CARE HOMES FOR OLDER PEOPLE
Dystlegh Grange 40 Jacksons Edge Road Disley Stockport Cheshire SK12 2JL Lead Inspector
David Jones Unannounced Inspection 24 May and 4 June 2007 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 Dystlegh Grange DS0000006619.V333339.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. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Dystlegh Grange Address 40 Jacksons Edge Road Disley Stockport Cheshire SK12 2JL 01663 765237 01663 766828 brianrobinson@dystlegh.fsnet.co.uk 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.V333339.R01.S.doc Version 5.2 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 15th December 2005 Brief Description of the Service: Dystlegh Grange is a privately owned care home, 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. The home was formerly two private houses which have been extensively altered and extended to provide single suites and other facilities for the people who live at the home. Each suite consists of a bedroom with a large sitting area, a kitchenette, ensuite toilet and bathing facilities and, where possible, a patio or a balcony. Some of the suites have a separate lounge. The suites are situated on two floors and access between floors is by passenger lifts or the stairs. There are a number of communal areas such as lounges and dining rooms within the home. Furnishings and interior decoration are of a high standard. There are sufficient numbers of toilets and bathing facilities for the number of people who live in the home. Aids such as grab rails and bath hoists are installed throughout the home to help people move around as independently as possible. There are communal gardens and a number of personal patio areas available to residents. Information about Dystlegh Grange including copies of the most recent inspection report is made available to each of the people who live at the home and can be acquired by contacting the home on the telephone number above. Information provided by the registered manager confirms that fees range from £530 to £640 per week. There are no additional charges other than hairdresser, toiletries, newspapers and other sundry items charged at cost. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key inspection of Dystlegh Grange was unannounced. It included a visit to the home that took place on the 24 May and 4 June 2007 taking 12 hours in total. The visits were just one part of the inspection. Before the visit, the manager of the home was asked to complete a questionnaire to provide CSCI with up to date information about the home. CSCI questionnaires were also made available for the people who live at the home, their families and health and social care professionals, such as nurses and doctors, and their views have been taken into account. Other information received since the last key inspection was also reviewed. During the visit, various records were looked at and a tour of the home was carried out. Observations were made of how staff interacted with and provided support and care for the people who live at the home. A number of people who live at the home, visiting relatives and care staff were spoken with. They gave their views and these have been included in this report. What the service does well:
People who live at Dystlegh Grange say it is their home and like to refer to it as “The Grange”. They, their relatives and others such as doctors and nurses involved in the care of people who live there are unanimous in their praise of the home. People moving to “The Grange” are able to stay at the home on a trial basis and have information about facilities and services provided so they can check that their needs can be met at the home. They have their needs assessed so they know how their needs will be met and have a contract so they know their rights and responsibilities before they make decisions about moving in permanently. Staff spend time and effort to make moving into the home personal and well managed, so the person moving in never feels they have lost control over important decisions about their lives. The health and personal care provided is based on each person’s individual needs, so they receive the care they need in the way they prefer. The principals of dignity and privacy are promoted so people who live at “The Grange” feel respected and valued. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 6 There is a range of imaginative and varied opportunities for people to develop and maintain their social lives. Highly effective methods are used to help people make their own decisions about all areas of their lives so that they stay in control of what they do. The atmosphere at “The Grange” can be relaxed or much more vibrant, according to what is happening in the home that day. People living at “The Grange” say that they love it. There is a varied programme of events so there is always something to do or somewhere to go. The people who live at “The Grange” and their relatives praise the care and services provided at the home very highly. One person said, “Dystlegh Grange is a life saver to me, it enables me to do things that I’d be unable to do”. Another said “The Grange” has given me a new life. My move here has been nothing but positive”. Another who was asked to sum up what was best about “The Grange” said, “ The main thing is feeling part of something, having your own place but feeling a part of The Grange”. People who live at “The Grange” are unanimous in their praise for the standard of catering and the presentation of food. There is a varied and nutritious diet, which covers individual preferences and special dietary needs so people can have the food they prefer in order to stay as healthy as possible. The home has received the “Gold Standard Award in Nutrition” from Macclesfield Borough Council. This reflects the ongoing drive by the management and staff teams to achieve the highest standards in nutrition, choice, food hygiene and staff training. Dystlegh Grange is well designed and maintained so that people live in spacious, comfortable, clean surroundings that suit their needs and enable them to be as independent as possible. All the accommodation at the home exceeds the National Minimum Standards for Care Homes. People living at “The Grange” are encouraged to bring personal possessions including furniture so they can make their rooms their own. The rooms are furnished and decorated to their personal preferences and aids to promote independence are provided as required. There is an effective, well supported and well managed team of staff. Care professionals who visit the home, including three doctors and a district nurse spoke highly of the standard of care provided at the home, saying that Dystlegh Grange is excellent. Staff were said to skilled, with a clear understanding of the needs of the people who live at the home. They act on specialist advice so the health care needs of the people living at “The Grange” are met. There is an effective management team so the home is run for the benefit of the people who live there. Without exception all the people who live at “The Grange” feel valued, included and respected.
