Inspection on 06/12/05 for Eastbourne Grange

This inspection was carried out on 6th December 2005.

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

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

Other inspections for this house

Eastbourne Grange 24/07/07

Eastbourne Grange 25/08/06

Eastbourne Grange 16/06/05

Eastbourne Grange 04/02/05

Eastbourne Grange 21/06/04

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

CARE HOMES FOR OLDER PEOPLE Eastbourne Grange 2 Grange Gardens Eastbourne East Sussex BN20 7DE Lead Inspector Nigel Thompson Unannounced Inspection 6th December 2005 09:30 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 Eastbourne Grange DS0000021091.V249250.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. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Eastbourne Grange Address 2 Grange Gardens Eastbourne East Sussex BN20 7DE 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) 01323 733466 Mr Trevor Pearce Mrs Patricia Pearce Mrs Patricia Pearce Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-five (25). That service users must be aged sixty- five ( 65 ) years and over on admission. Date of last inspection Brief Description of the Service: Eastbourne Grange is a large semi-detached house in a quiet residential area of Eastbourne, close to the seafront and town centre with its shops, amenities and local attractions. The home is on three floors with various communal areas and bathrooms. There are two lounges and a spacious dining area. All floors are accessible via a passenger lift The pleasant gardens are easily accessible to service users and the rear of the house also overlooks a secluded park. The service aims to provide a safe, homely environment in which service users are able to lead satisfying lives, retaining dignity, privacy and exercise choice. Regular social activities within the home and outings are arranged. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours in December 2005. It found that all of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. On the day of the inspection there were thirteen service users living at the home. The inspection involved a tour of the premises, examination of the home’s records and discussion with the Registered Manager. Two members of staff and five service users were also spoken with. The focus of the inspection was on the quality of life for people who live at the home. In order that a balanced and thorough view of the home is obtained, this report should be read in conjunction with previous inspection reports. What the service does well: The relaxed, homely and welcoming environment has evolved over several years and reflects the stability and commitment within the staff team and the open and inclusive management style. Effective systems are in place for the admission and ongoing care of service users. Individual care plans developed from comprehensive pre-admission assessments ensure that an individual’s needs are met in a structured and consistent manner. Communication and consultation with service users’ family members is effective and ongoing. Relatives have the opportunity to partake in individual assessment, care planning and reviewing processes. Staff receive effective induction and foundation training, regular supervision and are valued and supported by the management team. The service users at Eastbourne Grange benefit from a dedicated manager and stable staff team who are committed to providing consistent and high quality care. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 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. Eastbourne Grange DS0000021091.V249250.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 Eastbourne Grange DS0000021091.V249250.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): 3, 4 & 5 The thorough admission policy and procedures ensure that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. EVIDENCE: Since the previous inspection, one new service user has been admitted to Eastbourne Grange. Documentation examined, provided clear evidence that a full needs assessment had been carried out prior to the admission, to establish that the individual’s care and support needs could be met within the home. The Manager confirmed that the pre-admission assessment format is currently being reviewed and she will be forwarding a copy of the updated recording format to the CSCI. As part of the admission procedure, the Manager confirmed that prospective service users are invited to visit the home and have the opportunity to look around, possibly have lunch and meet with staff and existing service users. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 9 Service users and, where appropriate, their relatives are actively involved in both the needs assessment process and the subsequent development of the individual care plan. As a result of this, they know and are reassured that the home is able to meet their assessed needs. This was confirmed by service users and a relative, spoken with during the inspection: ‘I couldn’t wish for better care – everything she could possibly need is here!’. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8&9 Service users’ health care needs are regularly assessed and fully met. The current system for the administration of medication, including ‘potting up’ tablets, is unsatisfactory and arrangements should be reviewed to minimise risk and ensure the health and safety of service users. EVIDENCE: All service users continue to be registered with local GPs and have access to other health care professionals, via the surgeries. The Manager is keen to promote individuality and independence, within a risk management framework. Following individual assessments, two service users continue to maintain responsibility for self-administering their medication. In both cases they have a lockable cabinet in their room, in which to store the medicines. The situation is closely monitored and reviewed regularly by the Manager and the service users’ GP. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 11 There was no evidence of recent or updated medication training having been provided for staff. The Manager confirmed that staff do receive ‘in-house’ training, however this is not evident from records examined. Following discussion, regarding the possible involvement of a local Pharmacist and District Nurses, it is recommended that the Manager researches external training opportunities for staff, including specific aspects of the control and handling of medication and diabetes training. Although satisfactory procedures are in place for administering medicines at breakfast and lunchtime, it was noted that in the evenings, medication is often ‘potted up’ before being placed on individual supper trays. This constitutes poor practice and a potential risk to service users. It is required that the current system be reviewed and improved, in accordance with the home’s policy and procedures, already in place. The present system for storing medication in a large cupboard in the office could also be improved. Following discussion with the Manager, it is recommended that the cupboard be replaced by a secure drugs cabinet, more compact and suitable for its stated purpose. