CARE HOMES FOR OLDER PEOPLE
Dystlegh Grange 40 Jacksons Edge Road Disley Stockport Cheshire SK12 2JL Lead Inspector
David Jones Unannounced Inspection 15th December 2005 2.20pm 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 Dystlegh Grange DS0000006619.V271598.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. Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Dystlegh Grange Address 40 Jacksons Edge Road Disley Stockport Cheshire SK12 2JL 01663 765237 01663 766828 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 Brian Robinson Mr Brian Robinson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (5) of places Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The total number of Service Users must not exceed 40 40 of the Service Users may be OP 5 of the Service Users may be PD Date of last inspection 3rd August 2005 Brief Description of the Service: Dystlegh Grange is a privately owned care home, located close to the centre of Disley. There are a variety of shops, churches and other facilities nearby. There are adequate car parking facilities available at the home. Formally two private dwellings the home has been extensively altered and extended to provide care to older people in 37 single suites. Accommodation is provided on two floors. Access between floors is via one of two shaft lifts or the stairs. Each of the suites comprise a bedroom with a large sitting area, a kitchenette, en-suite toilet and bathing facilities and where possible a patio or balcony. Some of the suites have a separate lounge. There are a number of communal areas within the home that are available for residents. Furnishings and interior decoration are of a high standard. There are sufficient numbers of toilets and bathing facilities. Aids to facilitate independence are in evidence throughout the home; these include bath hoists fitted in individual en-suite bathing facilities as required, grab rails and an emergency call system. There are both communal gardens and a number of personal patio areas available to residents. Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was a routine unannounced inspection. It took place on the 15th December 2005 between 2.20pm and 6.20 pm. Eight residents and four members of staff were spoken with during the inspection. We looked at some parts of the building, inspected some records and read the case notes of one resident. What the service does well:
Dystlegh Grange is well managed and run in the best interests of residents. Residnets, and a visiting GP are unaminious in their praise of the home and the exempalry standards of care, accommodation, facilities and services provided. The lifestyle in the home reflects the expectations and personal preferences of residents and choice is promoted. Residents feel they are treated with respect and their rights to privacy are upheld. They identify with Dystlegh Grange and present with an air of self-respect in association with it. One resident corrected the inspector for referring to Dystlegh Grange as “a home” she said it is her home. Another said Dystlegh Grange is a marvellous place to live she feels she belongs, it is home and there is no doubt about it. She went on to say, “we are treated with respect and we have our dignity. We are not just tolerated we are looked after”. Other residents also reflect these sentiments and views. Residents are unanimous in the praise and appreciation for the standard of catering and the presentation of food. Meals are served in the home’s dining areas all of which are very pleasant and congenial. Resident’s guests are welcome to join them for a meal, which may be taken in the privacy of their suite or in the communal dining areas. Staff are clear about their roles and responsibilities. All staff are supervised as part of the normal management processes of the home and all receive formal supervision on a regular basis. A commitment to residents’ rights is demonstrated in the way the home is run and is reflected in the mission statement, brochures, service users guide and statement of purpose. Staff conduct their work with all due regard and respect for residents and residents know that their rights are unaffected by moving in. Residents are protected by the home’s recruitment procedures. The home’s quality assurance processes include an annual development plan, “The Business Plan”. This is based on a system involving continuous planning,
Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 6 action and review, reflecting the desired aims and outcomes for residents. The home also has the investors in people award, which is based on seeking the views of residents and the auditing of standards and staff support systems. The registered person/manager seeks to ensure the health and safety of all employees and residents. Risk assessment and risk management is central to the conduct of the home and appropriate maintenance checks and fire precautions are carried out. 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. Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 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 Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 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): None. None of the standards in this section of the report were addressed during the inspection. EVIDENCE: Dystlegh Grange DS0000006619.V271598.