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Inspection on 07/03/06 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 7th March 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.

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

There is a stable staff team, which is able to provide good consistent care its residents and in many cases is able to nurse individuals back to health. There is good liaison with specialist nurses at Chorley and South Ribble Health Authority, which enables close monitoring of medication and those at risk of falls. 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?

Both first floor and ground floor communal areas have been improved with a large extension being built at the back of the home. New furniture has been provided and environmental standards have been greatly improved.

What the care home could do better:

There are no statutory requirements or recommendations as a result of this inspection.

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 7th 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 Cuerden Grange Nursing Home DS0000025554.V275082.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. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 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.V275082.R01.S.doc Version 5.1 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. 5th September 2005 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. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over a five-hour period from 10:00 am. Care records were consulted and all residents living at the home were spoken to. Their care was discussed with them and visiting relatives. Comments received from residents and relatives were positive and were complementary about the care they receive. Comments seen during the inspection are as follows: “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.” “Staff are committed and helpful”. A visitor said “I am very happy with the care given to my relative, I visit regularly”. The building was toured and individual staff were spoken to. There was discussion with management and records were seen including policies and procedures. Questionnaires were issued to residents and relatives. Five residents completed questionnaires following the inspection all were positive and felt their privacy and dignity is respected. One relative completed a questionnaire, which was positive about care provided by the home. What the service does well: There is a stable staff team, which is able to provide good consistent care its residents and in many cases is able to nurse individuals back to health. There is good liaison with specialist nurses at Chorley and South Ribble Health Authority, which enables close monitoring of medication and those at risk of falls. Residents and relatives commented that there is good care provided and staff carry out their tasks with care and consideration. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 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.V275082.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 Cuerden Grange Nursing Home DS0000025554.V275082.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): All key Standards were assessed and met in the previous inspection. EVIDENCE: Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 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): 9 and 10 There are good policies and procedures in place for the safe handling and administration of drugs. Personal care provided to residents is carried out ensuring their privacy and dignity. EVIDENCE: Medication policies and procedures were looked at and records kept examined. Only those staff that 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. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 10 The home has 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.V275082.R01.S.doc Version 5.1 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): 14 and 15 Residents are enabled by the home to exercise choice and control in their daily lives. Residents receive a varied appealing diet and have choices in what they eat. EVIDENCE: 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. 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. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 12 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.V275082.R01.S.doc Version 5.1 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): All key Standards were assessed and met in the previous inspection. EVIDENCE: Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 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 Improvements made to the communal areas have contributed to a better environment for residents. EVIDENCE: Since the last inspection an extension has been completed, which provides much larger communal areas in both ground floor and first floor lounges. Residents are very happy with the improvements, which gives a more comfortable environment. Lounge areas have been redecorated and some new furniture provided. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 15 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): All key Standards were assessed and met in the previous inspection. EVIDENCE: Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 16 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): 33 and 38 There are quality assurance systems in place, which include obtaining residents and relatives views on the running of the home. The health and safety of residents and staff is promoted by the homes policies and procedures and training programme. EVIDENCE: The home is accredited with RDB (Residential and Domiciliary Benchmarking) and received five star rating from this organisation in October 2005. There are three monthly resident surveys carried out, examples were seen during the inspection. Comment from these was positive with regards to care provided. A resident said, “Staff are committed and helpful”. A visitor said “I am very happy with the care given to my relative, I visit regularly”. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 17 Regular one to one chats take place between staff and residents regarding any issues they may have. Residents confirmed this to be the case and said that staff and management are very approachable and things get done when they ask. Staff are motivated by management to interact with residents and to help in providing activities. Staff induction and training records show that all staff receive health and safety training and training in safe working practices. Moving and handling training is mandatory. Most staff are trained in first aid and food hygiene. In conjunction with a specialist nurse from Chorley Hospital a scoring sheet has been implemented for those at risk of falls. This has lead to some residents being provided with calcium and vitamin D supplements. Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 19 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. 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 Cuerden Grange Nursing Home DS0000025554.V275082.R01.S.doc Version 5.1 Page 20 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. 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