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 8 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.V333339.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People moving to Dystlegh Grange can visit the home to stay before they decide to move in. They are given information about the home and have their needs assessed so they know their needs can be met there. They have a contract so they know what their rights and responsibilities are whilst living at the home. EVIDENCE: People who live at Dystlegh Grange refer to it as “The Grange” and do not see it as a care home. Without exception all spoken with said they see “The Grange” as their home, with personal care, excellent facilities and services on hand when they need them. Their private rooms are personalised to reflect their individual tastes. They, their relatives and care professionals who visit the home, such as doctors and nurses, are unanimous in their praise of a home that reflects each individual’s needs and personal preferences and exceeds their expectations.
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 10 One person said, “Dystlegh Grange is a life saver to me, it enables me to do things that I’d be unable to do”. Another said “The Grange” has given me a new life. My move here has been nothing but positive”. People who interested in moving into the home and their families are treated as individuals, with dignity and respect for the life changing decisions they need to make. Discussion with the people who live at the home and staff confirms that there is a high value on responding to individual needs for information, reassurance and support. It is clear that time and effort is spent to make moving in to the home personal and well managed, so the person never feels they have lost control over important decisions about their lives. People can move into the home for a short stay so they are able to see for themselves if the home is suitable to meet their needs. They said they are encouraged to explore all their options, including staying in their own home with home care provided or looking at other types of supported accommodation before they make any decisions about moving into Dystlegh Grange permanently. All the people responding to CSCI’s questionnaires said that they received enough information about Dystlegh Grange before they moved in. There is a statement of purpose, service users guide and an illustrated brochure. People have a contract with the home so they know their rights and responsibilities. All new people have a comprehensive needs assessment before they move in. They say this is carried out with skill and sensitivity. For example one of the people living at the home said “they have the level of care just right it is there if we need it. It is very discreet but we have the security that it is there when we need it.” All other people who live at Dystlegh Grange who were spoken with during the visit expressed similar views. Information for the assessment is gathered from a range of sources including other relevant professionals and their views are taken into consideration. Before agreeing that the person can move in, the manager carefully considers the person’s needs and whether they can be met fully at the home. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that a person living at Dystlegh Grange receives is based on their individual needs, so they receive the care they need in the way they prefer. The principals of dignity and privacy are promoted so people who live at the home feel respected and valued. EVIDENCE: People who live at “The Grange” are unanimous in their praise for the standard of care provided. For example one said “They just keep on improving they never stop. I would describe the managers and staff as angels. There is no better way to describe them. Care could not be better, they know us so well and they respect us, they do things the way we want them doing. It makes us feel good. There is nothing that they could improve on.” The care planning system is person centred, structured and well thought out. The aim is to develop a care partnership involving the person and ensuring that they and their advocates are at the centre of decision making. A key
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 12 outcome of this is that people who live at “The Grange” are in control of their lives and they direct the service as far as it relates to them. The care plan is developed with the individual and is based on a full and up to date assessment. The plan is person centred and focuses on the individual’s strengths and personal preferences. Risk assessment is central to the care planning system so people living at “The Grange” know they have the right to take risks in their daily lives as part of a fulfilling lifestyle. Staff are fully committed to support people to lead purposeful and fulfilling lives as independently as possible. People living at “The Grange” express more than satisfaction with the support they receive to keep appointments and contact with their health care professionals, such as doctors. The manager or other senior staff member will attend appointments with people, if requested, to help with communication and ensure their health care needs are met. Visiting health and social care professionals including three doctors, a podiatrist and district nurse spoke highly of the standard of care provided at Dystlegh Grange. Staff were said to demonstrate a clear understanding of the needs of the people who live there and act on specialist advice, which is incorporated in the individual’s care plan. Quotes from visiting care professionals include: • “The overall standard of care at Dystlegh Grange is excellent. • “Each resident is well cared for as an individual and their dignity and privacy always respected.” • “ An outstanding home” • “I think Dystlegh Grange is an excellent residential care home and never hesitate to recommend it. A CSCI pharmacist inspected the medicines at the home. There is a very personalised medicine procedure that describes in detail how medicines are managed. Every stage is meticulously checked and recorded. The system of giving medicines is designed to enable the residents to take their medicines in their own time, in private and allows some to be taken before and some after food as needed. A risk assessment process shows how much help is needed and this can vary depending on how well people are. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social, educational, cultural and recreational activities meet and in certain circumstances exceed people’s expectations. People who live at the home are able to choose from a range of options so they can develop their lifestyle to reflect personal aspirations and preferences. EVIDENCE: The atmosphere at “The Grange” changes according to the tempo of life on that day. Sometimes it is relaxed and convivial and at other times it is positively vibrant. People living at “The Grange” say that they love it. They say there is always something to do or somewhere to go. There is a varied programme of events, which meets and in many instances exceeds their expectations. The promotion of choice including the recognition of the individual’s rights and responsibilities is fundamental to the values and beliefs of “The Grange”. Staff at the home provide imaginative and varied opportunities for people to develop and maintain social, emotional, communication and independent living skills where appropriate. Highly effective methods are used, which focus on