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): 8, 9, and 10. Residents’ health care needs are addressed and appropriate arrangements are in place for the storage, administarion and recording of medication. Residents are treated with respect and their rights to privacy are upheld. EVIDENCE: The manager ensures that residents are aware of their rights regarding health care, as detailed in the home’s “Supporting You” document. Reading of case records and discussion with residents and staff indicates that each resident’s health and welfare is monitored in accordance with assessed needs. Records are detailed and clear and where required contact is made and maintained with residents’ respective health care professionals. Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 10 A visiting GP expressed more than satisfaction with the level of communication and the standard of care provided. So much so that she would entrust her own care to the home should this ever be required. Residents express more than satisfaction with the support they receive keeping appointments and maintaining contact with the health care professionals. The registered person enables them to have access to specialist medical, nursing, dental, pharmaceutical, podiatry, and therapeutic services and care from hospitals and community health service according to need. When requested the registered person or other senior staff member will attend appointments with the resident to provide support and help communication. One resident who described Dystlegh Grange as a splendid place to live spoke of the kind and considerate care she received after a fall. She did not suffer any injuries but was shaken by the experience. She said it was comforting and reassuring that staff checked her regularly throughout the day and night to make sure that she was well. Residents are able to administer their own medication according to their assessed needs. Appropriate arrangements are in place for the storage, administration and recording of medication. Residents identify with Dystlegh Grange and present with an air of self-respect in association with it. All speak highly of the home describing it and the facilities and service provided with a range of superlatives from brilliant to amazing. One resident corrected the inspector for referring to Dystlegh Grange as “a home” she said it is her home. Another said Dystlegh Grange is a marvellous place to live she said she belongs here, it is home and there is no doubt about it. She went on to say “we are treated with respect we have our dignity. We are not just tolerated we are looked after”. Other residents also reflected these sentiments and views. Dystlegh Grange DS0000006619.V271598.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, and 15. The lifestyle in the home reflects the expectations and personal preferences of residents and choice is promoted. Visitors are made welcome, the standard of catering is good and residents have access to a range of appropriate activities. EVIDENCE: As noted at the previous inspection the atmosphere in the home is relaxed and convivial and at times positively vibrant. Residents advise that there is always something to do or somewhere to go. There is an active programme of events, which meets and in many instances exceeds residents’ expectations. One resident had developed a keen interest in the care of the home’s tropical fish and had been encourage to develop this hobby taking charge and managing the impressive aquarium. The promotion of choice including the recognition of residents’ rights and responsibilities is fundamental to the home’s values and beliefs. Prior to moving in residents are encouraged and enabled to make a positive choice about Dystlegh Grange by exploring and evaluating their options for care that could be provided by other establishments. They are provided with detailed information about the range of facilities and services available and their rights and responsibilities are confirmed in the contract. Residents are able to bring their own personal possessions into the home and their suites reflect their
Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 12 characters and personalities. They are furnished and decorated in accordance with individual needs and personal preferences and aids to promote independence are provided where required. The home’s mission statement and the way in which staff are trained, managed and supervised reflect these principles. Staff do not enter a resident’s suit without first knocking and seeking permission to enter and the sanctity of the resident’s domain is acknowledged and reinforced. Trained chefs undertake catering in the home. Residents are unanimous in the praise and appreciation for the standard of catering and the presentation of food. A varied and nutritious diet is on offer, which reflects individual preferences, and special dietary needs. Fresh fruit, snacks and beverages are readily available. Chefs regularly discuss food with residents and there is a facility for them to make suggestions. The evening meal comprised a number of options including a range of tasty delicacies served on individual platters. Wine is served with some meals on special occasions. Meals are served in the home’s dining areas all of which are very pleasant and congenial. A choice of vegetables is served in individual tureens; enabling residents to serve themselves and control portion size. Resident’s guests are welcome to join them for a meal, which may be taken in the privacy of their suite or in the communal dining areas. Dystlegh Grange DS0000006619.V271598.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): 17. Residents’ rights are promoted. EVIDENCE: A commitment to residents’ rights is demonstrated in the way the home is run and is reflected in the mission statement, brochures, service users guide and statement of purpose. Residents identify with Dystlegh Grange and know that their rights are not affected or diminished by moving in. They state that Dystlegh Grange is their home and there should be no doubt about it. Staff conduct their work with all due regard and respect for residents. Dystlegh Grange DS0000006619.V271598.