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. All key standards were assessed during the previous inspection carried out on 16 June 2005. EVIDENCE: Eastbourne Grange DS0000021091.V249250.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): 16 The home has a satisfactory complaints procedure in place and service users feel that their views and any concerns are listened to and acted upon. EVIDENCE: However, as discussed, it is recommended that it be further amended to include full updated contact details for the Commission for Social Care Inspection. Service users and their relatives, spoken with during the inspection, confirmed that they would have no hesitation raising concerns or making a complaint to the Manager and all were confident and assured that they would be listened to. Eastbourne Grange DS0000021091.V249250.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, 24, 25 & 26 The service is accessible and well maintained and remains clearly suitable for its stated purpose. Service users benefit from pleasant accommodation that is comfortable, clean and decorated to a satisfactory standard. EVIDENCE: There has been little change in the physical environment of the home since the previous inspection and standards remain high throughout. The well maintained décor and good quality furniture and furnishings provide a comfortable and pleasant environment for service users. There are two pleasant lounges and a quiet and spacious dining room. The gardens are directly accessible to service users. Lighting throughout the home is domestic in style and sufficiently bright. As previously documented, independence and individuality continues to be promoted within the home, as far as is practicable, and this is evident from the personalising of service users’ rooms, which clearly reflects individual tastes, preferences and interests. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 15 Infection control procedures are in place and clearly adhered to and levels of cleanliness remain high throughout. Eastbourne Grange DS0000021091.V249250.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): These standards were not assessed on this occasion. All key standards were assessed during the previous inspection carried out on 16 June 2005. EVIDENCE: Eastbourne Grange DS0000021091.V249250.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, 32, 33, 35, 36 & 38 Service users and staff benefit from the Manager’s calm, open and approachable style of leadership and clear and positive sense of direction. The home’s quality monitoring systems could be improved by seeking the views of service users’ relatives. Staff are generally aware of and adhere to up to date policies and procedures relating to health and safety, ensuring the welfare of service users and staff. However there is a potential risk for service users by the few remaining original wooden window frames, which have not been fitted with restrictors. EVIDENCE: As a qualified Registered General Nurse (RGN) and with over twenty years experience of managing related residential services, the Registered Manager is clearly competent to run the home. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 18 Following discussions with a local training provider, the Manager has been advised, that to ensure compliance with the Standard Requirements, she only needs to ‘top up’ her existing qualification with the relevant management units. It was evident from direct observation and through discussions that the Manager continues to maintain a relaxed, open and inclusive atmosphere within the home. Staff, service users and their relatives, spoken with during the inspection confirmed how approachable and supportive the Manager is. The Manager continues to provide all care staff with formal supervision every two months and these session are appropriately recorded. As previously documented, she also operates an ‘open door’ policy, with staff able to discuss any issues at anytime. Staff spoken to confirmed the support and training they receive and acknowledged the personal benefit of effective supervision. At present all service users at Eastbourne Grange maintain control over their personal finances or have a relative who takes on this responsibility. The Manager does not hold any personal monies on behalf of service users and does not currently act as appointee or signatory for anyone living in the home. The home operates effective quality monitoring systems, including satisfaction questionnaires for both service users. However, as discussed and recommended, this would be further enhanced by formally seeking the views of service users’ relatives. The health, safety and welfare of service users and staff remains of paramount importance within the home and staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. However it was noted during a tour of the premises that several old and original window frames have not yet been fitted with restrictors and, despite an ongoing programme to fit guards, a number of radiators remain uncovered. Eastbourne Grange DS0000021091.V249250.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 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 x 3 3 X X X 3 3 3 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 2 3 2 X 3 3 X 2 Eastbourne Grange DS0000021091.V249250.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. 1 Standard OP9 Regulation 13 (2) Requirement Timescale for action 31/12/05 2 3 OP38 OP38 13 (4) (a&c) 13 (4) (a&c) It is required that the current system of administering medication be reviewed and improved, in accordance with the home’s policy and procedures, already in place. It is required that restrictors be 31/12/05 fitted to all upper floor windows. It is required that, following risk 31/03/06 assessments, all remaining unguarded radiators be fitted with covers. 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 OP9 Good Practice Recommendations It is recommended that the Manager researches external training opportunities for staff, including specific aspects of the control and handling of medication and diabetes training. It is recommended that the current medicine cupboard be replaced by a secure drugs cabinet, more compact and DS0000021091.V249250.R01.S.doc Version 5.0 Page 21 2 OP9 Eastbourne Grange 3 4 OP31 OP33 suitable for its stated purpose. It is recommended that the Manager ‘tops up’ her existing qualification with the relevant ‘management’ units. It is recommended that the current quality assurance system be further enhanced by formally seeking the views of service users’ relatives. Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Eastbourne Grange DS0000021091.V249250.R01.S.doc Version 5.0 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. 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. 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