Inspection on 03/11/05 for Eckling Grange

This inspection was carried out on 3rd November 2005.

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

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

Other inspections for this house

Eckling Grange 13/02/09

Eckling Grange 01/11/06

Eckling Grange 30/06/05

Eckling Grange 15/03/05

Eckling Grange 10/01/05

Eckling Grange 25/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Eckling Grange Norwich Road Dereham Norfolk NR20 3BB Lead Inspector Ruth Hannent Announced Inspection 3rd November 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 Eckling Grange DS0000027267.V253015.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. Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Eckling Grange Address Norwich Road Dereham Norfolk NR20 3BB 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) 01362 692520 01362 690278 Eckling Grange Limited Mrs Irene Launchbury Care Home 65 Category(ies) of Old age, not falling within any other category registration, with number (65) of places Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 65 Older people of either sex may be accommodated Date of last inspection 30th June 2005 Brief Description of the Service: Eckling Grange is a large, two storey, Christian care home providing personal care and accommodation for up to sixty-five older people and is sited on the outskirts of the town of East Dereham. The service comprises of a large period house with extensions and has a complex of sheltered housing bungalows sited in the grounds that are not part of this registration. The home has two passenger lifts to the first floor, sixty bedrooms, thirty of which have en suite facilities, fifty-five are single rooms and a further five rooms that are registered as double rooms and made available to married couples, if required, or as single rooms. The home has communal toilet and bathroom facilities on each floor and service users have communal use of a large dining room, two dining areas, two large lounges, five sitting rooms and a conservatory. The home stands in it’s own grounds, the gardens are well maintained and there is parking to the front and the back of the premises. The service has a management committee with overall responsibility for the home. Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over five hours with both the managers present. Fifty eight residents were living in Eckling Grange on the day of the inspection. The pre inspection questionnaire and rota’s were discussed in full. A tour of the Home took place. Residents and staff were spoken to. No comment cards were received from relatives or residents. What the service does well: What has improved since the last inspection? What they could do better: Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 6 Some of the bedrooms are lacking in colour and stimulation that gives the area a tired look which need refurbishment and fresh paint. 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. Eckling Grange DS0000027267.V253015.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 Eckling Grange DS0000027267.V253015.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 and 5 Residents will be assessed and assured their needs will be met at Eckling Grange. Relatives and friends are welcomed and shown the facilities to assist in the decision making of the most suitable Home. EVIDENCE: On talking to two residents who had not lived at Eckling Grange for long both talked about the visit they had had prior to admission. (One lady was already a resident in the bungalows and was well known by the staff at the Home). They both said they had talked with the Manager about their care requirements and that the staff knew what help they needed when they moved in. This information had been transferred onto the care plan that on talking to a staff member is the guide staff use to get to know the resident. During the inspection a discussion took place with the Manager over one resident recently admitted who’s details were not given clearly by the placing officer and family. After discussion it was evident that the risk was too high for this resident to be cared for at Eckling Grange and plans will be put in place to Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 9 find a suitable Home for this person. In the meantime a risk assessment was in place and staff, were aware of the concerns and acting according to the identified risk. One visitor spoken to in the morning talked about knowing the Home well and being able to visit and be assured that her mother would be cared for as needed. Information leaflets were offered and “we were shown around the home and very reassured with the questions we asked”. Eckling Grange DS0000027267.V253015.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): 7, 8, 9 and 11 There is a care plan for each resident, which offers person centred care for the personal and health care needs. The recording of social care needs requires a little more thought. The residents are supported well for their health care needs. Medication procedures are improved and residents are protected by these improvements. From evidence seen and throughout discussions residents are treated with sensitivity and respect. EVIDENCE: Each resident has a care plan held in the main office. The information is clear on the personal and health needs of each resident (Four were seen). Although information is gathered about the social care needs the continuation of ensuring these needs are met is not so clear. (Recommendation). Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 11 The Home is supported well by the Community Nurses and GP’s from the local heath centres. Each care plan has an entry sheet to record the visit and the outcome such as ‘antibiotics prescribed or test for urine infection’ etc was seen written. The medication procedure is much improved with staff only signing the recording chart on ingestion of the medication. This was discussed in full with the manager as when this procedure was first requested some residents were unhappy but are now understanding and compliant. One resident spoken to has responsibility for her own medication. She talked of how she manages this in a way that suits her and showed the locked drawer where she stores her supply. Throughout the day she keeps the slide from the dossett box in her pocket of the day’s medication. A letter received from the local GP was shared with the Inspector, which showed the care and dedication of a team of staff who had recently cared for someone who was dying. The Home will call in extra staff if there is a need for when someone needs comforting and reassurance in their last few hours. Eckling Grange DS0000027267.V253015.