Both residents and visitors spoken to said that they found the manager and staff of the home approachable if they were concerned about anything. Information about the complaints procedure is available in the service users guide. A record of internal complaints is kept and outcomes recorded. There has been no complaint made to the CSCI since the last inspection. There is a procedure available to protect residents from abuse including a whistle blowing policy. Staff interviewed demonstrated an awareness and understanding of these policies. Saying that if they have any concerns they feel able to speak to the manager or the owners. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,25 and 26 The home is currently undergoing major building works and large parts of lounge areas are cordoned off. There are concerns that appropriate variation forms have not been completed for the changes taking place. Consequently fire and environmental health reports have not been obtained. Despite the work being carried out all parts of the home in use by residents were clean and hygienic. EVIDENCE: The inspector toured the building and observed that there are major building works in operation involving an extension at the rear of the building involving both the first floor and ground floor lounges. Some bedrooms and a dining room are involved in the changes. The inspector found that there has been no variation applied for in regard of these changes. Consequently neither, fire or environmental health reports regarding the changes had been obtained. Following the inspection a letter was sent to the owner asking for a variation form to be completed. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 15 The inspector observed that all parts of the home in use were clean, however residents are currently restricted to half the communal space they would normally occupy as large areas of both lounges had been cordoned off. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The number of staff on duty is sufficient to meet the needs of residents. The home places importance on training, care Staff are given the opportunity to do the NVQ 2 qualification in care. The procedures for the recruitment of staff offer protection to people living in the home. 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. Questionnaires received from residents and relatives confirmed that staff provide good levels of support to residents. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 17 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 F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32 and 35 The home is managed and run efficiently. There is leadership guidance and continuity. Staff and residents are aware of the management structure and know who to go to with any concerns. There are good systems in place to safeguard the interests of residents. 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 F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 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 live in the home are raised and discussed. Records were seen regarding accounting for residents personal allowances, these were in order. Records of any transactions are maintained. Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 2 x x x x 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 3 x x x Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19,20,25 Regulation 39 Requirement The Commission for Social Care Inspection must be given prior notice regarding any alterations or extensions to the building. And an appropriate variation applied for. Timescale for action Immediate 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 Good Practice Recommendations Cuerden Grange Nursing Home F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 F57 F09 S25554 Cuerden Grange Nursing Home V219948 030805 Stage 4.doc Version 1.40 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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