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 14 involving the individual in all areas of their life, so their rights to make informed choices are actively promoted including providing links to specialist support when needed. This includes developing and maintaining family and personal relationships. Visitors are welcome and people living at “The Grange” are able to entertain their visitors in their own rooms or in the many communal areas of the home. People living at “The Grange” are actively encouraged to use personal possessions and their own pieces of furniture to make their rooms their own. Their rooms are furnished and decorated as they would wish; personal preferences are met and aids to promote independence are provided where required. The mission statement for the home and the way in which staff are trained, managed and supervised reflect the principles of dignity and respect. Staff do not go into people’s rooms without first knocking and seeking permission to enter. The home has received the “Gold Standard Award in Nutrition” from Macclesfield Borough Council. This reflects the ongoing drive by the management and staff teams to achieve the highest standards in nutrition, choice, food hygiene and staff training. Trained chefs provide catering in the home. People who live there and their visitors are unanimous in their praise 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 drinks are readily available. Chefs regularly discuss food with the people who live at the home and they can make suggestions about food and menus. 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 so people can serve themselves with the amount they would prefer. People living at “The Grange are able to entertain guests who 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.V333339.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who live at Dystlegh Grange are able to express their concerns, and have access to an effective complaints procedure, so they know their concerns and complaints will be listened to and dealt with. Adult safeguarding procedures are in place so the people who live at the home are protected from abuse. EVIDENCE: The culture at Dystlegh Grange is open and inclusive. Managers and staff work with the people who live in the home in a care partnership so their needs, personal preferences and aspirations are known and understood. People feel safe and supported to share any concerns they may have about any aspect of the home but say they have not needed to. There is an effective complaints procedure; managers and staff are keen to make sure that people do let them know of any concerns so they can resolve them. However no complaints have been received since the date of the last inspection and people living at “The Grange” say that they don’t think they will ever need to make a complaint. A commitment to residents’ rights is demonstrated in the way the “The Grange” is run and is reflected in the mission statement, brochures, service users guide and statement of purpose. People who live at “The Grange” know that their rights are not affected or diminished by moving in. They say that Dystlegh Grange is their home and they are all very clear about this.
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 16 Policies and procedures regarding safeguarding adults are available to staff and give them clear guidance about what action should be taken if they think that abuse or harm is happening to anybody who lives at the home. Access to external agencies or advocacy services is actively promoted and managers and staff are clear when an incident needs to be referred to the local authority as part of the local safeguarding procedures. The local authority’s safeguarding procedures are in place so staff and the people who live at “The Grange” can access this information should the need arise Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is very well designed and maintained so that people live in spacious, comfortable and clean surroundings that suit their needs, exceed their expectations and allow them to remain as independent as possible. EVIDENCE: The accommodation exceeds the national minimum standards in all areas of provision including communal and private facilities. Thirty-six of the thirtyseven suites are more than 2½ times the size of the national minimum standard for a shared room. All have en-suite facilities, except for one room which has a private bathroom next door. There are a number of communal areas both inside and outside of the home so that people living there have a choice of places to sit quietly, meet with family and friends or socialise with other people who live there. There are garden
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 18 areas and a number of individual patios that are accessible and beautifully maintained. People who live at the Grange describe it as beautiful and say the facilities are excellent and exceed all expectations. Their suites reflect people’s individual characters and personalities. They are furnished and decorated according to individual needs and personal preferences. Aids to help people move around as independently as possible 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 drink and snack making facilities. Managers and staff encourage the people who live at “The Grange” to keep their larders stocked with milk, fruit, fruit juices including orange juice and cranberry juice, biscuits and snacks that are freely available on open display for them to help themselves. 