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, 20, 21, 22, 23, 24 and 26. Residents live in safe, well-maintained accommodation, which meets and exceeds their expectations and the national minimum standards. EVIDENCE: Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 15 The accommodation exceeds the national minimum standards in all areas of provision including communal and private facilities. The location and layout of the home is suitable for its stated purpose. There are garden areas and a number of individual patios that are accessible and beautifully maintained. Residents describe the accommodation as marvellous. Their suites reflect their characters and personalities. They are furnished and decorated in accordance with individual needs and personal preferences. Aids to promote independence are provided where required. The suites include a bedroom with a large sitting area, a kitchenette, en-suite toilet and bathing facilities and a patio or balcony where possible. Seventeen of the suites have a separate lounge. There are a number of communal areas, some equipped with beverage and snack making facilities. Furnishings and interior decoration are of a high standard. There are sufficient numbers of toilets and bathing facilities and there are aids to promote independence around the home. All residents speak highly of the home indicating that the accommodation meets and exceeds all expectations. One resident said she could not praise the home enough she was delighted with all the nice places to sit and loved the Christmas decorations. She said she is so happy here she cannot put it into words. Dystlegh Grange DS0000006619.V271598.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): 29. Recruitment procedures are thorough ensuring the protection of residents. EVIDENCE: The registered person operates thorough recruitment procedures. All new recruits complete an application form with details of employment history, skills, qualifications and experience and attend a two-tear interview process. Staff records confirm that appropriate references including and POVA First (adult protection register) checks are received before the individual is employed in the home. New staff are confirmed in post following receipt of satisfactory Criminal Records Bureau Disclosure and satisfactory probation period. A recently recruited member of staff advised that she is in the process of completing her induction training. She said that she benefits from having a designated supervisor and regular formal supervision meetings. Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 17 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, 36. And 38. The home is managed in the best interests of residents. The manager is a qualified and competent person who is fit to be in charge. Staff are appropriately supervised and the health and safety of residents and staff is promoted. EVIDENCE: The manager is registered with the Commission for Social Care Inspection. He has a long experience of managing the home and has a certificate in Gerontology and the Registered Manager’s Award. Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 18 The home’s quality assurance processes include an annual development plan, “The Business Plan”. This is based on a system involving continuous planning, action and review, reflecting the desired aims and outcomes for residents. The home also has the “Investors In People Award”, which is based on seeking the views of residents and the auditing of standards and staff support systems. Residents are unanimous in their praise for the home and the exemplary standards of care; facilities and services provided. Two of the residents said that the standards of care and attention to detail are such that the registered person should receive formal recognition for what has been achieved. Staff are clear about their roles and responsibilities. All staff are supervised as part of the normal management processes of the home and all receive formal supervision on a regular basis. The manager seeks to ensure the health and safety of all employees and residents. Risk assessment and risk management is central to the conduct of the home. A senior member of staff takes the lead on health and safety matters ensuring that records and maintenance checks are up to date. Reading of records indicates that all relevant data relating to the Control Of Substances Hazardous to Health Regulations is maintained in a separate file. This is available to staff for guidance and information. Potable electrical appliances and electrical wiring systems are tested at appropriate intervals and appropriate fire precaution procedures are in place. These include regular checks of the alarm and emergency lighting systems, safe area evacuation fire drills and the training of staff. The Fire Safety Officer inspected the home on 2nd March 2005 and the registered manager confirmed that all recommendations from the fire service have been addressed. Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 19 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 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 x 4 4 4 4 4 4 x 4 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 20 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 Dystlegh Grange DS0000006619.V271598.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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