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): 12, 13 and 15 The Home works hard to ensure interests, recreational and religious needs are met. Some form of individual recording will improve the practise further. Residents are encouraged and do remain in contact with their family and friends. The meals served are wholesome and well balanced with choice available for all residents. EVIDENCE: Due to the ethos of Eckling Grange residents are aware of the Christian beliefs and ways the Home is run. Regular services, prayers and meetings are arranged. Activities are available and although not planned will take place adhoc when staff are available. On the day of the inspection parachute games, dominoes and light exercises were taking place and a record is kept of who took part. Smaller, individual person centred stimulation is not always recorded and ways to include this practise to evidence person centred care needs some thought. (Recommendation). Plans were also coming together for a big celebration for bonfire night with a big anniversary for one couple and a birthday party of a resident who is 102. Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 13 The Home has regular visitors coming and going. Letters and compliments were seen from grateful families and on talking to two visitors they were made to feel welcome and involved in the life of their loved one. Residents spoken to all knew what was on the menu for lunch that day. One lady said she was a “fussy eater” and would always be offered a choice that suited her. Everyone spoken to praised the quality of the food and knew they could have an alternative if requested. The meal for that day was a stew with three vegetables. (One person was having a jacket potato with cheese). There was a choice of hot pudding, yoghurt or fruit. Every resident spoken to felt the quantity, quality and choice was always available for them. Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 14 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 Residents are listened to and any form of concern/complaint will be acted upon. EVIDENCE: The Home has not received any formal complaints. There is a complaints procedure in the service users guide and the Managers both stated they have an open door policy and will listen and act on any concerns. One resident spoken to was not happy with being asked to go to bed at a certain time. This was dealt with verbally and immediately with the resident being reassured that he can go to bed when he wishes. The care plan was looked at which identified choice. A member of staff will be spoken to by the Manager to ensure a clear understanding is in place for this persons needs. Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 15 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 and 26 Residents live in a safe and well-maintained environment. The indoor and outdoor areas are safe and comfortable for all residents and visitors. The bedrooms are safe but some lack warmth and appear a little drab and colourless. The Home is clean and hygienic with no unpleasant odours. EVIDENCE: The Home stretches out over a wide area with communal rooms decorated well and are light and bright. The entrance hall is inviting and comfortable for people to wait in. The small lounge has recently had a new wide screen television as also has the new conservatory lounge. The main lounge has recently had all the windows replaced with double glazing and ongoing work on the replacement of some of the Homes pipe work is still taking place. Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 16 The fire records were looked at which included the most recent fire inspection, the servicing of the fire extinguishers, the weekly alarm checks and the evacuation fire drill practise. (Both Managers have been involved in setting the alarm off at various times of the day and night to be assured that staff feel able to manage the situation). The gardens are well maintained with some flowerbeds cared for by the bungalow residents with bright colourful plants. The Home hold regular meetings and prayers in the lounge and offers grace before each meal in the dining room. These rooms are suitable furnished and the various dining areas offer choice to where people would prefer to eat. The bedrooms seen varied greatly in, if the resident had made it their own room or if it remained a bedroom in a home. Two residents showed their room of which they had greatly improved the look. One resident had laid a colourful carpet and had added furniture, bedcovers and personal belongings to personalise the room. Some of the other bedrooms, although held the basic furniture and appeared clean were in need of a fresher brighter look to try and individualise the rooms. (Recommendation) The Home has a very large laundry in a building separate from the main home. The floor and walls are of a surface that is easily cleaned. The dirty laundry is sorted into trolley units and washed according to the need. The machines have hot wash temperatures for soiled items and are fed by liquid soap dispensers. On seeing the staff member carrying out her duties in the laundry it was evident that the methods used to control infection are in place. There was no unpleasant odours and all clothes were folded and in place in the correct area to be returned to their owner. Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 17 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): 27, 28, 29 and 30 The resident’s needs are met by a number of mixed skill ability staff. The Home is encouraging staff to gain a recognised qualification. The Home needs to improve their practice when recruiting to ensure all references are in place and that CRB’s are applied for immediately. The Managers support and train the staff to ensure they are competent to carry out their jobs. EVIDENCE: The rota’s were discussed and studied in depth. The home aims to have approximately one staff member to five residents throughout the day across the Home with the concentrate of the staff being in the area where the greatest demand is of residents needs. There is a varying group of mixed ability staff who are graded and paid according to their experience and qualifications achieved. The staff are encouraged at all times to improve in their learning and although only 27 of staff hold the NVQ qualification at present the Manager is encouraging them at all times to achieve this award. (Recommendation). All personnel files are locked away by the Manager and three of the latest recruits were inspected. It was noted that only one reference had been Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 18 received for two recruits and this was made clear to the managers that two references need to be in place before a staff member commences employment. (Requirement). It was also noted on the pre inspection questionnaire that staff who have been recruited from overseas did not have a CRB in place. This was discussed and will be rectified. Both Managers are now clear that all CRB’s must be applied for and the POVA check completed on ALL recruits. (Requirement) The Home has a programme of training completed with copies of training held on file. A concentrated in depth fire awareness training has been completed by all the staff over the past few weeks after it was identified that some staff were not as competent as they should be in fire awareness. All the statutory training such as moving and handling for the assessors, basic moving and handling for all staff and basic food hygiene were completed. At present the Home has 24 staff trained in first aid and the aim over the next few months is to cascade the dementia care training programme recently purchased to all staff. . Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 19 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 and 36 Eckling Grange is run competently. The Managers are fit to be in charge of this establishment and are able to discharge their duties fully. The completion of the Management qualification will happen shortly. The Home is managed by a good, open and clear leadership approach. The Home works hard to achieve quality and measure that quality. The records seen and the explanation given ensures the financial interests of the residents is safeguarded. Staff supervision needs to be planned and more regular. EVIDENCE: Eckling Grange is managed by two competent and experienced staff members who have worked in the Home for many years. The one manager has been Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 20 working towards the NVQ 4 Management qualification for a long time and through no fault of her own has battled against many barriers to keep focused with her aims to achieve this qualification. Letters were seen of the problems that have arisen between course organisers and the Manager and which hopefully have now been resolved. On talking to two staff members it was clear that the Managers are supportive and offer an open office approach which is comfortable and easy for all staff. One staff member had returned to the Home after a short gap as she enjoyed the work environment at Eckling Grange. The Home has just introduced staff sessions to be able to brief staff on the latest developments within the Home and to be seen as inclusive and transparent. The Home has the support of a personnel consultant who has worked with the Home to produced a very comprehensive quality assurance feedback document.(Sept 2005) Questionnaires had been sent to residents, families and staff and the findings placed in a report. These findings reflected favourably for the Home with just the odd one or two comments that will be looked at by management to improve further the care on offer. The personal money held within the Home with any transactions that occur are recorded and signed for. Where a resident cannot sign the Home ensures that two staff signatures are obtained. The manager with make regular checks on the amount of money held in the safe and that it balances with the records kept on file with receipts to accompany all purchases or services offered such as the hairdresser or chiropodist. The Home is struggling to offer times for supervision as stated at least six times a year. Records were seen but the meetings are not regular and some have not occurred in the past six months. (Requirement). Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 21 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 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 3 x x x 2 x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 x x Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 22 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 OP29 Regulation 19 sch.2 Requirement It is a requirement that two references are obtained before any new staff recruit commences employment. It is a requirement that all staff have CRB checks to include all overseas staff. It is a requirement that all staff have supervision at least 6 times a year. Timescale for action 03/11/05 2 3 OP29 OP36 19 sch. 2 18 (2) 03/11/05 31/12/05 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 2 3 Refer to Standard OP12OP7 OP24 OP28 Good Practice Recommendations It is recommended that ways of recording ongoing stimulation and social activities to meet the individual need of residents is planned. It is recommended that a review of the décor in bedrooms takes place to freshen and make rooms more individual It is recommended that the encouragement to staff continues to bring the number of NVQ qualified staff in line with the standard up to the level of 50 DS0000027267.V253015.R01.S.doc Version 5.0 Page 23 Eckling Grange Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Eckling Grange DS0000027267.V253015.R01.S.doc Version 5.0 Page 25 - 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!