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. Improvements to the internal and external environment are made according to an ongoing programme of development, re-decoration and refurbishment. One of the people who lived at “The Grange” pointed out that the managers make sure that developments reflect the needs of the people who live there. For example the decking area outside one of the dining areas was very popular last summer due to the good weather but on good days it became too crowded. The management team have responded to this by enlarging the decking area so more people can make use of it this year. Quotes from the people who live at “The Grange” and their relatives included: • “The accommodation is maintained to a very high standard.” • “The place could not be cleaner even in Buckingham Palace. In other words it is fit for a Queen.” Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are thorough to make sure that staff are suitable to work with the people who live at the home. Staff are trained, skilled and there are enough on duty to make sure that the people who live at “The Grange” are safe and receive the care and support they need. EVIDENCE: Recruitment procedures are thorough and highly selective so vulnerable people are protected and only those individuals with the right attitude and aptitude for care are recruited. Interviews can last a day and involve observation of the candidate interacting with the people who live at “The Grange” whose views are taken into consideration when selection is made. Managers appreciate the vocational nature of the caring role and are keen to ensure that new recruits have the values and beliefs that reflect the philosophy at the home. This helps to make sure that the staff are able to provide person centred care and the service and the needs of the people who live at “The Grange” are met in the way they prefer. People who live at “The Grange” describe the staff as “wonderful” to “excellent” and one said they could only be described as angels. Visiting relatives and health care professionals speak highly of the staff team who are said to be well
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 20 trained, knowledgeable, and work in partnership to ensure that the needs of the people who live at “The Grange” are met. New staff benefit from comprehensive induction training that reflects “Skills for Care” common induction standards. This training sets down minimum expectations about the learning needed by new staff so that they will know how to work safely and effectively. In addition there is a comprehensive staff training programme, which includes training in the protection of vulnerable adults, training in the care of people who have had a stroke, moving and handling, pressure area care, health and safety, positive communication, first aid and fire training amongst a number of other relevant topics. Eleven of the nineteen care staff have achieved an NVQ at level 2 or above and four others are working towards the qualification. This training ensures that care staff have the knowledge and skills they require to meet the needs of the people who call the “The Grange” their home. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect so that the people who live there feel valued and respected. EVIDENCE: The manager has a long experience of managing the home, has a certificate in Gerontology and the Registered Manager’s Award at NVQ level 4. He has a sound knowledge of both strategic and financial planning and is highly competent to run the home and meet its stated aims and objectives. He is supported by an effective, experienced and well-trained management team. Together they have developed a management style which is open and inclusive. This benefits all people who live and work at “The Grange” who feel valued and respected.
Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 22 The people who live at “The Grange”, their relatives and people such as doctors and nurses who visit the home to provide care highly praise the standard of care facilities and services provided. Some of the people who live at “The Grange” were asked if they could some up what living at the home is like. One expressed a point of view that others agreed with. They said, “the main thing is feeling part of something, having your own place but feeling a part of The Grange”. A number of relatives said that “The Grange” does everything well and they were unable to suggest what could be done to improve the standard of care and services provided. People who live at “The Grange” agreed and said it does not stop the management team from continuing make improvements. Quality assurance processes include an annual development plan, “The Business Plan”. This involves continuous planning, action and review to make sure that the people who live at the home continue to are happy with the care and services they get. The home also has the “Investors In People Award”, which is based on seeking the views of the people who use the service and auditing standards and staff support systems. Staff are clear about their roles and responsibilities. They benefit from well thought out staff support systems including regular supervision, focused training and self assessment and appraisal, which puts them in control of their own learning and personal development. One staff member who had worked at the home for six years talked about the inclusive management style and explained how this had helped them to understand the philosophy of “The Grange”. They said, “equality and understanding people and appreciating individualism is at the centre of the home’s philosophy”. They said they “have learned a lot about older people” and “now recognise that older people are people first as different or as similar as you or I with individual needs, emotional needs, preferences and wants”. Record keeping is of a consistently high standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. People who use the service can gain access to their records and contribute to them. The manager seeks to ensure the health and safety of all people who live at, work at or visit “The Grange”. Risk assessment and risk management is central to the conduct of the home. Staff are trained in health and safety matters; individual training records reflect this, and regular updates are planned. A senior member of staff takes the lead on health and safety matters ensuring that records and maintenance checks are up to date, so everybody at “The Grange” is safe. Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 23 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 3 3 3 4 4 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 4 18 3 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 4 4 3 Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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.V333339.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Dystlegh Grange DS0000006619.V333339.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
